title: Left atrial size increases with body mass index in children.
abstract: OBJECTIVE
  To evaluate the association between body mass index (BMI) z-score and left atrial (LA) size in childhood and to determine whether LA size differs between healthy weight (HW), overweight (OW) and obese (OB) children.
  
  
  BACKGROUND
  LA enlargement is an independent risk factor for adverse cardiovascular outcomes. BMI is associated with LA size in adults but this may be mediated by co-morbidities that accompany adult obesity. Thus the relationship between LA size and BMI z-score in children is of interest, to assess the effect of increased body mass per se.
  
  
  METHODS
  991 children aged 5-15 years (9.3+/-2.8 years, 60% male), with normal cardiac structure and function, were studied by ultrasound. LA diameter (indexed to height) was measured and regression analysis assessed the association with possible determinants.
  
  
  RESULTS
  Indexed LA diameter was significantly associated with BMI z-score (r=0.239), age (r=0.282), left ventricular (LV) posterior wall (LVPW) thickness (r=0.125) and LV mass index (r=0.349) (p<0.001 for all). On multivariate analysis, BMI z-score was significantly related to Indexed LA diameter after controlling for age, sex and LV mass index or LVPW thickness. Indexed LA diameter increased across weight groups [19.8+/-2.9, 20.5+/-2.8 and 21.9+/-3.3 mm/m for HW, OW and OB, respectively (p<0.001)].
  
  
  CONCLUSIONS
  In children, higher BMI z-score is an independent determinant of increased LA size, suggesting that obesity exerts an effect on LA size at an early age and thus potentially predisposes to later cardiovascular morbidity.
authors.affiliation: Department of Cardiology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
authors.forename: Julian Ganesh
authors.initials: JG
authors.lastname: Ayer
authors.forename: Gary Fred
authors.initials: GF
authors.lastname: Sholler
authors.forename: David Stephen
authors.initials: DS
authors.lastname: Celermajer
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000473:pathology; D050177:Overweight / Q000150:complications* / Q000473:pathology*; D012189:Retrospective Studies