title: Cardiovascular impact of the pediatric obesity epidemic: higher left ventricular mass is related to higher body mass index.
abstract: OBJECTIVE
  To compare secular changes in body mass index (BMI) and left ventricular mass (LVM) in today's children versus children of a generation earlier.
  
  
  METHODS
  All healthy patients aged 2 to 19 years who underwent echocardiography at a single US academic medical center in 1986 to 1989 (prior era) and 2008 (current era) were included in this retrospective cross-sectional study. BMI, BMI z score, LVM indexed to height (LVMI), LVM z score, and relative wall thickness were calculated. Cardiac geometries were assigned based on LVM z score and relative wall thickness and classified as normal, concentric hypertrophy, eccentric hypertrophy, or concentric remodeling. Stepwise regression analysis was performed to identify determinants of LVMI.
  
  
  RESULTS
  There were 350 subjects in the prior era and 350 age- and sex-matched subjects in the current era. Mean BMI and LVMI were both significantly higher in the current era than in the prior era (BMI, 19.9 ± 5.6 kg/m(2) vs 18.1 ± 3.8 kg/m(2), P = .0004; LVMI, 32.7 ± 7.8 g/m(2.7) vs 31.5 ± 8.1 g/m(2.7); P = .02). Determinants of LVMI in both eras were BMI z score, younger age, male sex, and African-American race.
  
  
  CONCLUSIONS
  Today's children have higher BMI, LVMI, and predicted cardiovascular risk than their counterparts a generation earlier. Reversal of these trends is needed, and intervention is required.
authors.affiliation: Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: David I
authors.initials: DI
authors.lastname: Crowley
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Urbina
authors.forename: Holly M
authors.initials: HM
authors.lastname: Ippisch
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kimball
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left / Q000502:physiology; D055815:Young Adult