Stressed hearts in children with obesity and diabetes: a cause for concern?
Obesity in young people is an emerging public health problem, particularly because of its association with type 2 diabetes. Since obesity and diabetes contribute to the development of cardiovascular disease in adults, the question arises as to whether or not these conditions may be associated with cardiovascular abnormalities in children and adolescents. In this issue of Diabetologia, Shah et al. report the results of a cross-sectional study of heart structure and function in 612 adolescents and young adults (aged 10-24 years) subdivided into three groups: (1) those with obesity and type 2 diabetes; (2) those with type 2 diabetes but without obesity; and (3) lean healthy controls. Their results revealed that left ventricular mass (indexed to body surface area) was greater in the obese individuals than in lean controls. Left ventricular systolic function was more dynamic in obese participants and obese participants with type 2 diabetes compared with lean controls, whereas systolic function was comparable in obese patients with or without type 2 diabetes. Furthermore, compared with the healthy lean control participants, diastolic function was impaired in the obese group and further impaired in the obese individuals with diabetes. These results, and those of a few other similar studies, lend support to the notion that obesity and diabetes in children cause subtle abnormalities in cardiovascular structure and function. The present commentary discusses potential mechanisms and possible clinical ramifications for such findings.
Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, 126 University Place, University of Glasgow, Glasgow G12 8TA, UK. colin.berry@glasgow.ac.uk
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D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology*; D013599:Systole / Q000502:physiology; D055105:Waist Circumference / Q000502:physiology; D055815:Young Adult
BMJ. 2010 Nov 25;341:c6224
21109577
Pediatr Cardiol. 2010 Aug;31(6):792-9
20419296
Obesity (Silver Spring). 2009 Oct;17(10):1878-83
19543213
Diabetologia. 2011 Apr;54(4):722-30
21085926
BMJ. 2006 Nov 18;333(7577):1060-3
17110725
Ann Nutr Metab. 2010;56(1):16-22
19940472
Circulation. 2009 Jun 9;119(22):2913-9
19470890
Pediatr Cardiol. 2010 Aug;31(6):853-60
20461364
Pediatr Cardiol. 2009 Oct;30(7):946-53
19488804
Congenit Heart Dis. 2009 Sep-Oct;4(5):338-47
19740188
Diabetes Technol Ther. 2010 Apr;12(4):297-305
20210569
Diabetologia. 2010 Aug;53(8):1620-30
20454952
BMC Public Health. 2009 Mar 25;9:88
19320986
Diabetes Metab Res Rev. 2011 Jan;27(1):63-9
21218509
J Obes. 2010;2010:
20700410
Endocr Dev. 2010;19:53-61
20551668
Pediatr Int. 2010 Apr;52(2):218-23
19674355
Eur Heart J. 2008 Oct;29(19):2388-442
18799522
Obesity (Silver Spring). 2011 Jan;19(1):128-33
20559301