title: Early cardiac abnormalities and serum N-terminal pro B-type natriuretic peptide levels in obese children.
abstract: OBJECTIVE
  The aim of this study was to evaluate early cardiac abnormalities in obese children by the conventional echocardiography and to verify whether N-terminal pro B-type natriuretic peptide (NT-proBNP) differ between obese and healthy children.
  
  
  METHODS
  We started this study with 68 obese children and 35 healthy controls matched for age and sex. Body mass index (BMI) was calculated. Children with a BMI > or = 95th percentile were considered obese. Thirty children in the obese group were also diagnosed with metabolic syndrome, according to the International Diabetes Federation criteria. Standard echocardiographic study was performed on each patient and control subject. Diastolic filling parameters were evaluated using pulsed-wave tissue Doppler method. Blood samples were taken at 8 a.m. to study blood biochemistry tests, including insulin, lipids, glucose, and NT-proBNP. Serum NT-proBNP levels were measured by a solid-phase, enzyme-labeled chemiluminescent immunometric assay. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Children with HOMA-IR > 3.16 were considered insulin-resistant.
  
  
  RESULTS
  There were diastolic filling abnormalities in obese children, as shown by a decreased mitral valve early filling (E) wave/late filling (A) ratio and a prolongation in E-wave deceleration time. The levels of NT-proBNP were not statistically different among the groups. The levels of NT-proBNP were not different between obese children with and without metabolic syndrome, those with and without hypertension, and those with and without insulin resistance, respectively.
  
  
  CONCLUSIONS
  Although there were diastolic filling abnormalities in obese children, their NT-proBNP levels were not different from healthy controls. It seems that there is no diagnostic value in NT-proBNP levels between obese children and healthy controls.
authors.affiliation: Department of Pediatrics, Karaelmas University, Zonguldak, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Battal
authors.forename: Bahri
authors.initials: B
authors.lastname: Ermis
authors.forename: Ziyaeddin
authors.initials: Z
authors.lastname: Aktop
authors.forename: Murat
authors.initials: M
authors.lastname: Can
authors.forename: Fatma
authors.initials: F
authors.lastname: Demirel
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000453:epidemiology*; D010446:Peptide Fragments / Q000097:blood*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain