title: Cardiometabolic phenotype in children with obesity.
abstract: OBJECTIVE
  To investigate the anthropometric and metabolic correlates of different patterns of left ventricular (LV) geometry in a cohort of outpatient children with high prevalence of obesity.
  
  
  METHODS
  Anthropometric measures, lipid profile, blood pressure (BP), fasting plasma glucose (FPG), and echocardiographic variables were evaluated in 281 white children (6-16 years), of whom 105 were obese and 105 were morbidly obese. Patterns of LV geometry were defined as follows: normal geometry, eccentric LV hypertrophy (LVH), concentric LV remodeling, and concentric LVH.
  
  
  RESULTS
  One hundred forty-eight children exhibited normal LV geometry, 53 eccentric LVH, 36 concentric LV remodeling, and 44 concentric LVH. The 4 groups differed in body mass index, waist circumference, waist-to-height ratio, triglycerides/high-density lipoprotein cholesterol ratio (Tg/HDL-C), and BP (P < .05-.0001). A statistically significant impairment of diastolic function (expressed as greater E/E', P < .002) was observed across patterns of LV geometry. Among anthropometric measures, waist-to-height ratio showed better performance in relation to LVH, with an optimal cut-point of 0.58, compared with body mass index and waist circumference. Children with concentric LVH exhibited the worst metabolic risk profile, with greater prevalence of visceral obesity, high Tg/HDL-C, high BP, and high-normal FPG, than children with normal LV geometry.
  
  
  CONCLUSIONS
  In children with high levels of obesity, an unfavorable "cardiometabolic phenotype" can be identified, which includes concentric LVH, visceral obesity, high BP, high Tg/HDL-C, and high-normal FPG.
authors.affiliation: Department of Internal Medicine, Pozzuoli Hospital, Naples, Italy. Electronic address: procolodibonito@alice.it.
authors.forename: Procolo
authors.initials: P
authors.lastname: Di Bonito
authors.affiliation: Department of Cardiology, Pozzuoli Hospital, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Moio
authors.affiliation: Department of Cardiology, Pozzuoli Hospital, Naples, Italy.
authors.forename: Gerolamo
authors.initials: G
authors.lastname: Sibilio
authors.affiliation: Department of Cardiology, Pozzuoli Hospital, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cavuto
authors.affiliation: Department of Pediatrics, Pozzuoli Hospital, Naples, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sanguigno
authors.affiliation: Department of Pediatrics, Pozzuoli Hospital, Naples, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Forziato
authors.affiliation: Department of Translational Medical Sciences, Federico II University, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
authors.forename: Brunella
authors.initials: B
authors.lastname: Capaldo
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D009765:Obesity / Q000000981:diagnostic imaging / Q000503:physiopathology*; D056128:Obesity, Abdominal / Q000503:physiopathology; D010641:Phenotype; D014463:Ultrasonography; D020257:Ventricular Remodeling / Q000502:physiology*; D055105:Waist Circumference; D065927:Waist-Height Ratio
chemical_list: D001786:Blood Glucose