title: Cardiac Diastolic Dysfunction and Regional Body Fat Distribution in Insulin Resistant Peripubertal Obese Males.
abstract: To evaluate presence of diastolic dysfunction in obese peripubertal males (8-18 years of age). To correlate diastolic dysfunction with insulin resistance, insulin levels and omental and epicardial fat.
  
  
  
  Obese males (n=46) and age matched healthy lean controls (n=50) in the age group of 8-18 years were included in this study. Anthropometric measurements were recorded. Investigations done: Fasting blood sugar and serum insulin levels, lipid profile, 2-D Echocardiography to assess left ventricular diastolic function and epicardial fat, abdominal CT scan to measure omental fat and ultrasound for NAFLD.
  
  
  
  Isovolumetric relaxation time (IVRT) above 100 msec seen in 18/46, E/A ratio of 0.75 seen in 4/46 cases. Left ventricular mass > 125gm seen in 10/46 cases. All the left ventricular diastolic function parameters were within normal range in controls. Significant difference in LVM (p=0.00099), LVPW(d) (p=0.0018), IVS(d) (p=0.007), E/A ratio (p=0.043), epicardial fat (p=0.0000) were seen in cases as compared to controls. Correlation of visceral fat with HOMA-IR, insulin levels and left ventricular diastolic parameters in cases was as follows HOMA vs omental fat (p=0.0008), Insulin vs omental fat (p=0.0015), E/A vs omental fat (p=0.015), LVM vs omental fat (p=0.0000), IVRT vs omental fat (p-=0.005). HOMA vs epicardial fat (p=0.0000), insulin vs epicardial fat (p=0.0000), E/A vs epicardial fat (p=0.09), LVM vs epicardial fat (p=0.006), IVRT vs epicardial fat (p=0.011).
  
  
  
  Left ventricular hypertrophy and diastolic derangements start early in obese peripubertal males with positive correlation between left ventricular diastolic dysfunction and HOMA-IR and insulin levels. Epicardial fat mass and visceral fat show positive correlation with diastolic dysfunction.
authors.affiliation: Assistant Professor.
authors.forename: A V
authors.initials: AV
authors.lastname: Sahasrabuddhe
authors.affiliation: Consultant Endocrinologist, Pitale Diabetes and Hormone Center, Nagpur, Maharashtra.
authors.forename: S U
authors.initials: SU
authors.lastname: Pitale
authors.affiliation: Assistant Professor, Medicine Department, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra.
authors.lastname: Dhoble
authors.affiliation: Associate Professor, Department of Statistics, Hislop College, Nagpur, Maharashtra.
authors.forename: J
authors.initials: J
authors.lastname: Shivalkar
authors.affiliation: Professor and HOD, Physiology Department.
authors.forename: M M
authors.initials: MM
authors.lastname: Sagdeo
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D050218:Body Fat Distribution; D002648:Child; D003971:Diastole / Q000502:physiology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D007328:Insulin