medigraphic.com
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2011, Number 4

<< Back Next >>

Rev Esp Med Quir 2011; 16 (4)

Cardiovascular disorders in a pediatric population and their relation to metabolic and anthropometric disorders

Ramírez GMM, Núñez PAB, Velázquez MH, Tejeda KOA, Cortés BB, Parra IA, Rosas BV

Language: Spanish
References: 17
Page: 199-207
PDF size: 324.41 Kb.


ABSTRACT

Background: Hypertension, ventricular hypertrophy and changes in the thickness of the intima-media of the carotid arteries can be identified in patients overweight or obese.
Objective: To report the increase of left ventricular mass, hypertension and intima-media thickness of carotid artery, metabolic syndrome and body mass index in pediatric patients.
Patients and method: We made a transversal, prospective, observational and descriptive study of pediatric patients aged between 6 and 18 years. All patients underwent medical history, anthropometry, determination of glucose, insulin, cholesterol and triglycerides, HOMA and QUICKI index calculation and left ventricular mass and intima-media thickness measurement by echocardiography.
Results: We studied 55 pediatric patients, of whom 28 (50.9%) were men and 27 (49.1%) women; 23 were children and 32 adolescents. With regard to BMI, 27 (49%) were between 25 and 29.9 and 14 (25.4%) were greater than 30. In the obese waist circumference was ›0.85, index of waist/hip ratio ›0.88, the HOMA-IR = 4.5 and QUICKI = 0.32. The left ventricular mass was 48.2 g and intima-media thickness was 0.42. Insulin resistance was more common in scholars and hypertension in adolescents. The left ventricular mass was found in children with hypertrophied insulin resistance, especially in males.
Conclusions: Children who are overweight and obese have left ventricular hypertrophy and incipient changes in the thickness of the intima-media of the carotid artery. Increased ventricular mass index is associated to insulin resistance.


REFERENCES

  1. Ortiz RO. Obesidad en la niñez: La pandemia. Rev Mex Pediatr 2009;76:38-43.

  2. García GE, de la Llata RM, Kaufer HM, Tusié LM. La obesidad y el síndrome metabólico como problema de salud pública. Una reflexión. Salud Publica Mex 2008;50:530-547.

  3. INSP. Encuesta Nacional de Salud y Nutrición. México: Instituto Nacional de Salud Pública, 2006;94-97.

  4. Tapia CL. Síndrome metabólico en la infancia. An Pediatr (Barc) 2007;66:159-166.

  5. Castillo ML. Obesidad en pediatría. México: Intersistemas, 2009;1-74.

  6. Perea MA, Bárcena SE, Rodríguez HR, Greenawalt RS y col. Obesidad y comorbilidades en niños y adolescentes asistidos en el Instituto Nacional de Pediatría. Acta Pediatr Mex 2009;30(3):167-174.

  7. Luján SA, Lillyan PG, Ronald AO. Obesidad infantil, la lucha contra un ambiente obesogénico. Revista de Posgrado de la Vía Cátedra de Medicina 2010;197:19-24.

  8. Bras Marquillas J. Obesidad en la infancia y adolescencia. Rev Pediatr Aten Primaria 2005;7:209-230.

  9. Kaufer-Horwitz M, Toussaint G. Indicadores antropométricos para evaluar sobrepeso y obesidad en pediatría. Bol Med Hosp Infant Mex 2008;65:502-518.

  10. Li S, Chen W, Srinivasan SR. Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. JAMA 2003:290; 2271-2276.

  11. Palermo CA. Factores de riesgo coronario en la adolescencia. Estudio FRICELA. Rev Esp Cardiol 2003;56:462-468.

  12. Arellano MS, Bastarrachea SR, Bourges RH, Calzada LR. La obesidad en México. Rev Endocrinol Nutr 2004:12 (4):580-587.

  13. García CB, García LC, Jiménez LC, González VA y col. Índice HOMA y QUICKI, insulina y péptido C en niños sanos. Puntos de corte de riesgo cardiovascular. An Pediatr (Barc) 2007;66:481-490.

  14. Kavey RW, Daniels SR, Lauer RM, Atkins DL. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. J Pediatr 2003:142:368-372.

  15. Piñán LE, Montero SA, Sáenz AP. Recomendaciones para el diagnóstico y tratamiento de la hipercolesterolemia en la infancia y adolescencia. Foro Pediátrico 4-10.

  16. Sorof JM, Alexandrov AV, Cardwell G, Portman RJ. Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics 2003;111:61-66.

  17. Amaiz P, Acevedo M, Barja S, Berrios X y col. Arterioesclerosis subclínica y factores de riesgo cardiovascular clásicos y emergentes en niños obesos chilenos. Arch Pediatr Uru 2009:80:22-27.




2020     |     www.medigraphic.com