Miscellaneous
Relation of Increase in Adiposity to Increase in Left Ventricular Mass from Childhood to Young Adulthood

https://doi.org/10.1016/j.amjcard.2006.02.044Get rights and content

This study evaluated the influence of adiposity on the progression of left ventricular (LV) mass from childhood to adulthood and the relation of LV mass to insulin resistance in young adulthood. One hundred thirty-two healthy children recruited into a longitudinal study at a mean age of 13 years and reevaluated at 27 years, at which time insulin resistance studies were also performed, were studied. Echocardiographic assessment of LV mass was made and indexed for height2.7. Body mass index (BMI) at 13 years was highly correlated with BMI at 27 years, as was LV mass index at 13 and 27 years. The cross-sectional correlation of LV mass index and BMI at 13 years (r = 0.38, p <0.0001) had strengthened considerably by 27 years (r = 0.55, p <0.0001). A BMI increase ≥5.5 kg/m2 from 13 to 27 years was associated with a significantly greater increase in the LV mass index (p <0.0001) than a BMI change <5.5 kg/m2, and this relation was similar in children who were thin and heavy at baseline. In young adulthood, the relation of LV mass index to lean mass was weaker than that of LV mass index to fat mass. The association of LV mass with insulin resistance was dependent on adiposity. In conclusion, adiposity and LV mass are related in childhood, and this association tracks and becomes stronger in young adulthood. Moreover, the increase in LV mass from childhood to young adulthood is related to the degree of increase in BMI, independent of BMI at 13 years, suggesting that an excessive increase in LV mass could be limited by controlling gain in body fat during adolescence.

Section snippets

Methods

This study was approved by the Committee for the Use of Human Subjects in Research at the University of Minnesota. Informed consent was obtained from participants and their parents when the subjects were <18 years of age and from the participants ≥18 years of age. The participants were recruited in 1985 and 1986 after blood pressure screening of 19,452 (93% of all eligible) fifth to eighth grade students in the Minneapolis and St. Paul, Minnesota, public schools. All black, white, and Hispanic

Results

In this longitudinal study, 132 healthy patients (64 males, 68 females; 118 white) were examined at mean ages of 13 and 27 years. The clinical data of the cohort are listed in Table 2. There was a significant increase in body mass index (BMI) from 13 to 27 years. Systolic and diastolic blood pressure increased significantly from 13 to 27 years. Mean LV mass indexed for height2.7 (LV mass index) and diastolic dimensions of the LV cavity, posterior wall, and septum also increased significantly

Discussion

This longitudinal study from age 13 to 27 years examined the impact of adiposity on LV mass and the relation of LV mass to insulin resistance and metabolic syndrome. The results show that BMI and LV mass are significantly related in childhood and track into adulthood, but the association of LV mass with adiposity is considerably stronger in adulthood than in childhood. The degree of increase in LV mass from childhood to young adulthood is related to the degree of increase in BMI, independent of

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    This study was supported by Grants HL 04000-05, HL 52851, and M01 RR00400 from the National Institutes of Health, Bethesda, Maryland. Dr. Sivanandam was partially funded by the Lillehei Heart Institute, University of Minnesota, Minneapolis, Minnesota, as a Lillehei Scholar for the duration of this project.

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