Impaired left ventricular diastolic function in overweight youth is associated with insulin resistance, subclinical inflammation and adipokine dysregulation: a novel cardiometabolic link

Dayiha, Rachana, Schultz, Sarah P., Gibbons, Kristen, Duncan, Danusia, Cardinal, John, Kostner, Karam, Byrne, Nuala, Hills, Andrew P., Harris, Mark, Conwell, Louise S. and Leong, Gary Martin (2013). Impaired left ventricular diastolic function in overweight youth is associated with insulin resistance, subclinical inflammation and adipokine dysregulation: a novel cardiometabolic link. In: The Endocrine Society's 95th Annual Meeting and Expo. Abstracts. ENDO 2013: Endocrine Society 95th Annual Scientific Meeting & Expo, San Francisco, CA, USA, (1-1). 15-18 June, 2013. doi:10.1210/endo-meetings.2013.OABA.12.SAT-693


Author Dayiha, Rachana
Schultz, Sarah P.
Gibbons, Kristen
Duncan, Danusia
Cardinal, John
Kostner, Karam
Byrne, Nuala
Hills, Andrew P.
Harris, Mark
Conwell, Louise S.
Leong, Gary Martin
Title of paper Impaired left ventricular diastolic function in overweight youth is associated with insulin resistance, subclinical inflammation and adipokine dysregulation: a novel cardiometabolic link
Conference name ENDO 2013: Endocrine Society 95th Annual Scientific Meeting & Expo
Conference location San Francisco, CA, USA
Conference dates 15-18 June, 2013
Proceedings title The Endocrine Society's 95th Annual Meeting and Expo. Abstracts   Check publisher's open access policy
Journal name Endocrine Reviews   Check publisher's open access policy
Place of Publication Chevy Chase, MD, United States
Publisher The Endocrine Society
Publication Year 2013
Sub-type Published abstract
DOI 10.1210/endo-meetings.2013.OABA.12.SAT-693
Open Access Status
ISSN 0163-769X
1945-7189
Volume 34
Issue 3 Supp.
Start page 1
End page 1
Total pages 1
Language eng
Formatted Abstract/Summary
Impaired left ventricular diastolic function is the first sign of obesity cardiomyopathy and is evident in obese children (1) and adolescents (2). Whether this occurs due to adiposity, obesity-induced inflammation and/or insulin resistance (IR) is unclear.

Objective To evaluate if overweight and obese youth have adverse cardiovascular structure & function compared with non-overweight youth and to determine whether these changes are associated with IR and adipokine dysregulation.

Methods 35 overweight and obese (15.1±1.6 y; M:F, 14:21; BMI SDS 2.0±0.8) and 30 non-overweight youth (14.9±2.3 y; M:F, 19:11; BMI SDS -0.1±0.9) participated in the study. Height (Ht), weight, waist circumference (WC) were measured with resting blood pressure. Body mass index (BMI), BMI SDS and WC/Ht were calculated as markers of adiposity. Fasting blood samples were analysed for glucose, insulin, lipid profile, hs-CRP, interleukin (IL)-1b, IL-6, IL-1 receptor antagonist (RA), TNF-a, leptin, adiponectin and resistin. A homeostatic model of assessment (HOMA-IR) was calculated for IR. Echocardiography was used to determine left atrial (LA) and left ventricular (LV) volume, LA area and LV mass. Using transthoracic Doppler echocardiography, diastolic LV function was assessed by recording EA ratio (ratio of early and late diastolic LV filling), septal E prime (LV myocardial elasticity) and E/e’ (LV filling pressures).

Results Overweight and obese youth compared to non-overweight controls had higher fasting insulin, hs-CRP, triglycerides and cholesterol (all p<0.001), LDL (p=0.001) and lower HDL (p<0.05). Compared to non-overweight (NO) and non-insulin resistant (NIR) overweight youth (n=19), IR overweight youth (IR defined as HOMA-IR>3.0; n=16) had higher hs-CRP, resistin (both p<0.01), IL-6 (p<0.05), IL-1RA and leptin (both p<0.001) and lower adiponectin (p<0.001). Diastolic function was impaired in IR overweight youth compared with NO youth, as indicated by a lower EA ratio and septal E prime (p<0.05, p<0.001 respectively) and higher E/e’ (p<0.001). Septal E prime and E/e’ were strongly correlated with BMI SDS and WC/Ht (all p<0.001). In addition, septal E prime was significantly associated with insulin, adiponectin (both p=0.005), hs-CRP, leptin and resistin (all p<0.05) independently of blood pressure in a Spearman’s correlation analysis.

Conclusion Diastolic function of the left ventricle was impaired in overweight and obese youth compared with non-overweight controls, particularly in those with IR. These changes were correlated with measures of adiposity and adipokines. Thus, overweight youth with IR and adipokine dysregulation are more likely to have impaired left ventricular diastolic function which may predispose to premature cardiovascular disease in adulthood.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Presented at Poster Board SAT-693 as Paper 5293.

Document type: Conference Paper
Collections: Mater Research Institute-UQ (MRI-UQ)
School of Medicine Publications
 
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Created: Mon, 22 Dec 2014, 15:33:29 EST by Dr Louise Conwell on behalf of Paediatrics & Child Health - RBWH