| Objective In this study,ultrasound imaging technology was used to evaluate the metabolic phenotypic changes of left ventricular system and carotid artery(that is,changes in cardiovascular structure and function)in children with simple obesity and obesity-related metabolic syndrome.Analysis of the relationship between insulin resistance and cardiovascular damage.Subjects and Methods This study chosen 10 to 14-year-old children who visited the Department of Pediatrics of the General Hospital of Tianjin Medical University,from July 2019 to March 2020.Participants were divided into the MS、OB and NO group,according to IDF diagnostic criteria,blood pressure and blood glucose level,as well as BMI range.A total of 106 children were enrolled,including 78 boys and 28 girls.Physical examination and laboratory examination indexes of all participants were recorded.High-frequency linear array probe was used to measure C-IMT in conventional two-dimensional ultrasound mode,CAC in M-mode.Phased array probe was used to measure LVEF,IVST,LVPWT,LVEDD in conventional two-dimensional mode,and then calculating the LVMI and LAVI;E,A in the PW mode,and then calculating the value of E/A;MADs in M-mode;s’,e ’,a’,IVA,Tei index in TDI mode,and then calculating E/e’.The data of three experimental groups were compared by two to two,and the MS group was selected to analyze the correlation between HOMA-IR and cardiovascular metabolic phenotypes.Results1.Carotid parameters: C-IMT was statistically significant among the MS group,OB group and NO group(p<0.05);CAC was statistically significant between MS group and OB group,as well as between MS group and NO group(p <0.05).2.Left ventricular structural parameters: LVEDD,IVST,LVPWT,LVMI and LAVI were statistically significant among the MS group,OB group and NO group(p<0.05).3.Left ventricular function parameters:(1)Diastolic function parameters: A,E/A,E/e’ were statistically significant among the three groups(p<0.05);e’ was statistically significant between the MS group and OB group,as well as between between the OB groups and NO groups(p<0.05);E,a’ had no statistical difference among the three groups(p>0.05).(2)Systolic function parameters: IVA and MADs were statistically different between the MS group and OB group,as well as between the MS group and NO group(p<0.05);LVEF and s’ were not statistically different among the three groups(p>0.05).(3)Overall functional parameters: the Tei index was statistically different among the three groups(p<0.05).4.Analysis of the correlation between HOMA-IR and abdominal obesity in MS group(WC as representing indicator),and there was a correlation between the two sets of data(r=0.7514,p< 0.001;Analysis of the correlation between HOMA-IR and carotid metabolic phenotype(C-IMT represented structural change,CAC represented functional change),HOMA-IR had correlation with both groups of arrays(r= 0.3881,p = 0.0451;r=﹣0.4227,p=0.0114);Analysis of the correlation between HOMA-IR and the left heart metabolic phenotype(LVMI and LAVI represented structural changes,and the Tei index represented functional changes).HOMA-IR was correlated with all three groups of data(r = 0.4609,p = 0.0155;r = 0.5342,p =0.0041;r = 0.4953,p = 0.0086).Conclusions Cardiovascular ultrasound could detect the changes of cardiovascular metabolic phenotypes in children with obesity and obesity-related metabolic syndrome,and could detect subtle cardiovascular differences in children with different degrees.Cardiovascular remodeling occurred in the child of the OB group,and the degree of cardiovascular remodeling in the MS group was further aggravated which was positively correlated with the degree of metabolic abnormalities.The left ventricular diastolic function was impaired and systolic function was preserved in the OB group,and the diastolic and systolic function were impaired in the MS group.The obesity-related metabolic risk factors first affected the left ventricular diastolic function.With the metabolic abnormality increased,left heart dysfunction appears. |
