ABSTRACT
BACKGROUND: Obesity can cause alterations in cardiac dimensions and function. Cardiac dysfunction during childhood may affect the quality of life in adulthood. This study evaluated left ventricular (LV) dimensions, systolic function and left ventricular myocardial performance index (LMPI) in children with obesity. METHODS AND RESULTS: Thirty-three obese children with mean age of 9.8 +/- 2.4 years, weight 61.3 +/- 20.8 kg, BMI 29.5 +/- 5.8 kg/m2 and percentage of actual weight to ideal body weight for height (%IBW) 170 +/- 25%, underwent echocardiography to assess LV dimensions, systolic and global functions. There were 2, 14 and 17 children with mild (<or= 140% IBW), moderate (141-160% IBW) and severe obesity (>160%IBW), respectively. The mean ratio of left ventricular end-diastolic dimension (LVEDD) to predicted LVEDD expressed in percentage (%LVEDD) was 98.3 +/- 7.8%, the left ventricular shortening fraction (LVFS) was 37.5 +/- 4.9% and the left ventricular ejection fraction (LVEF) was 67.5 +/- 5.9%. All were within normal range except that 2 children (6%) had mild LV dilatation. The mean LMPI was 0.35 +/- 0.08. However, 11 children (33%) had abnormal LMPI (>0.4). The severity of obese children did not correlate with the global LV dysfunction. CONCLUSION: The left ventricular dimensions and systolic function in children with obesity were essentially normal. LMPI which indicates LV global function was found to be abnormal in 33% of children with obesity and may be used to do early detection of LV global dysfunction.
Subject(s)
Anthropometry , Body Mass Index , Child , Female , Health Status Indicators , Heart Ventricles/anatomy & histology , Humans , Male , Obesity/complications , Reference Values , Stroke Volume , Systole , Ventricular Dysfunction, Left/physiopathology , Ventricular Function, Left/physiologyABSTRACT
BACKGROUND: Obesity can cause alterations in cardiac dimensions and function, and cardiac dysfunction during childhood may affect the quality of life in adulthood. This study was done to evaluate left ventricular dimensions, systolic function, and the left ventricular myocardial performance index in children with obesity. MEHTODS AND RESULTS: Thirty-three obese children whose mean age was 9.8 +/- 2.4 years, weight was 61.3 +/- 20.8 kg, body mass index was 29.5 +/- 5.8 kg/m(2), and percentage of actual weight to ideal body weight for height (% IBW) was 170 +/- 25%, underwent echocardiography for the assessment of left ventricular dimensions, and systolic and global functions. There were 2, 14, and 17 children with mild (< 140% IBW), moderate (141-160% IBW), and severe obesity (> 160% IBW), respectively. The mean ratio of left ventricular end-diastolic dimension to predicted left ventricular end-diastolic dimension expressed in percentage was 98.3 +/- 7.8%, the left ventricular shortening fraction was 37.5 +/- 4.9%, and the left ventricular ejection fraction was 67.5 +/- 5.9%. All were within the normal range, with the exception of two children (6%) who had mild left ventricular dilatation. The mean left ventricular myocardial performance index was 0.35 +/- 0.08. However, 11 children (33%) had an abnormal index (< 0.4). The severity of obesity did not correlate with the global left ventricular dysfunction. CONCLUSION: The left ventricular dimensions and systolic function in children with obesity were essentially normal. The left ventricular myocardial performance index, which is an indicator for left ventricular global function, was found to be abnormal in 33% of the children, and may be used for the early detection of left ventricular global dysfunction.
ABSTRACT
BACKGROUND: Recent studies in the USA and Hong Kong demonstrated the onset of puberty in girls has shifted toward a younger age. Based upon previous studies on variations of pubertal maturation in Thai girls, the secular trend has also moved toward an earlier age. The latest study in 1995 revealed the mean age of menarche was 12.3 years. OBJECTIVES: To identify the onset of puberty, menarche and pubarche in female children and adolescents in 2 Bangkok schools. METHOD: Three hundred school girls aged 9-19 years were enrolled in the study. Data were collected from January 1997 through December 1999. Assessment of pubertal staging by Tanner's criteria was performed by a trained pediatrician. All were in good physical health and had normal height and weight. The median ages of thelarche, menarche and pubarche were estimated by probit analysis. All other parameters were expressed as mean +/- SD. RESULTS: The median ages of thelarche and pubarche were 9.4 and 11.1 years, respectively. Two hundred and twenty one girls had experienced menstruation. The median age of menarche was 11.2 years, whereas, the mean age was 12.1 years. Most girls reached near final adult height after 14 years old. CONCLUSION: The secular trend in decline of the ages of thelarche (or puberty) and menarche was observed in Bangkok girls. Further study in a larger population including a younger age group is required to define the current reference interval of onset of puberty.