Cardiac dimensions and function in children with obesity.

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.

Cardiac dimensions and function in children with obesity.

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.

Risk factors of high lead level in Bangkok children.

Lead poisoning is the most important pollution in children which affects the developing brain and IQ. Previous studies of blood lead levels in Thai children were all higher than 10 microg/dl. OBJECTIVE: To identify risk factors and impacts associated with high lead levels (>10 microg/dl) in Bangkok children MATERIAL AND METHOD: The longitudinal study (n = 84) followed blood lead levels of a birth cohort, 6, 12, 18, 24 and 72 months of age from 1993 to 1999. Multiple cross-sectional studies (1992-1996) comprising children under 15 years of age attending the outpatient clinic, Ramathibodi Hospital (n = 511), kindergartens (n = 60), 6 primary school students (n = 564) and secondary school students (n = 377) in Bangkok, were recruited. Blood lead levels were assessed by atomic absorption spectrometry. Questionnaires to identify risk factors were completed by parents of under 2-year-old children and primary school students. IQ was assessed in the longitudinal group at 2 years of age and in primary students. RESULTS: The mean blood lead levels (microg/dl) were 5.57 +/- 2.31 at birth, 5.03 +/- 2.21 at 6 years of age in a cohort study, 6.74 +/- 2.02 in kindergartens, 9.26 +/- 3.68 in primary students and 9.03 +/- 3.65 in secondary school students. The proportion of high blood lead increased with age from 1 per cent at birth to 35 per cent in secondary school students. In the kindergartens and secondary school, males had higher lead levels than females. In the primary school study, the significant risk factors (Odd Ratio-OR) of high lead level were; living in Bangkok (6.18), male (1.67), maternal labour workers (1.79), family income lower than 3,000 baht/month (2.24), a crowded family with more than 9 members (2.22), household members whose present occupation was related to printing (4.55) or lead smelting previously (4.85). Children in the high lead group had lower weight (p = 0.0000) and height (p = 0.0000) and were slow learners determined by their teachers (p = 0.0332). CONCLUSION: The blood lead levels in Bangkok children were not high and have tended to decrease following the reduction of air lead levels because of unleaded gasoline usage. A periodic surveillance survey is still necessary to monitor blood lead level in Bangkok children especially among those with risk factors.