Growth in infants and children with congenital cyanotic and acyanotic heart disease: impact of serum leptin and hemodynamic abnormalities

ABSTRACT

This work was carried out to study growth parameters, serum leptin and different hemodynamic data in infants and children with cyanotic and acyanotic congenital heart disease [CHD] to delineate any abnormality and the correlation between different studied parameters. The study included 44 patients with CHD divided into 2 groups cyanotic CHD/acyanotic CHD [23/21], the cyanotic group was further subdivided according to pulmonary blood flow [PBF] into patients with decreased PBF/patients with increased PBF [15/8] based on echocardiographic study and cardiac catheterization in some patients. Another 12 healthy children of matched age and sex served as a control group. Patients were subjected to clinical examination, anthropometric measurements according to Roles of Tanner. Laboratory investigations were performed for all the studied groups including arterial oxygen saturation, hemoglobin level, arterial oxygen content and serum leptin level using immunoenzymometric assay. The results showed that patients with CHD had growth retardation compared to healthy Egyptian infants and children of matched age and sex. Height was affected more that weight in both groups while weight and mid arm circumference [MAC] were affected more in the cyanotic group. Body mass index [BMI] was not so affected in both groups. On the other hand, serum leptin level showed no significant difference between both groups and between patients and control group, In addition, arterial oxygen contents showed no significant difference between all the studied groups. The degree of left to right shunt [QP/QS] in patients with acyanotic CHD was negatively correlated with weight standard deviation score [SDs], MAC SDs, BMI SDs and serum leptin level. CHD is associated with reduction in weight, height and MAC. The increased QP/QS ratio in acyanotic CHD is correlated with the degree of retardation in weight, MAC and BMI. Serum leptin levels show no significant difference between groups which exclude the role of leptin in the pathogenesis of weight loss in patients with CHD