Research Article Details
| Article ID: | A17588 |
| PMID: | 27730776 |
| Source: | J Assoc Physicians India |
| Title: | Cardiac Diastolic Dysfunction and Regional Body Fat Distribution in Insulin Resistant Peripubertal Obese Males. |
| Abstract: | BACKGROUND: To evaluate presence of diastolic dysfunction in obese peripubertal males (8-18 years of age). To correlate diastolic dysfunction with insulin resistance, insulin levels and omental and epicardial fat. METHODS: Obese males (n=46) and age matched healthy lean controls (n=50) in the age group of 8-18 years were included in this study. Anthropometric measurements were recorded. Investigations done: Fasting blood sugar and serum insulin levels, lipid profile, 2-D Echocardiography to assess left ventricular diastolic function and epicardial fat, abdominal CT scan to measure omental fat and ultrasound for NAFLD. RESULTS: Isovolumetric relaxation time (IVRT) above 100 msec seen in 18/46, E/A ratio of 0.75 seen in 4/46 cases. Left ventricular mass > 125gm seen in 10/46 cases. All the left ventricular diastolic function parameters were within normal range in controls. Significant difference in LVM (p=0.00099), LVPW(d) (p=0.0018), IVS(d) (p=0.007), E/A ratio (p=0.043), epicardial fat (p=0.0000) were seen in cases as compared to controls. Correlation of visceral fat with HOMA-IR, insulin levels and left ventricular diastolic parameters in cases was as follows HOMA vs omental fat (p=0.0008), Insulin vs omental fat (p=0.0015), E/A vs omental fat (p=0.015), LVM vs omental fat (p=0.0000), IVRT vs omental fat (p-=0.005). HOMA vs epicardial fat (p=0.0000), insulin vs epicardial fat (p=0.0000), E/A vs epicardial fat (p=0.09), LVM vs epicardial fat (p=0.006), IVRT vs epicardial fat (p=0.011). CONCLUSIONS: Left ventricular hypertrophy and diastolic derangements start early in obese peripubertal males with positive correlation between left ventricular diastolic dysfunction and HOMA-IR and insulin levels. Epicardial fat mass and visceral fat show positive correlation with diastolic dysfunction. |
| DOI: |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S01 | Improve insulin resistance | insulin sensitizer; insulin resistance; glucose tolerance | Biguanide: increases 5-AMP activated protein kinase signaling; SGLT-2 inhibitor; Thiazalidinedione: selective PPAR-γ agonists; GLP-1 agonist | Metformin; Empagliflozin; Canagliflozin; Rosiglitazone; Pioglitazone; Liraglutide | Details |
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| I14 | 9970 | Obesity | An overnutrition that is characterized by excess body fat, traditionally defined as an elevated ratio of weight to height (specifically 30 kilograms per meter squared), has_material_basis_in a multifactorial etiology related to excess nutrition intake, decreased caloric utilization, and genetic susceptibility, and possibly medications and certain disorders of metabolism, endocrine function, and mental illness. https://en.wikipedia.org/wiki/Obesity | disease of metabolism/acquired metabolic disease/ nutrition disease/overnutrition | Details |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D328 | Serine | Chemical drug | DB00133 | SRR | Improve insulin resistance | Under clinical trials | Details |
| D010 | Amoxicillin | Chemical drug | DB01060 | -- | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |
| D248 | Obeticholic Acid | Chemical drug | DB05990 | NR1H4 activator; NR1H4 agonist; FXR agonist | Enhance lipid metabolism | Approval rejected | Details |
| D094 | Cysteamine | Chemical drug | DB00847 | GSS stimulant | Renal drug | Under clinical trials | Details |
| D095 | Cysteamine bitartrate | Chemical drug | DB00847 | -- | -- | Under clinical trials | Details |