Plasminogen Activator Inhibitor-1 in Children with Central Obesity : Effect on Left Ventricular Function 1

The aim of the study was to investigate the Plasminogen activator inhibitor-1(PAI-1) expression in obese children and to clarify its role with respect to left ventricular (LV) function. Patients and methods. This study included 69 obese children and adolescents ad 40 lean healthy controls. Children were considered obese according to body mass index (BMI) percentile for age and sex curves of growth for our population. Each subject's fat distribution was assessed by measuring waist hip ratio (WHR). Obese children with peripheral fat distribution were excluded. Exclusion criteria included hypertension, endocrine, cardiovascular, renal, insulin dependent or independent diabetes mellitus and smoking habits. Laboratory investigations included measurement of plasma PAI1 antigen. Determination of total serum cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, blood glucose and fasting serum insulin. Echocardiograph study was obtained by two dimensionally guided M mode. Results: BMI and WHR were significantly higher in obese compared to lean children (P<0.001). In addition fasting blood glucose, fasting insulin, HOMA and Triglyceride were significantly higher in obese than in lean children. Left ventricular mass (LVM) and LVM/H were significantly higher in obese compared to controls (P<0.001) while left ventricular systolic (EF%, FS %) and diastolic function (E/A ratio, decceleration time) did not differ between the two groups P>0.05. Plasma PAI-1 were significantly higher in obese compared to controls P=0.03. A significant direct correlation was revealed between PAI-1 in comparison to WHR, fasting insulin and LVM/H. Plasma PAI -1 and WHR were independent predictors of LVM/H. Conclusions: Obese children with central fat distribution showed an increase in plasma PAI-1 antigen. Also PAI-1 contributes directly to the complication of obesity including type 2 diabetes and cardiovascular disease.