Relation of Left Atrial Stiffness to Insulin Resistance in Obese Children: Doppler Strain Imaging Study

Background The main objective of the study was to assess the strain measures (peak systolic longitudinal strain [ LAS ] and stiffness index [ LAS t]) and their relation to insulin resistance in obese children. Methods and results Eighty obese children (body mass index was 28.2 ± 3.1) and 60 age‐matched healthy nonobese children were recruited. Conventional, tissue Doppler imaging LAS and LAS t were measured for all children using 2D speckle tracking imaging (2 DSI ). Insulin resistance was assessed for obese children. Mean LAS was lower, and mean LAS t was higher in obese children as compared to control group (11.3 + 2.2 vs. 38.2 + 11.6, P < 0.001, and 1.12 ± 0.23 vs. 0.21 ± 0.11, P < 0.001, respectively). LAS t was significantly correlated with insulin resistance (P < 0.0001), and a value of >1.0 of LAS t was the best cutoff value which can predict insulin resistance in obese children with a sensitivity of 92% and specificity of 86%. Conclusions LAS and LAS t differed significantly in obese and nonobese children, in spite of normal left ventricular systolic and diastolic functions. LAS and LAS t were associated with insulin resistance in obese children.