{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:01:21Z","timestamp":1760238081080,"version":"build-2065373602"},"reference-count":67,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"State Scholarship Foundation","award":["2012-2014"],"award-info":[{"award-number":["2012-2014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>\u0395merging data indicate that various effects of obesity on the cardiovascular system can be evident during childhood. The aim of this study was to detect early changes in left ventricular structure and function in obese normotensive children and explore possible associations of these changes with anthropometric and biochemical parameters. Normotensive 8\u201311-year-old obese and normal weight children were included in the study. They all underwent anthropometric measurements, laboratory tests, and echocardiography study by conventional and tissue Doppler to assess geometric pattern and function of left ventricle. Statistically significant differences in most anthropometric and metabolic parameters were noticed between groups. Obese children showed higher left ventricular mass index (LVMI) (40.05 \u00b1 9.44 vs. 28.31 \u00b1 6.22), lower E\/A ratio (1.76 \u00b1 0.33 vs. 2.08 \u00b1 0.56), and higher E\/e\u2019 (6.04 \u00b1 1.13 vs. 5.43 \u00b1 0.96) compared to lean peers. Waist-to-height ratio and hs-CRP correlated significantly with E\/A in the obese group. Left ventricular hypertrophy was present in 47.2% of obese children and eccentric was the prominent type. Waist-to-height ratio and serum cortisol levels in plasma increased the odds of having any type of abnormal ventricular geometric pattern. Echocardiographic evaluation of left ventricle and diastolic function could be considered for obese normotensive children based on waist-to-height ratio, hs-CRP, and serum cortisol.<\/jats:p>","DOI":"10.3390\/diagnostics10070468","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T04:46:01Z","timestamp":1594701961000},"page":"468","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Anthropometric and Biochemical Markers as Possible Indicators of Left Ventricular Abnormal Geometric Pattern and Function Impairment in Obese Normotensive Children"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5598-0531","authenticated-orcid":false,"given":"Filippina","family":"Giannisi","sequence":"first","affiliation":[{"name":"2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA General Hospital, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Keivanidou","sequence":"additional","affiliation":[{"name":"2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA General Hospital, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioanna","family":"Sakellari","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Balala","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Hassapidou","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Areti","family":"Hitoglou-Makedou","sequence":"additional","affiliation":[{"name":"2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA General Hospital, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Giannopoulos","sequence":"additional","affiliation":[{"name":"2nd Pediatric Department, Aristotle University of Thessaloniki, AHEPA General Hospital, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, Regional, and National Prevalence of Overweight and Obesity in Children and Adults during 1980\u20132013: A Systematic Analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"ref_2","unstructured":"(2020, March 10). 2018 Global Nutrition Report\u2014Global Nutrition Report. Available online: https:\/\/globalnutritionreport.org\/reports\/global-nutrition-report-2018\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1006\/pmed.1993.1014","article-title":"Do Obese Children Become Obese Adults? A Review of the Literature","volume":"22","author":"Serdula","year":"1993","journal-title":"Prev. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1038\/ijo.2009.102","article-title":"Is Body Mass Index before Middle Age Related to Coronary Heart Disease Risk in Later Life? Evidence from Observational Studies","volume":"33","author":"Owen","year":"2009","journal-title":"Int. J. Obes."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1056\/NEJMoa1503840","article-title":"Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood","volume":"374","author":"Twig","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kumar, S., and Kelly, A.S. (2017). Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clinic Proceedings, Elsevier Ltd.","DOI":"10.1016\/j.mayocp.2016.09.017"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1056\/NEJM199005313222203","article-title":"Prognostic Implications of Echocardiographically Determined Left Ventricular Mass in the Framingham Heart Study","volume":"322","author":"Levy","year":"1990","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/S0002-9149(01)01460-6","article-title":"M-Mode Echocardiographic Predictors of Six- to Seven-Year Incidence of Coronary Heart Disease, Stroke, Congestive Heart Failure, and Mortality in an Elderly Cohort (The Cardiovascular Health Study)","volume":"87","author":"Gardin","year":"2001","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1016\/j.jacc.2006.03.004","article-title":"Impact of Obesity on Cardiac Geometry and Function in a Population of Adolescents. The Strong Heart Study","volume":"47","author":"Chinali","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1097\/HJH.0000000000000176","article-title":"The Effect of Hypertension and Obesity on Left Ventricular Geometry and Cardiac Functions in Children and Adolescents","volume":"32","author":"Alp","year":"2014","journal-title":"J. Hypertens."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1097\/HJH.0000000000000552","article-title":"The Role of Blood Pressure, Body Weight and Fat Distribution on Left Ventricular Mass, Diastolic Function and Cardiac Geometry in Children","volume":"33","author":"Pieruzzi","year":"2015","journal-title":"J. Hypertens."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1001\/jama.1991.03470020057032","article-title":"The Impact of Obesity on Left Ventricular Mass and Geometry: The Framingham Heart Study","volume":"266","author":"Lauer","year":"1991","journal-title":"JAMA J. Am. Med. Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1093\/eurheartj\/ehv089","article-title":"Lifetime Risk: Childhood Obesity and Cardiovascular Risk","volume":"36","author":"Ayer","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.1093\/eurheartj\/ehl163","article-title":"Abnormal Myocardial Deformation Properties in Obese, Non-Hypertensive Children: An Ambulatory Blood Pressure Monitoring, Standard Echocardiographic, and Strain Rate Imaging Study","volume":"27","author":"Pacileo","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1001\/archpediatrics.2010.158","article-title":"Impaired Cardiac Function among Obese Adolescents: Effect of Aerobic Interval Training","volume":"164","author":"Ingul","year":"2010","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1038\/oby.2010.134","article-title":"Association of Obesity and Hypertension with Left Ventricular Geometry and Function in Children and Adolescents","volume":"19","author":"Dhuper","year":"2011","journal-title":"Obesity"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1093\/ehjci\/jes238","article-title":"Alterations of Left Ventricular Myocardial Strain in Obese Children","volume":"14","author":"Labombarda","year":"2013","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1017\/S1047951111001910","article-title":"Echocardiographic Evaluation of Cardiac Structure and Function in Obese Egyptian Adolescents","volume":"22","author":"Kamal","year":"2012","journal-title":"Cardiol. Young"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1007\/s11936-014-0340-3","article-title":"Early Ventricular Remodeling and Dysfunction in Obese Children and Adolescents","volume":"16","author":"Sanchez","year":"2014","journal-title":"Curr. Treat. Opt. Cardiovasc. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/obr.12305","article-title":"Pathophysiology of Hypertension in Obese Children: A Systematic Review","volume":"16","author":"Wirix","year":"2015","journal-title":"Obes. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.amjcard.2015.02.005","article-title":"Relation of Reduced Preclinical Left Ventricular Diastolic Function and Cardiac Remodeling in Overweight Youth to Insulin Resistance and Inflammation","volume":"115","author":"Dahiya","year":"2015","journal-title":"Am. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.numecd.2014.08.013","article-title":"Left Ventricular Diastolic Function and Cardiometabolic Factors in Obese Normotensive Children","volume":"25","author":"Ferrando","year":"2015","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s40292-014-0068-x","article-title":"Left Ventricular Hypertrophy and Obesity: Only a Matter of Fat?","volume":"22","author":"Murdolo","year":"2015","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11906-015-0608-3","article-title":"The Role of Obesity in the Development of Left Ventricular Hypertrophy among Children and Adolescents","volume":"18","author":"Brady","year":"2016","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey","volume":"320","author":"Cole","year":"2000","journal-title":"Br. Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2047-6310.2012.00052.x","article-title":"Neck Circumference: A Useful Screening Tool of Cardiovascular Risk in Children","volume":"7","author":"Androutsos","year":"2012","journal-title":"Pediatr. Obes."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/ajcn\/69.2.308","article-title":"Relation of Circumferences and Skinfold Thicknesses to Lipid and Insulin Concentrations in Children and Adolescents: The Bogalusa Heart Study","volume":"69","author":"Freedman","year":"1999","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1136\/adc.51.3.170","article-title":"Clinical Longitudinal Standards for Height, Weight, Height Velocity, Weight Velocity, and Stages of Puberty","volume":"51","author":"Tanner","year":"1976","journal-title":"Arch. Dis. Child."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1002\/clc.22437","article-title":"Conicity Index and Waist-to-Hip Ratio Are Superior Obesity Indices in Predicting 10-Year Cardiovascular Risk among Men and Women","volume":"38","author":"Motamed","year":"2015","journal-title":"Clin. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1002\/oby.22170","article-title":"Anthropometric Indices Based on Waist Circumference as Measures of Adiposity in Children","volume":"26","author":"Santos","year":"2018","journal-title":"Obesity"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e500","DOI":"10.1542\/peds.2004-1921","article-title":"Homeostasis Model Assessment Is More Reliable than the Fasting Glucose\/Insulin Ratio and Quantitative Insulin Sensitivity Check Index for Assessing Insulin Resistance among Obese Children and Adolescents","volume":"115","author":"Keskin","year":"2005","journal-title":"Pediatrics"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Flynn, J.T., Kaelber, D.C., Baker-Smith, C.M., Blowey, D., Carroll, A.E., Daniels, S.R., De Ferranti, S.D., Dionne, J.M., Falkner, B., and Flinn, S.K. (2017). Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics.","DOI":"10.1542\/peds.2017-1904"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.echo.2009.03.003","article-title":"Age-Specific Reference Intervals for Indexed Left Ventricular Mass in Children","volume":"22","author":"Khoury","year":"2009","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1161\/01.CIR.97.19.1907","article-title":"Left Ventricular Geometry and Severe Left Ventricular Hypertrophy in Children and Adolescents With Essential Hypertension","volume":"97","author":"Daniels","year":"1998","journal-title":"Circulation"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lang, R.M., Badano, L.P., Victor, M.A., Afilalo, J., Armstrong, A., Ernande, L., Flachskampf, F.A., Foster, E., Goldstein, S.A., and Kuznetsova, T. (2015). Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J. Am. Soc. Echocardiogr., 28.","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00246-013-0782-5","article-title":"Childhood Obesity Increases Left-Ventricular Mass Irrespective of Blood Pressure Status","volume":"35","author":"Kharod","year":"2014","journal-title":"Pediatr. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12968-017-0401-3","article-title":"Ambulatory Systolic Blood Pressure and Obesity Are Independently Associated with Left Ventricular Hypertrophic Remodeling in Children","volume":"19","author":"Jing","year":"2017","journal-title":"J. Cardiovasc. Magn. Reson."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.numecd.2007.09.002","article-title":"Central Adiposity and Left Ventricular Mass in Obese Children","volume":"18","author":"Capaldo","year":"2008","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1017\/S1047951115000803","article-title":"Waist Circumference to Height Ratio and Left Ventricular Mass in Children and Adolescents","volume":"26","author":"Mehta","year":"2016","journal-title":"Cardiol. Young"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.nut.2017.09.001","article-title":"Early Cardiac Abnormalities in Obese Children and Their Relationship with Adiposity","volume":"46","author":"Rodicio","year":"2018","journal-title":"Nutrition"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1515\/JPEM.2006.19.8.1007","article-title":"The Effect of Obesity on Echocardiographic and Metabolic Parameters in Childhood","volume":"19","author":"Kinik","year":"2006","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2275","DOI":"10.1016\/S0735-1097(03)00493-5","article-title":"Left Ventricular Structural Andnfunctional Characteristics in Cushing\u2019s Syndrome","volume":"41","author":"Muiesan","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1530\/EJE-09-0621","article-title":"Cardiac Dysfunction Is Reversed upon Successful Treatment of Cushing\u2019s Syndrome","volume":"162","author":"Pereira","year":"2010","journal-title":"Eur. J. Endocrinol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1159\/000443864","article-title":"Metabolic Alterations and Cardiovascular Outcomes of Cortisol Excess","volume":"46","author":"Pivonello","year":"2016","journal-title":"Front. Horm. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"4543","DOI":"10.1210\/jc.2018-00617","article-title":"Cortisol Excess in Patients with Primary Aldosteronism Impacts Left Ventricular Hypertrophy","volume":"103","author":"Adolf","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1515\/JPEM.2011.267","article-title":"The Association between Morning Cortisol and Adiposity in Children Varies by Weight Status","volume":"24","author":"Hill","year":"2011","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1016\/j.amjcard.2008.01.045","article-title":"Relation of Childhood Risk Factors to Left Ventricular Hypertrophy (Eccentric or Concentric) in Relatively Young Adulthood (from the Bogalusa Heart Study)","volume":"101","author":"Toprak","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jpeds.2012.06.009","article-title":"High Risk Blood Pressure and Obesity Increase the Risk for Left Ventricular Hypertrophy in African-American Adolescents","volume":"162","author":"Falkner","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_49","first-page":"266","article-title":"Insulin Resistance, Dyslipidemia and Cardiovascular Changes in a Group of Obese Children","volume":"104","author":"Pires","year":"2015","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Jing, L., Binkley, C.M., Suever, J.D., Umasankar, N., Haggerty, C.M., Rich, J., Nevius, C.D., Wehner, G.J., Hamlet, S.M., and Powell, D.K. (2016). Cardiac Remodeling and Dysfunction in Childhood Obesity: A Cardiovascular Magnetic Resonance Study. J. Cardiovasc. Magn. Reson., 18.","DOI":"10.1186\/s12968-016-0247-0"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3923\/ajcn.2009.58.64","article-title":"Left Ventricular Mass and Geometry in Obese Children","volume":"1","author":"Khositseth","year":"2009","journal-title":"Asian J. Clin. Nutr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"28","DOI":"10.4103\/apc.APC_75_17","article-title":"Evaluation of Left Ventricular Function in Obese Children without Hypertension by a Tissue Doppler Imaging Study","volume":"11","author":"Ghandi","year":"2018","journal-title":"Ann. Pediatr. Cardiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1007\/s00246-013-0674-8","article-title":"Early Subclinical Left-Ventricular Dysfunction in Obese Nonhypertensive Children: A Tissue Doppler Imaging Study","volume":"34","author":"Kibar","year":"2013","journal-title":"Pediatr. Cardiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1515\/jpem-2014-0526","article-title":"Waist-to-Height Ratio as a Marker of Low-Grade Inflammation in Obese Children and Adolescents","volume":"29","author":"Caminiti","year":"2016","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1017\/S1368980013003285","article-title":"Waist-to-Height Ratio, Inflammation and CVD Risk in Obese Children","volume":"17","author":"Olza","year":"2013","journal-title":"Public Health Nutr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"127","DOI":"10.5551\/jat.9.127","article-title":"Waist-to-Height Ratio Is the Best Predictor of Cardiovascular Disease Risk Factors in Japanese Schoolchildren","volume":"9","author":"Hara","year":"2002","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1017\/S0954422410000144","article-title":"A Systematic Review of Waist-to-Height Ratio as a Screening Tool for the Prediction of Cardiovascular Disease and Diabetes: 05 Could Be a Suitable Global Boundary Value","volume":"23","author":"Browning","year":"2010","journal-title":"Nutr. Res. Rev."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1161\/01.CIR.0000053730.47739.3C","article-title":"Clinical Application of C-Reactive Protein for Cardiovascular Disease Detection and Prevention","volume":"107","author":"Ridker","year":"2003","journal-title":"Circulation"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.cardfail.2005.08.003","article-title":"High-Sensitivity C-Reactive Protein and Parameters of Left Ventricular Dysfunction","volume":"12","author":"Shah","year":"2006","journal-title":"J. Card. Fail."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1620\/tjem.223.263","article-title":"Association between High-Sensitivity C-Reactive Protein and Left Ventricular Diastolic Function Assessed by Echocardiography in Patients with Cardiovascular Risk Factors","volume":"223","author":"Masugata","year":"2011","journal-title":"Tohoku J. Exp. Med."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Wang, K.-T., Liu, Y.-Y., Sung, K.-T., Liu, C.-C., Su, C.-H., Hung, T.-C., Hung, C.-L., Chien, C.-Y., and Yeh, H.-I. (2020). Circulating Monocyte Count as a Surrogate Marker for Ventricular-Arterial Remodeling and Incident Heart Failure with Preserved Ejection Fraction. Diagnostics, 10.","DOI":"10.3390\/diagnostics10050287"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"29","author":"Nagueh","year":"2016","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1017\/S1047951117001627","article-title":"Left Ventricular Diastolic Dysfunction without Left Ventricular Hypertrophy in Obese Children and Adolescents: A Tissue Doppler Imaging and Cardiac Troponin I Study","volume":"28","author":"Mira","year":"2018","journal-title":"Cardiol. Young"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1093\/ehjci\/jes294","article-title":"Assessing Pre-Clinical Ventricular Dysfunction in Obese Children and Adolescents: The Value of Speckle Tracking Imaging","volume":"14","author":"Barbosa","year":"2013","journal-title":"Eur. Hear. J. Cardiovasc. Imaging"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.ijcard.2005.08.033","article-title":"Relationship between Insulin Resistance and Left Ventricular Diastolic Dysfunction in Patients with Impaired Glucose Tolerance and Type 2 Diabetes","volume":"110","author":"Bajraktari","year":"2006","journal-title":"Int. J. Cardiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1007\/s00467-005-1979-5","article-title":"White-Coat and Masked Hypertension in Children: Association with Target-Organ Damage","volume":"20","author":"Stabouli","year":"2005","journal-title":"Pediatr. Nephrol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.2047-6310.2013.00202.x","article-title":"Cardiometabolic Risk Factors and Insulin Resistance in Obese Children and Adolescents: Relation to Puberty","volume":"10","author":"Tobisch","year":"2015","journal-title":"Pediatr. Obes."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/7\/468\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:05Z","timestamp":1760176205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/10\/7\/468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,10]]},"references-count":67,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["diagnostics10070468"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics10070468","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2020,7,10]]}}}