Study of the Effects of Adolescent Weight Disorders (Obesity, Anorexia Nervosa) on Heart Function
Condition: Anorexia Nervosa; Obesity
MeSH terms: Obesity; Anorexia; Anorexia Nervosa
Study type: Observational

Summary: 
      The study aims to better understand the functioning of the heart of children and adolescents
      with anorexia nervosa or obesity, compared to the heart function of control subject. This
      project seeks to find out if a weight disorder affects the heart and whether a systematic
      cardiac assessment with appropriate management is then to be considered.

      To meet this objective, several analyzes are planned including a speckle tracking
      echocardiography, allowing a non-invasive study of myocardial deformations.

      The hypothesis is that two opposite weight disorders (anorexia nervosa and obesity) lead to
      similar complications: inflammation, fibrosis altering the myocardial structure and therefore
      its contractility. Both systolic and diastolic dysfunction appear. Investigator hypothesize
      that the determinants of this dysfunction involve part of the alteration of body mass, and
      partly qualitative alterations specific to each pathology.
    

Detailed description: 
      The main objective is to evaluate the cardiac dysfunctions through the study of myocardial
      deformities in anorexic and obese adolescents, in comparison with controls. The choice of a
      pediatric population is explained by the probable precocity of the cardiac repercussions of
      these weight disorders. The desire to bring together in the same study two opposite weight
      disorders is because a certain number of complications are common to both: repercussions on
      the cardiac mass, presence of chronic systemic inflammation, and fibrosis. Comparison to
      normo-weighted healthy subjects will make it possible to determine whether certain
      alterations are directly attributable to body composition (in the case of a continuum of a
      parameter between the three groups) or, on the contrary, independent of body composition.

      The search for the mechanisms at the origin of these alterations represents our secondary
      objective. For this, a correlation of the cardiac parameters with several factors such as:
      duration and severity of disorders, body composition, heart mass, presence of myocardial
      fibrosis, epicardial fat level, sympatho-vagal balance (by the cardiac variability), systemic
      inflammatory profile and potential pathways signaling involved (metabolomic analysis) will be
      carried out. All these parameters may impact cardiac function.

      Adolescent girls participating in the study will benefit from a clinical examination with fat
      / lean body mass measurement by impedance, assessment of heart rate variability, blood test
      (inflammation marker, metabolomic analysis) and ultrasound heart. Thus, screening for heart
      disease, and more generally complications of their pathology, will be performed.

      This project is important to answer the question of the necessity or not of a systematic
      cardiac assessment in these adolescents and the setting up of an adapted care
    

Intervention name(s): echocardiography
Intervention type(s): Behavioral
Intervention description(s): speckle tracking echocardiography
evaluation of cardiac variability by recording heart rate as several hours (POLAR watch)
bioimpedance
blood test for biological assays (metabolomic analysis)
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        girls between 12 and 18 with or without weight disorders
      
Biospecimen description: 
      blood sample for inflammatory factors (CRP, sedimentary rate, metabolomic)
    
Keywords: cardiac function; adolescent; obesity; speckle tracking echocardiography; anorexia nervosa; metabolomic