mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2022-13-2-102-112mvjr-1405Research ArticleПЕДИАТРИЯPAEDIATRICSОсобенности кардиометаболических нарушений при ожирении на примере детской популяции Ростовской областиFeatures of cardiometabolic disorders in obesity on the example of the children’s population of the Rostov regionhttps://orcid.org/0000-0002-0676-2570БочароваО. В.BocharovaO. V.

Бочарова Ольга Владимировна, заведующая педиатрическим отделением № 2; аспирант кафедры детских болезней № 3

Ростов-на-Дону

Olga V. Bocharova, Head of pediatric department No. 2 municipal budgetary healthcare institution «Children’s City Polyclinic No. 4», PhD student Department of Children’s Diseases No. 3 

Rostov-on-Don

bocharova.olga.vl@gmail.comhttps://orcid.org/0000-0002-3585-7026ТепляковаЕ. Д.TeplyakovaE. D.

Теплякова Елена Дмитриевна, д.м.н., доц., профессор кафедры детских болезней № 3

Ростов-на-Дону

Elena D. Teplyakova, Doctor of Medical Sciences, Associate Professor, Professor of the Department of Children’s Diseases No. 3 

Rostov-on-Don

elenatepl7@yandex.ruhttps://orcid.org/0000-0001-6197-7374ШкуратТ. П.ShkuratT. P.

Шкурат Татьяна Павловна, д.б.н., проф., заведующий кафедрой генетики, Академия биологии и биотехнологий 

Ростов-на-Дону

Tatyana P. Shkurat, doctor of Biological sciences, professor, head of the department of genetics 

Rostov-on-Don

tshkurat@yandex.ruhttps://orcid.org/0000-0001-9130-6491КарантышГ. В.KarantyshG. V.

Карантыш Галина Владимировна, д.б.н., доц., профессор кафедры коррекционной педагогики

Ростов-на-Дону

Galina V. Karantysh, Dr. Sci. (Biol.), Associate Professor, Professor of the Department of Correctional Pedagogy 

Rostov-on-Don

gvkarantys@sfedu.ruhttps://orcid.org/0000-0002-9664-7751Абд АлиАлаа ХашимAbd AliAlaa Hashim

Алаа Хашим Абд Али, аспирант, кафедра генетики, Академия биологии и биотехнологий

Ростов-на-Дону

Куфа, Ирак

Alaa Hashim Abd Ali, PhD student, Department of Genetics, Academy of Biology and Biotechnologies

Rostov-on-Don

Kufa, Iraq

alaahashim960@gmail.comДетская городская поликлиника № 4; Ростовский государственный медицинский университетРоссияChildren’s City Hospital No 1Russian FederationРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian FederationЮжный федеральный университетРоссияSouth Federal UniversityRussian FederationЮжный федеральный университет; ООО «Наука»РоссияSouth Federal University; Limited Liability Company «Science»Russian FederationЮжный федеральный университет; Технический университет Аль-Фурат Аль-АвсатРоссияSouth Federal University; Technical University Al-Furat Al-AwsatRussian Federation202206072022132102112Copyright © Бочарова О.В., Теплякова Е.Д., Шкурат Т.П., Карантыш Г.В., Абд Али А.Х., 20222022Бочарова О.В., Теплякова Е.Д., Шкурат Т.П., Карантыш Г.В., Абд Али А.Х.Bocharova O.V., Teplyakova E.D., Shkurat T.P., Karantysh G.V., Abd Ali A.H.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1405Цель

Цель: изучение особенностей липидного профиля у детей и подростков с ожирением в зависимости от наличия инсулинорезистентности, эндотелиальной дисфункции и минимальной диастолической дисфункции левого желудочка

Материалы и методы

Материалы и методы: В обследовании приняли участие 370 пациентов с ожирением от 7 до 17 лет (основная группа) с ИМТ > 30, контрольная группа составила 123 ребенка того же возраста без ожирения. Методы: клинический, параклинический (биохимическое исследование крови, измерение уровня АД, оценка эндотелиальной дисфункции, оценка минимальной диастолической дисфункции)

Результаты

Результаты: Кардиометаболические нарушения при ожирении в детском и подростковом возрасте сопровождаются, в первую очередь, гипертриглицеридемией, которая влечет за собой дальнейшие нарушения липидного профиля. Установлена положительная корреляционная связь между изменением уровня инсулина и триглицеридов у детей и подростков с ожирением и эндотелиальной дисфункцией, а также у пациентов с HOMA IR ˂ 3,2 и сочетании эндотелиальной дисфункции и минимальной дисфункции левого желудочка .

Выводы

Выводы: В  формировании кардиометаболических нарушений при ожирении в детском и подростковом возрасте важную роль играет гипертриглицеридемия, связанная с высоким уровнем инсулина и способствующая развитию инсулинорезистентности. Исследование характера нарушений липидного спектра и кардиоваскулярной патологии у данных пациентов показывает, что ожирение в этом возрасте чаще сопровождается минимальной диастолической дисфункцией левого желудочка или сочетанием эндотелиальной дисфункции и дисфункцией левого желудочка. Развитие инсулинорезистентности приводит к увеличению сочетанной патологии.

Objective: to study the features of the blood lipid profile in obese children and adolescents, depending on the presence of insulin resistance, endothelial dysfunction and minimal diastolic dysfunction of the left ventricle. Materials and methods: the study involved 370 obese children and adolescents from 7 to 17 years of age (the main group) with a body mass index BMI > 30, the control group consisted of 123 children of the same age without obesity. Methods: clinical, paraclinical (biochemical blood test, blood pressure measurement, functional diagnosis of endothelial dysfunction, assessment of minimal diastolic dysfunction). Results: cardiometabolic disorders in obesity in childhood and adolescence are accompanied, first of all, by hypertriglyceridemia, which entails further violations of the lipid profile. There was also a positive correlation between changes in insulin and triglyceride levels in children and adolescents with obesity and endothelial dysfunction, as well as in patients with HOMA IR 3.2 and a combination of endothelial dysfunction and minimal dysfunction. Conclusions: based on the study of the nature of lipid spectrum disorders in obese children and adolescents and the presence of signs of endothelial dysfunction and/or minimal left ventricular dysfunction, it was concluded that obesity at this age is more often accompanied by minimal left ventricular diastolic dysfunction or a combination of endothelial dysfunction and left ventricular dysfunction. The development of insulin resistance leads to an increase in the combined pathology (ED and MDLj). Hypertriglyceridemia, which is associated with high levels of insulin and presumably determines the development of insulin resistance, plays an important role in the development of cardiometabolic disorders in obesity in childhood and adolescence.

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The authors declare that there are no conflicts of interest present.