January/February 2015 Volume 7/ Issue 1

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■ Original articles

Kryuchko T.O., Poda O.A. Мetabolic syndrome and nonalcoholic fatty liver disease in pediatric patients - what comes first? International Journal of Pediatrics, Obstetrics and Gynecology 2015;Vol 7(1):25-33

Мetabolic syndrome and nonalcoholic fatty liver disease in pediatric patients - what comes first?

Kryuchko T.O., Poda O.A.

Ukrainian Medical Stomatological Academy, Poltava, Ukraine

■ Abstract:

The objective. Еxamine disorders of carbohydrate and lipid metabolism. Determine the frequency spread of the separate components of metabolic syndrome in children and adolescent with a diagnosis of non-alcoholic fatty liver disease (NAFLD) and exogenous constitutional obesity (ECO). Materials and methods. 81 children where examine at the age from 7 to 17 years. They were divided in two groups: I group (n=38) – patients, who have expressed obesity and diagnosed nonalcoholic liver fatty disease, II group (n= 43) patients with constitutional obesity without liver dysfunction. All children were performed full complex of diagnostic procedures that includes anthropometric, clinical analyses, glucose concentration in blood, standard test on glucose tolerance, concentration of immunreactive insulin, index HOMA-IR and Caro, also data of lipid spectrum of blood – general cholesterol, triglyceride, cholesterol of lipoproteins high density, cholesterol of lipoproteins low density, cholesterol of lipoproteins very low density, blood pressure measurement. Results. Our research showed that more common sing of carbohydrate metabolism disorder in examined patients where insulin resistance. So increased level of HOMA-IR index were in 84% children with lipid liver degeneration and almost third patients with constitutional obesity. Disruption of lipid metabolism where manifested in hypertriglyceridemia, which were in third patients in main group (34.2%), which is seven fold higher in patients with constitutional obesity (p=0.002). Dyslipidemia by reducing of cholesterol of lipoproteins high density where in 42.1% cases. Almost 92% children have severe obesity by viscera-abdominal type. 36.8% patients has manifestation of arterial hypertension. Full form from five components of metabolic syndrome were found almost in every forth (24%) patient with nonalcoholic liver fatty disease , 31.6% has four criteria, all other children (44.4%) has different combinations of three components. In group of children with diagnosed obesity without liver dysfunction were not find fully manifested metabolic syndrome, only 25.6% have three components of metabolic syndrome, other 74.4% have not full metabolic syndrome with two components. Conclusion. Results of this study shows that development of liver degeneration in children and adolescents occurs at the background of lipid and carbohydrate metabolism. Active diagnostic and prevention of early manifestations of metabolic syndrome in children and adolescents with obesity can lower’s the risk of diseases associated with metabolic syndrome, especially nonalcoholic liver fatty disease.

■ Key words:

Metabolic syndrome, nonalcoholic liver fatty disease, children, insulin resistance, atherogenic dyslipidemia

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