January/February 2015 Volume 7/ Issue 1

<<< contents

■ Original articles

Smіshchuk V.V., Tyazhka O.V., Bryuzgіna T.S., Denisova S.E., Zamula V.V. Modern viewpoint about etiopathogenesis of cholelithiasis in children and possible ways to correct the detected disorders. International Journal of Pediatrics, Obstetrics and Gynecology 2015;Vol 7(1):38-45

Modern viewpoint about etiopathogenesis of cholelithiasis in children and possible ways to correct the detected disorders

Smіshchuk V.V.1,3, Tyazhka O.V.1, Bryuzgіna T.S.2, Denisova S.E.3, Zamula V.V.4

1 Bohomolets National Medical University, Kyiv, Ukraine

2 Pathology Problems Institute of Bohomolets National Medical University, Kyiv, Ukraine

3 SE "Road Clinical Hospital №1 station Kyiv STBA"South-Western Railway", Kyiv, Ukraine

4 Children’s Clinical Hospital № 9, Kyiv, Ukraine

■ Abstract:

The objective. To determine the serum lipid content of fatty acids (FA) in children with cholelithiasis and children of risk group by gas-liquid chromatography. Patients and methods. We examined 102 children aged 3-18 years: I group - patients with cholelithiasis (n=34), II group - children with dysfunction of biliary tract with burdened heredity (n=68). Diagnostic complex: clinical and anamnestic data, general and biochemical blood analysis, determination of FA composition of serum lipids by gas-liquid chromatography, ultrasonic examination of the biliary tract, duodenal intubation. Results. The content of myristic FA was increased sixfold in patients of both groups. Patients of I group had 14,5% lower than control content of palmitic FA and 46,0 % lower stearic FA content. In children of II group the lever of palmitic FA was 32,3% and stearic FA was 34,0% lower than control. The level of oleic FA was reduced twice in both groups, that was accompanied by higher content of linoleic and arachidonic FA (its content was increased threefold) and as result polyunsaturated FA. Conclusions. These data suggest, that children in both groups have a disorder of FA lipid metabolism, that contributes to the formation of bile stones because of certain FA accumulation. The results of this research may help to create a therapeutic and preventive complex for patients with cholelithiasis and children of risk group, which will reduce the incidence of this disease with further complications in childhood and prospectively in adults.

■ Key words:

children, cholelithiasis, fatty acids, lipid metabolism, diagnostics, prophylaxis

■ References:

1. Shadrin O.G., Shutova Ye.V. Podkhody k terapii ranney stadii zhelchnokamennoy bolezni u detey. Zdorovye rebenka. 2013; 7(50): 176-180.

2. Zaprudnov A.M., Kharitonova L.A. Osobennosti zhelchnokamennoy bolezni v detskom vozdaste. Frayburg: Dr.Falk Farma GmbKh; 2002:52.

3. Zaprudnov A.M. Biliarnaya patologiya u detey. M.: OOO “Meditsinskoye informatsionnoye agenstvo“; 2008:376.

4. Privorotskiy V.F., Luppova N.E. Zhelchnokamennaya bolezn u detey: staraya novaya bolezn. Vserossiyskiy mezhdistsiplinarnyy meditsinskiy zhurnal. Pediatriya. 2012; 4:9-16.

5. Belousov Yu.V., Shutova Ye.V. Nachalnaya (dokamnevaya) stadiya zhelchnokamennoy bolezni u detey. Sovremennaya pediatriya. 2011; 1(35):78-80.

6. Moіseenko R. O. Chastota ta struktura zakhvoryuvanostі dіtey v Ukraїnі ta shlyakhi її znizhennya. Sovremennaya pediatriya. 2009; 2(24):10-14.

7. Bordbar M., Karami R., Kamali K., Pishva N., Haghighat M. Prevalence of Asymptomatic Gallstone in Healthy Neonates in Shiraz, Southern Iran. Iran Red Crescent Med. J. 2011; 13(11): 839-840.

8. Zhelchnokamennaya bolezn u detey rannego vozrasta: ucheb.-metod. posobiye pod red. Kharitonovoy L.A., Zaprudnova A.M. - M.: 4Te; 2012:30.

9. Punia R., Garg S., Bisht B., Dalai U., Mohan H. Clinico-pathological spectrum of gallbladder disease in children. Acta Paediatr. 2010; 99(10): 1561-4.

10. Zaprudnov A.M., Kharitonova L.A., Bogomaz L.V., Yudina T.M. Bolezni biliarnogo trakta u detey. Voprosy detskoy diyetologii. 2011; 6:39-43.

11. Zaprudnov A.M., Kharitonova JI.A. Aktualnyye aspekty zabolevaniy biliarnogo trakta v detskom vozraste. Eksperimentalnaya i klinicheskaya gastroenterologiya. 2010); 1:3-7.

12. Vovk Ye.I. Zhelchnokamennaya bolezn v XXI veke: chto novogo? Lechashchiy vrach. Gastroenterologiya. 2011; 2:58-65.

13. Roglans N., Vazquez-Carrera M., Alegret M., Novell F., Zambon D., Ros E., Laguna J.S., Sanchez R.M. Fibrates modify the expression of key factors involved in bile-acid synthesis and biliary-lipid secretion in gallstone patients. Eur. J. Clin. Pharm. 2004; 59 (12): 855-60.

14. Bronsky J., Nevoral J., Jirsa M., Hrebicek M. Role of common canalicular transporter gene variations in aetiology of idiopathic gallstones in childhood. Folia Biologica. 2010; 56(1):9-13.

15. Dikkers A., Tietge U.J. Biliary cholesterol secretion: more than a simple ABC. World J Gastroenterol. 2010; 16(47):5936-45.

16. Lammert F. Gallstone disease: from genes to evidence-based therapy. J. Hepatol. 2008; 48(1):124-135.

17. Shutova Ye.V. Sovremennyye napravleniya sovershenstvovaniya diagnostiki, profilaktiki, patogeneticheskoy korrektsii kholesterinovogo kholelitiaza v detskom vozraste. Sovremennaya pediatriya. 2012; 1(41):110-113.

18. Gaby A.R. Nutritional approaches to prevention and treatment of gallstones. Altern. Med. Rev. 2009; 14(3):258-67.

19. Mozaffarian D., Aro A., Willett W.S. Health effects of trans-fatty acids: experimental and observational evidence. Eur. J. Clin. Nutr. 2009; 63(2):5–21.

20. Uauy R., Aro A., Clarke R., Ghafoorunissa, L'Abbé M.R., Mozaffarian D., et al. WHO Scientific Update on trans fatty acids: summary and conclusions. Eur. J. Clin. Nutr. 2009; 63(2):68-75.