There has been an increase the prevalence of andrological diseases in all age groups in recent decades, including those with comorbid conditions such as pathology of the cardiovascular system and liver, which are manifestations of metabolic syndrome.Research aim: to investigate the relationship between formation of hepatic steatosis and hypoandrogenism (HA) in adolescent boys.Materials and methods. The study involved 42 adolescent boys aged 14–18 years with laboratory confirmed HA in whom total testosterone levels were less than 12.0 nmol/l. Sex hormones, gonadotropins, insulin levels, biochemical parameters of liver function, the state of free radical oxidation and antioxidant protection were determined in patients. Based on ultrasound examination adolescents with HA were divided into 2 groups: group 1 – 15 adolescents with signs of liver steatosis; group 2 – 27 adolescents with normal ultrasound parameters of a liver. The control group consisted of 38 boys of the same age with normal indicators of physical and sexual development without signs of pathology of the hepatobiliary system. Results. Individual assessment of sexual development allowed to diagnose I degree of delayed sexual development in 44.7%, II degree in 38.3% and III degree in 17.0% of adolescents. HA negatively affects the physical development of most boys (78.7%), due to short stature (40.0%), weight deficiency (20.0%) and overweight (18.7%). Factor analysis allowed to build a factor model of hepatic steatosis formation in adolescents with delayed sexual development and HA, which describes 76.0% of the sample and consists of five factors. Conclusion. Atherogenic changes of the lipid profile, androgen deficiency, insulin resistance, activation of cytolytic processes in the liver and oxidative stress formation due to a decrease in the effectiveness of antioxidant protection are important in the pathogenesis of hepatic steatosis in boys with HA. A factor model of the hepatic steatosis development in adolescent boys with HA gives grounds for the development of therapeutic and preventive measures in adolescent boys with HA and comorbid liver pathology.
Metabolic syndrome (MS) and the conditions associated with it are pressing problems for humanity. The gastroenterological component of MS is considered to be non-alcoholic fatty liver disease (NAFLD). There are no scientific studies on the influence of hypoandrogenism (HA) on metabolic control and the formation of NAFLD in adolescent boys. Purpose - to determine the prognostic value of changes in the lipid profile for the formation of NAFLD in adolescent boys with HA. Materials and methods. In 2019-2021 was carried out a comprehensive examination of 107 adolescent boys aged 13-18 with HA: the clinical examination, blood tests to determine the level of γ-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, lipidogram, testosterone, immunoreactive insulin. The morpho-functional state of the hepatobiliary system was studied by ultrasound, according to the results of which adolescent boys with HA were divided into observation groups (the Group 1 - with normal liver parameters, the Group 2 - with signs of steatosis). Prognostic assessment of the formation of liver steatosis in HA was carried out using ROC analysis with AUC calculation. Results. According to the ultrasound signs of NAFLD was detected in a third of adolescent boys with HA. The state of insulin resistance was established in 22% of adolescent boys, significantly more often in patients with NAFLD. Analysis of blood lipid spectrum indicators in young men with HA showed the presence of proatherogenic changes more pronounced in the group with NAFLD. ROC analysis for quantitative biochemical indicators demonstrated that while using the distribution point for β-lipoproteins >5.8 g/l for the detection of liver enlargement as a sign of NAFLD in adolescent boys with HA the sensitivity was 72.0%, the specificity - 55.3%. The value of the area under the ROC curve was 0.624 [0.514; 0.725] with the level of statistical significance p=0.045. Conclusions. A third part of adolescent boys with HA according to ultrasound examination had signs of NAFLD at the stage of steatosis. Atherogenic dyslipidemia was found in all adolescents with HA, which was more pronounced in patients with NAFLD. The predictive value of determining the level of β-lipoproteins for the detection of NAFLD in adolescent boys with HA was revealed. The determination of β-lipoproteins may be economically feasible in relation to the diagnostic examination of adolescent boys with HA. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
На сьогодні ожиріння визнано неінфекційною епідемією ХХI сторіччя як серед дорослого населення, так і серед дітей. За даними ВООЗ, у 2016 році 340 мільйонів дітей та підлітків віком від 5 до 19 років страждали від надлишкової ваги або ожиріння. Медико-соціальне значення цієї проблеми визначається не лише зростанням захворюваності, але й тяжкістю ускладнень, що маніфестують вже в дитячому віці та в подальшому ведуть до втрати працездатності дорослого населення й передчасної смерті [1]. Тісно пов'язана з ожирінням патологія травної системи, при цьому найбільше страждають органи Êë³í³÷íà ãàñòðîåíòåðîëîã³ÿ / Clinical Gastroenterology
Abstract. Background. The purpose of the study is to evaluate the efficacy of hepatoprotectors in comprehensive treatment of adolescents with obesity, non-alcoholic fatty liver disease and dysfunctional disorders of the biliary tract (DDBT
Background. The purpose was to determine the structure and age characteristics of clinical and endoscopic features of gastroduodenal pathology in adolescence. Materials and methods. The study included 493 adolescents between 10 and 14 years of age and 444 adolescents aged 15 to 18 years. Clinical, laboratory and instrumental studies were conducted (esophagogastroduodenoscopy, intragastric pH-metry, Helicobacter pylori DNA). Results. The study showed that in adolescence, the inflammatory lesions of the upper digestive tract predominate in both age groups. Destructive lesions occur in 8-10 % of patients in the 10-14 age group, and their incidence increases 2 times in boys and 1.5 times-in girls in the 15-18 age group. Motility disorders of the upper digestive tract are determined in 30 % of patients regardless of age, more often in girls. Lesions of the upper digestive tract are usually accompanied by basal gastric hyperacidity in boys, while in girls the basal normacidity is more often determined. Helicobacter pylori infection is detected in 2/3 of adolescents with disorders of the upper digestive tract, slightly more often in the 10-14 age group. Conclusions. The results obtained in the course of the study can focus the directions of etiotropic and pathogenetic therapy for the upper digestive tract diseases depending on the age and gender of the patients.
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