Background. Metabolic syndrome (MS) is perceived as a cluster of risk factors for cardiovascular disease and type 2 diabetes. The prevalence of MS in children and adolescents reaches 6–39 % depending on the identification criteria. Despite the considerable attention paid to MS in children and adolescents, there is no unified agreed consensus on its early screening. Consequently, the purpose of the study was along with the generally accepted criteria evaluate additional markers for MS early screening in children and adolescents. Materials and methods. A cross sectional study was conducted with 155 children aged 9–18 years, which formed 2 groups: a group of children with MS — 90 children with MS on the background of abdominal obesity and a group of children without MS — 65 children with normal body weight. Clinical (antrometric data, blood pressure) and laboratory (fasting glucose, fasting insulin, lipids) parameters were assessed. MS verification was performed according to the recommendations of the IDF Сonsensus (2007). Results. For MS screening in addition to the generally accepted criteria according to IDF Consensus (2007): abdominal obesity (waist circumference > 90th percentile according to age and gender), fasting glucose > 5.6 mmol/l, triglycerides > 1.7 mmol/l, blood pressure > 130/85 mm Hg, the most probable additional markers were established: neck and hip circumference, waist/hip ratio, body surface area > 90th percentile of distribution according to age and sex, fasting insulin > 15.0 mU/l, homeostasis model assessment for insulin ratio (HOMA-IR) > 2.8, total cholesterol > 5.2 mmol/l, LDL-C > 3.25 mmol/l, VLDL-C > 0.78 mmol/l, blood pressure in terms of distribution > 95th percentile, which contributes to its early detection and correction. Conclusions. Expanding the list of MS additional markers for its early screening in the pediatric and adolescent population is relevant and provides a basis for its timely correction and prevention.
Background. Male infertility is one of the most serious medical and social problems. Idiopathic infertility accounts for about 30 % of cases of infertile men. Rheumatoid arthritis is associated with a decreased fertility potential. The aim of the present work was to determine the lipid peroxidation level and the activity of antioxidant enzymes such as glutathione peroxidase and glutathione reductase in seminal plasma and blood plasma of infertile men with idiopathic infertility and concomitant autoimmune joint pathology (rheumatoid arthritis). Materials and Methods. 45 infertile men aged 22–48 were examined. They were divided into 2 groups: first group – 23 somatically healthy patients with idiopathic infertility; second group – 22 infertile men with rheumatoid arthritis. The control group consisted of 27 males with normal semen profile according to the WHO criteria and confirmed parenthood. The concentration of thiobarbituric acid reactive substance and activity of antioxidant enzymes were measured in the blood and seminal plasma. Results. When analyzing the seminal fluid, we found that the TBARS content was 4-fold greater in infertile men with autoimmune pathology compared to fertile men (p <0.001), whereas, in patients with idiopathic infertility its level was within the normal range. The activation of lipid peroxidation in infertile men with idiopathic infertility and in combination with rheumatoid arthritis was accompanied by a statistically significant decrease in the activity of enzymes of glutathione antioxidant system. It should be noted that more pronounced disorders of lipid peroxidation and antioxidant enzymes activity were found in seminal plasma compared to blood plasma. Conclusions. (1) An increased lipid peroxidation was observed in seminal and blood plasma of infertile men in combination with rheumatoid arthritis compared to normospermic men, whereas no differences were observed between men with idiopathic infertility and fertile men; (2) An impaired antioxidant status was observed in seminal and blood plasma of both men with idiopathic infertility and infertile men in combination with rheumatoid arthritis compared to normospermic men; (3) infertile men in combination with rheumatoid arthritis showed a significantly higher lipid peroxidation levels compared to men with idiopathic infertility, whereas no differences were observed in GPx and GR activity between groups.
The aim: To evaluate anthropometric, hemodynamic parameters, as well as changes in blood and leptin lipid spectrum in children and adults with overweight and obesity. Materials and methods: We examined 68 overweight children and 90 patients with obesity in combination with stage 2, grade 2 AH who were electively inpatient. The control group consisted of practically healthy individuals – 20 adults and 55 children. Results: Obesity in childhood isaccompanied by the development of dyslipidemia, hypercholesterolemia, hyperleptinemia and hypertension, and in adulthood may be an additional risk factor for cardiovascular disease, in particular AH. According to the study, total leptin level in overweight children was significantly higher compared to the control group (p<0.01). The concentration of leptin in patients with hypertension in combination with obesity was 3 times higher compared to the control group (p<0.01) Conclusions: Thus, obesity or overweight, accompanied by hyperleptinemia and an increase in the proatherogenic fractions of the blood lipid spectrum, is an important problem that needs to be addressed in childhood to prevent cardiovascular disease in adulthood.
Background. Insulin resistance is the major sign of etiology and pathogenesis of type 2 diabetes mellitus and metabolic syndrome and can precede its development for many years. Early identifying the beginning of insulin resistance in children is important to prevent diabetes mellitus in adult life. The purpose was to identify metabolic and somatic changes in children with insulin resistance. Material and methods. Out of 182 children of the general sample, who was estimated fasting plasma insulin and glucose, HOMA-IR, and glucose/insulin ratio, 2 groups were formed: group 1 — children with IR — 56 (30.8 %) and group 2 — 126 (69.2 %) children with normal insulin sensitivity. In children anthropometric data, lipid metabolism (total cholesterol, triglycerides, HDL-C, LDL-C, VLDL-C), blood pressure, leptin were determined. Results. From examined subjects 56 children were generally obese (BMI > 95th percentile), 71 children were abdominally obese (WC > 90th percentile), 55 children were with normal body mass (BMI < 90th percentile). Insulin resistance was identified in 21 (37.5 %) children with general obesity more rarely, than in 38 (39.4 %) children with abdominal obesity (p = .049) and in 7 (12.7 %) children with normal BMI (p = .003). In insulin-resistant children BMI, waist and hip circumference was larger than in children with normal insulin sensitivity. The lipid profile in children with different insulin sensitivity did not differ, but in insulin-resistant children an association of basal glucose with TG/HDL-C ratio (r = .53; p = .001), blood insulin with TG (r = .34; p = .018), and TG/HDL-C ratio (r = .54; p = .001) was estimated. The HOMA-IR significantly correlated with VLD-C (r = .40; p = .005), TG (r = .49; p = .001), TG/HDL-C ratio (r = .43; p = .002). The glucose/insulin ratio was in significant association with the TG/non-HDL-C ratio. The incidence of hypetension (> 95th percentile) diagnosis in insulin-resistant children was by 33.8 % higher (p = .001). Blood leptin concentration was 1.8 falled higher in insulin-resistant children and significantly correlates with waist circumference, fasting insulin, HOMA-IR, and diastolic blood pressure. Conclusions. Insulin resistance is related to cardiometabolic risks, such as general and abdominal obesity, hypertension, dyslipidemia, hyperleptinemia, and leptin resistance, and is a screening biomarker for children and adolescents with an increased risk of cardiometabolic diseases.
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