Obesity is an important health problem in many countries. Obesity among the child population is growing steadily, including the Russian Federation. Development of this disease often occurs in childhood and sometimes the origin of obesity goes back to prenatal period. There are a number of endogenous and exogenous factors than play an important role in development of obesity. These are heredity, socioeconomic status of the family, factors which are revealed during pregnancy and child delivery — weight gain, administration of antibacterial drugs and hyperglycemia in mother during her pregnancy, mode of delivery, feeding type and time of complementary food introduction, excessive consumption of calories with food, improper daily routine and lack of sleep, skipping meals, use of gadgets and associated physical inactivity and excessive food intake, marketing of high-calorie foods and others. Prevailing risk factors can be identified for each age period. Study and early identification of risk factors taking into account age of a child is necessary to take timely prevention measures and inform parents and their children about possible reasons and consequences of obesity.
BACKGROUND: Essential arterial hypertension (AH) develops more often in children with accompanying risk factors — obesity, overweight, positive heredity and genetic predisposition.AIM: Study of peculiarities of arterial hypertension clinical course in adolescents with normal body weight, overweight and obesity.MATERIALS AND METHODS: The study was conducted on children with arterial hypertension who received treatment in two hospitals in Voronezh in 2016–2020. A retrospective analysis of the children’s case histories was carried out taking into account the anamnesis, clinical laboratory and instrumental examination data and the pharmacotherapy. Some children underwent polymerase chain reaction genetic testing to determine pathological alleles of genes regulating blood pressure (BP).RESULTS: 96 patients aged 9 to 17 took part in the study. The group with normal body weight included 38 children (39.6%), median age 16.4 (aged 10.7; 17.9), with overweight — 33 people (34.4%), median age 15.2 (aged 12.0; 17.9), with obesity — 25 children (26.0%), median age 14.5 (aged 9.2; 17.9). Obese children developed arterial hypertension at earlier age (p = 0.023). According to blood pressure daily monitoring (BPDM), pathological values of systolic blood pressure (SBP) during the day (above the 95th percentile) among children with normal body weight were observed in 17 patients (44.7%), with excess body weight — in 14 people (42.4%), with obesity — in 16 people (64%), p = 0.031. Accurate difference values between the groups were obtained in terms of time index (TI) of SBP at night (p = 0.006). Time index of diastolic BP during the day > 50% was observed only in the obese children group — 4 people (16%) (p = 0.042). Pathological alleles of the angiotensinogen gene (AGT: 704 T>C), aldosterone synthase gene (CYP11B2: -344 C>T) and endothelial nitrogen synthase type 3 (NOS3: -786 T> C) were identified most frequently during genetic testing in some patients.CONCLUSION: Children with obesity developed earlier arterial hypertension compared to the same-age children with normal body weight and more often had unfavorable type of arterial hypertension according to BPDM. These results can be used to choose individual therapy and to develop special attention as regards certain target organs damage.
The article discusses the issues of steatohepatitis development, diagnosis, and management in children. Steatohepatitis is one of the forms of non-alcoholic fatty liver disease diagnosed in 12–26% of children with obesity. The major pathogenetic factors are the following: oxidative stress, genetic predisposition, microbiota disorders, vitamin D deficiency. The information on the diagnostic algorithm is presented in accordance with the guidelines of the European and North American Societies of Pediatric Gastroenterologists, Hepatologists and Nutritionists. The characteristics of instrumental methods of steatohepatitis diagnostics (biopsy, ultrasound, magnetic resonance and computed tomography, elastography, biochemical tests) are given, as well as indications for their use in children are determined. The data on steatohepatitis management (including diet and physical activity) is presented. The use of hepatoprotective agents (ursodeoxycholic acid, essential phospholipids) and biologically active substances in children is discussed.
Aim to find effective methods for detecting and preventing obesity at early age. Material and methods. A dataset including the risk factors for child obesity was processed with artificial neural networks (ANN) and Statistica Neural Networks software. Clinical observations of 30 patients were used. The neural network was trained to predict the risk of obesity in children depending on the values of the selected parameters: standard deviation of body mass index from the norm, sex, age, obesity in parents, birth weight, duration of breastfeeding, deviation of body fat tissue content from the norm, and deviation of nutrition calories from the recommended values. Results. After training, the neural network MLP-8-7-1 was selected due to its high coefficients of determination 0.999999; 0.999407; 0.984930 for the training, test and control samples, respectively. This indicates the high performance of the trained ANN, the adequacy of which was checked graphically by constructing a histogram of residuals the difference between the entered and received by the network values of the risk of obesity development in children. Conclusion. The trained neural network can be used to predict the degree of risk of obesity in children and develop the necessary preventive measures in patients from risk groups.
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