Hormonal and metabolic disturbances and their correction in children with obesity

Abstract

The paper deals with the prevalence and specific features of the metabolic syndrome (MS) in children with different forms of obesity and with the capacities of its correction. Ninety-eight children aged 9-17years, including 44 children with exogenous constitutional obesity and 54 with pubertal juvenile dyspituitarism, were examined. For the diagnosis of MS, clinical exami­nations methods were used. These included: estimation of the body mass index, circumferences of the waist and hips, their ra­tio, the levels of total cholesterol, triglycerides, coagulogram, fasting insulin, the routine glucose tolerance test, and fasting glucose/insulin ratio. The incidence of MS in obese children was 42.9%. A combination of 5 components of MS, such as in­sulin resistence, abdominal obesity, hyperlipidemia, hyperco- agulative changes, and aterial hypertension, was noted in 23.8% of the children and that of 4 and 3 (incomplete MS) components in different combinations was in 52.4 and 23.8%, respectively.

The combined therapy low-calorie diet and metformin (Siofor, Berlin-Chemie) was used to correct the metabolic disturbances detected in 28 children aged above 13 years. The use of Siofor in children with MS, unlike dietary monotherapy, substantially improved the values of total cholesterol, fibrinogen, and blood pressure and normalized a response to glycemic load in most patients