[Biliary dysfunction in obese children].

To examine the state of the biliary system, a study of properties of bile "case-control") 100 children and adolescents aged 8 to 18 years, held checkup in consultative and diagnostic center for chronic gastroduodenitis. BMI children were divided into 2 groups: group 1-60 children with obesity (BMI of 30 to 40) and group 2-40 children with normal anthropometric indices. Survey methods included clinical examination pediatrician, endocrinologist, biochemical parameters (ALT, AST, alkaline phosphatase level, total protein, bilirubin, lipidogram, glucose, insulin, HOMA-index), ultrasound of the abdomen and retroperitoneum, EGD with aspiration of gallbladder bile. Crystallography bile produced by crystallization of biological substrates micromethods modification Prima AV, 1992. Obese children with chronic gastroduodenita more likely than children of normal weight, had complaints and objective laboratory and instrumental evidence of insulin resistance and motor disorders of the upper gastrointestinal and biliary tract, liver enlargement and biliary "sludge". Biochemical parameters of obese children indicate initial metabolic changes in carbohydrate and fat metabolism and cholestasis, as compared to control children. Colloidal properties of bile in obese children with chronic gastroduodenita reduced, as indicated by the nature of the crystallographic pattern. Conclusions: Obese children with chronic gastroduodenitis often identified enlarged liver, cholestasis and biliary dysfunction, including with the presence of sludge in the gallbladder; most often--hypertonic bile dysfunction. Biochemical features of carbohydrate and fat metabolism reflect the features of the metabolic profile of obese children. Crystallography bile in obese children reveals the instability of the colloidal structure of bile, predisposing children to biliary sludge, which is a risk factor for gallstones.

[Hepatic steatosis and fatty pancreas--2 targets of metabolic syndrom in children].

OBJECTIVES: This study aimed to assess frequency of association between hepatic steatosis and pancreatic steatosis in obese children and find out common chains of pathogenesis. METHODS: This study was conducted among 100 children aged 12-17 years, consisted 2 groups: 60 overweight children (BMI from 30,1 to 42,87-1st group) and 40 children with normal BMI (2nd group). Diagnosis of the hepatic steatosis and pancreatic steatosis was based on sonographic findings. Were investigated peculiarities of carbohydrates and lipid metabolism and pancreatic exocrine function. RESULTS: Sonographic findings compatible with pancreatic steatosis in obese children were found with frequency- 70%, whereas sonographic findings compatible with hepatic steatosis were found with frequency- 46.6%. These findings were associated with BMI, parameters of metabolic syndrome: waist circumference, insulinresistancy, disturbances of the carbohydrates and lipid metabolism. Was found decreasing level of the elastase-1 in children with obesity. CONCLUSION: In 70% obese children was found pancreatic steatosis. The presence of fatty pancreas represents a meaningful manifestation of metabolic syndrome together with obesity and hepatic steatosis.