[State of the hepatobiliary system on the data of ultrasonic examination in children and adolescents with overweight and obesity].

Currently, a stable increase in the incidence of overweight and obesity is noted, this fact leads to an elevation in comorbidity with them. The relevance of the study is due to the involvement of the hepatobiliary system in the development of metabolic dysfunction and the formation of non-alcoholic fatty liver disease in the future. The aim of the research was to study the effect of overweight and obesity in children and adolescents on the state of the hepatobiliary system on the basis of ultrasound examination. Material and methods. A single-center retrospective comparative study was conducted. The main group consisted of 112 children and adolescents with Z-score body mass index (BMI) above +1SD, the comparison group consisted of 264 persons with a BMI from -2 to +1SD aged 5-17 years. An analysis of the results of anthropometric, including the assessment of BMI, ultrasound and biochemical studies was carried out. Results. The Z-score of BMI corresponding to overweight was recorded in 54 (13.8%) examined persons, and obesity - in 58 (14.8%) patients. In children of the main group, an increase in the size of the liver was recorded 3.6 fold more often, diffuse changes in the liver were revealed 32.4 fold more often, an increase in the volume of the gallbladder - 2.1 fold, signs of excessive aerocolia - 3.3 fold more often (p<0.001). In children with overweight and obesity, the level of triglycerides (p=0.003), low-density lipoprotein cholesterol (p=0.035), glucose (p=0.012), C-reactive protein (p=0.011), malon dyalldehyde (p=0.012), the activity of alaninaminotransferase (p<0.001) and alkaline phosphatase (p=0.001) were statistically significant, with a significantly lower level of high-density lipoprotein cholesterol (p<0.001). Statistically significant logistic models of the probability of an increase in the linear dimensions of the liver, diffuse changes, an increase in the volume of the gallbladder, the presence of excessive aerocolia signs from the Z-score BMI value were obtained. The Nigelkirk determination coefficient was 0.34, 0.17, 0.11 and 0.10 c.u. respectively. Conclusion. The contribution of overweight and obesity to the increase in the linear dimensions of the liver and the volume of the gallbladder, the formation of diffuse changes and excessive aerocolia according to the ultrasound examination was 10-34%.

[Substantiating reference values of active anterior rhinomanometry in children aged 4-14]. / Obosnovanie referensnykh znachenii perednei aktivnoi rinomanometrii u detei v vozraste 4­14 let.

RELEVANCE: Objective diagnostics of nasal breathing disorders in children is a vital issue given frequent inconsistency between patients' subjective feelings and actual nasal patency. Active anterior rhinomanometry (AAR) is an objective procedure and the golden standard for nasal breathing evaluation. But still, there are no actual data in literature on relevant criteria used to evaluate nasal breathing in children. OBJECTIVE: To determine reference values for indicators evaluated by active anterior rhinomanometry in Caucasian children aged 4-14 based on statistical data. MATERIAL AND METHODS: Overall, we examined 659 healthy children of both sexes who were divided into 7 groups as per their height. All children included into our research underwent AAR according to the conventional procedure. AAR indicators (Summary Flow left, Summary Flow right, Summary Flow, Summary Resistance left, Summary Resistance right and Summary Resistance Flow) are given as median (Me) and values of 2.5, 25, 75, and 97.5 percentiles. RESULTS: We determined direct moderate, significant and strong correlations between summary speed of the flow and resistance in both nasal passages and separate speeds of the flow and right and left resistance in inhalation and exhalation (r=0.46-0.98, p<0.001). We also established weak correlations between AAR indicators and age (r= -0.08-0.11), and between ARR indicators and height (r= -0.07-0.15). Reference values for AAR indicators were successfully determined. CONCLUSIONS: AAR indicators are likely to be determined bearing a child's height in mind. Determined reference intervals can be applied in clinical practice.

[Age and gender peculiarities of body composition in pupils according to bioelectrical impedance analysis].

The study is relevant due to insufficient diagnostic sensitivity of the body mass index to assess the risk of nutrition disorders and determine the range and the content of preventive measures. The aim of the research was to investigate age and gender characteristics of body composition indicators in schoolchildren according to bioimpedance analysis. Material and methods. 136 students of the city secondary school divided in four age groups (7-8, 10-11, 12-14, 15-17 years old) were examined, each group was divided into gender subgroups. All children underwent bio-impedance research using the analyzer ABC-01 «Medass¼. A comparative analysis of anthropometric data, absolute and relative average values of the main parameters of bio-impedance analysis and the frequency of deviation of the parameter from standard values was carried out. Results and discussion. Boys in the age group of 7-8 years showed a tendency to more frequent registration of both deficiency and excess body fat relative to girls (36 vs 8% and 36 vs 15%). The body composition of girls in this age group was characterized by higher values of the indicators of the development of musculoskeletal system. Children aged 10-11 years, demonstrated less sexual differentiation between indicators of fat metabolism; adipose tissue deficiency was detected with a frequency up to 13-20%, an excess - up to 40-47%. Girls were also characterized by higher parameters of skeletal muscle mass. In boys of the 12-14 year old age group, the average values of the phase angle, active cell mass and its proportion were statistically significantly lower than the similar indicators for girls. The most pronounced gender differences were found in children in the age group of 15-17 years. The average height and body weight of boys exceeded that of girls. The average values of the phase angle, lean mass, active cell mass, musculoskeletal mass and their proportion were statistically significantly higher in boys, against the background of lower parameters of fat metabolism relative to similar indicators of girls. A direct relationship of age with the proportion of skeletal muscle mass and the relative value of active cell mass in boys, and the proportion of fat mass in girls has been shown. It is noteworthy that the frequency of high values of the proportion of fat mass was up to 2.2 fold higher than the percentage of high values of the body mass index. Conclusion. In boys in the period from 7 to 17 years, there was observed an increase in indicators characterizing the level of motor activity and overall physical development, and in girls the prevalence of the adipose tissue excess and obesity increased.

[Peculiarities the main types of metabolism of students of middle educational institutions depending on the organization of the educational process and public catering].

Taking into account the fact that factors of intra-school environment are of great importance when forming health of pupils, this study aimed to investigate the main kinds of metabolism among pupils of secondary educational institutions depending on the organization of educational process and food services. MATERIAL AND METHODS: The observing group comprised of 137 students of Secondary School focusing on physico-mathematical sciences at the age of 12.9±1.3 years; the comparison group consisted of 131 students of Secondary School at the age of 12.7±1.2 years. To conduct a sociological study, a special questionnaire was developed, allowing to assess the socio-economic characteristics of the families of the surveyed pupils, the regularity and duration of sport activity, the time spent on compulsory and additional education, home nutrition, etc. The assessment of school meals was carried out using the menu-layouts (14-day approximate menu) and by individual weight method. Anthropometric measurements were conducted. Indicators of fat [total cholesterol, triglycerides, HDL, LDL, apolipoprotein A1 (ApoA1), ApoB and ApoB/ApoA1], protein (total protein, albumin), carbohydrate (glucose) and mineral metabolism (calcium, phosphorus, magnesium, iron) and blood serum concentration of dopamine, leptin and cortisol were determined by biochemical and ELISA methods. RESULTS AND DISCUSSION: When assessing the compliance of the educational regime with the requirements of Sanitary Regulations and Standards 2.4.2.2821-10 at school affording intensive study of various subjects the violations of hygienic requirements for scheduling lessons, the exceedance of weekly load, a large total workload calculated on the subject difficult scale were revealed. It was found out that students of school affording intensive study spend more time on school and out-of-school education while motor activity was significantly reduced. Up to 87.0% of children ate at home irregularly, dry, consumed fast food and snacks. Despite the possibility of choosing a dish the rations actually consumed at school affording intensive study didn't meet the average need for nutrients and energy during breakfast (25% of the established daily need), in terms of the content of macronutrients and energy by 20%, calcium and vitamin B1 by 45-55%, phosphorus by 39%, magnesium by 18%. At school focusing on physico-mathematical sciences the proportion of overweight children was 2.8-fold higher than in general school (19.0 vs 6.0%, OR=3.5, DI=1.4-9.6; p=0.01). The trend towards increased atherogenic structure of the lipid spectrum because of higher blood levels of LDL and lower levels of ApoA1 and HDL (p=0.004-0.02) has been found out. The established features of the main types of metabolism among pupils of school affording intensive study of various subjects have been associated with relatively high concentrations of cortisol, leptin and dopamine (p=0.0001-0.03) that indicated tension of neuroendocrine regulation. CONCLUSION: Intensification of the learning process in profiled schools in combination with a low level of physical activity, inadequate nutrition and eating disorders up to 3.5 times increases the risk of overweight in schoolchildren against the background of endocrine regulation stress.

[Lipid metabolism changes in population residing in area influenced by storage of ore-processing waste containing lead, cadmium and arsenic].

Clinical, laboratory and ultrasound examination covered features of lipid metabolism disorders in 137 adults and 170 children, neighbouring storage of ore-processing and extraction waste, in conditions of chronic exposure to metals from various sources (ambient air, water, foods). Findings are that children with higher serum levels of cadmium and arsenic (1.4-2.0 times vs. the reference group) demonstrated 2.2 times more frequent endocrine diseases, up to 2.7 times more frequent obesity related diseases, if compared to the reference group (OR = 2.74; DI = 1.05-7.14; p < 0.05). Chronic noncarcinogenous risk for endocrine system was characterized by jeopardy index (THI) 3.78 - unacceptable risk. With unacceptable risk due'to multi-source exposure to lead, cadmium and arsenic, the findings are: dysfunction of hypothalamus-pituitary-thyroid link, with activated free radical oxidation and accumulation of perioxidation products, depletion of antioxidant defence resources, disorders of neuromediator processes and lipid metabolism, with obesity formation (ICD: E67.8-66.0), mostly related to negative influence of arsenic (r = 0.37-0.59; p = 0.004-0.05).