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    Lembryk I. S., Tymoshchuk O. V., Kocherga Z. R.

    CONDITION OF THE MICROCIRCULATION IN ADOLESCENTS WITH OBESITY AND CONCOMITANT INVOLVEMENT OF THE PANCREAS: MODERN LOOK AT THE PROBLEM AND OUR OWN CLINICAL SUPERVISION


    About the author: Lembryk I. S., Tymoshchuk O. V., Kocherga Z. R.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation In view of worldwide burden of obesity, triggers leading to it in children and adolescents have to be urgently identified. Publications of recent years reveal the important pathogenetic role of the pancreas in regulation and activity of the microcirculation, at the level of target organs due to future appearance of abdominal ischemic syndrome, and in general, systemic atherosclerosis. Microcirculation (in particular, arterioles, capillaries and venules) is conceivably a key compartment or “special mirror” determining the situation in a whole organism. It is confirmed, that indirect methods of investigation of microcirculation are not known since nowadays. Objectives of the study: to improve condition of the microcirculation in adolescents with alimentary-constitutional obesity with involvement of the pancreas. Materials and methods of investigation. The article presents data on the state of microcirculation in 120 adolescents with primary obesity combined with functional pancreatic disorder and without it, as well as in 30 adolescent control groups. All children were examined in accordance with modern diagnostic and treatment protocols. During the work, the basic principles of bioethics were adhered to: informed consent was received from one parent (mother) for the participation of the child in the study, adhered to the basic principles of the Helsinki Declaration (1975 with its subsequent revision in 2000). During the conduction of scientific research, no biological experiment was conducted involving vertebrate animals. The min principles of bioethics were followed. Results of the investigation. According to our data, alimentary-constitutional obesity in adolescence is accompanied by pancreatic lesion more frequently (54.2% and 45.8%, p> 0.05). The combined pathology of the digestive system predominantly affects boys (61.5% and 38.5%, p <0.05). The prevalence of ailment before the time of hospitalization in most of the examined children with combined pathology is 6.0 ± 2.1% years, and in the case of an isolated course of the disease - 4.5 ± 3.1% years. Among the symptoms of pancreatic damage in obese children, pain in the left hypochondrium lasting several hours and poorly removed by spasmolytics (76.9% and 21.8%, χ2 = 17.69, p <0.05) was the most common. The duration of the disease in patients with this co-morbidity was 6.0 ± 2.1% years. These children also represent signs of insulin resistance (HOMA index was more than 3.5 U.S.), an increase in Hipstick / Waistline of more than 0.7, and an increased BMI of 26.0 ± 0.1.Violation of the exo-and endocrine functions of the pancreas is also noted in adolescents with a combined course of obesity. Among violations of microcirculation, according to biomicroscopy data of bulbar conjunctiva, extravascular disorders of microcirculation (the appearance of hemorrhages and perivascular edema) are more frequent than in the case of isolated pathology (64.6 ± 1.2% and 41.8 ± 2.3%, p < 0.05). Among the vascular disorders, the tortuosity of venules and capillaries (in 70.2 ± 5.2% of cases), the unevenness of the caliber of vessels (52.0 ± 8.2% of cases), the reduction of the arteriolo-venular coefficient to 1: 4 were more often considered. Alimentary-constitutional obesity is often accompanied by lesions of the pancreas with a pronounced clinic, a violation of the exo- and endocrine functions of the pancreas. In combined pathology, extra-vascular microcirculatory disorders, such as hemorrhages and edema, are more often noted.
    Tags adolescents, obesity, pancreas, microcirculation, diagnostics
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    Publication of the article «World of Medicine and Biology» №1(63), 2018 year, 042-046 pages, index UDK 616-056.52+616.37+613.96
    DOI 10.26724/2079-8334-2018-1-63-42-46