ОСОБЕННОСТИ ФАКТОРОВ РИСКА РАЗВИТИЯ КАРДИОВАСКУЛЯРНЫХ ОСЛОЖНЕНИЙ ПРИ ОЖИРЕНИИ У ДЕТЕЙ

Abstract

Introduction. The most common risk factors for the development of cardiovascular diseases are hypertension and obesity, which are formed in childhood, however, the most significant clinical and metabolic markers of cardiovascular risk have not yet been identified in pediatric practice. Aim. To study the characteristics and interrelations of cardiovascular risk factors in obese children and adolescents for planning correction at the stage of functional changes. Material and methods. The study included 141 obese children – 69 boys and 72 girls (in whom the degree of standard deviation of the body mass index was 2.88 [2.75; 3.41] and 2.93 [2.59; 4.05], respectively) and 78 healthy children (40 boys and 38 girls), comparable by sex and age. Results and discussion. In the examined children, there is an insufficient decrease in blood pressure at night from both systolic blood pressure and diastolic blood pressure, in the absence of clinically and statistically significant deviations in single measurements. The triglyceride-glucose index and the N-terminal inactive peptide of natriuretic hormone demonstrated high concentrations in normoglycemia and the absence of dyslipidemia. Against the background of obesity, trimethylaminoxide concentrations were lower than in healthy children. Conclusion. In order to timely correct blood pressure, it is necessary to use daily monitoring in obese children, even against the background of the absence of signs of arterial hypertension with single measurements. Even against the background of lean normoglycemia in obese children and adolescents, it is advisable to diagnose the formation of insulin resistance and hyperinsulinemia using indicators of insulin levels, calculation of the HOMA-IR index, triglyceride-glucose index. Correction of blood pressure variability is possible with changes in certain parameters of body composition (decrease in fat mass and increase in muscle mass) and hormonal and metabolic parameters (decrease in glycemia, very low-density lipoproteins, insulin and increase in high-density lipoproteins). The level of trimethylaminoxide showed lower rates of obesity in children compared to healthy peers, which differs from the literature data on the adult population and limits its use as a biomarker for the development of cardiovascular complications in obesity in children