Combined damage to the pancreas and thyroid glands in children with obesity and metabolic syndrome

Abstract

There is a functional relationship between the thyroid (thyroid) and pancreatic (pancreatic) glands and a high frequency of combined lesions of these organs. The purpose of the study: to assess the morphofunctional state of the pancreas and thyroid in obese children complicated by metabolic syndrome.Materials and methods. 483 children with various forms and degrees of obesity aged from 6 to 15 years were examined. Group I — 237 children with obesity complicated by MS, group II — 246 children with obesity without signs of MS. A complex of clinical, laboratory and instrumental examination methods was carried out according to standard and author’s methods. Results. The majority of children of both groups have various changes in the structure of the pancreas. The postprandial reaction in group I was lower than in group II, and in 17% of children in group I it was less than 5%. A tendency to increase the level of glucose, insulin and the index НОМА was established as the postprandial reaction of the pancreas decreased. Changes in the lipid spectrum of the blood were revealed depending on the postprandial reaction of the pancreas. Regardless of the group, the thyroid volume and thyroid hormone levels in most children corresponded to the normative values. Diff use increase in thyroid was detected in 11% of group I children and 4% of group II children. The data indicating the relationship of structural and functional disorders of the pancreas and thyroid gland were obtained. In children with increased thyroid volume, the size of the pancreatic head on an empty stomach was significantly higher than in children with normal thyroid sizes. With a change in the thyroid gland, more pronounced violations of the functional activity of the pancreas were recorded.Conclusions. In the absolute majority of obese children, regardless of the presence of MS, various structural changes of the pancreas are detected. The most pronounced disorders of the functional state of the pancreas are diagnosed in children with obesity complicated by MS. In 17% of children with MS, there is a significant decrease (less than 5%) of the postprandial reaction of the pancreas, indicating a decrease in adaptive capabilities and the development of a chronic inflammatory process in the pancreas. With a decrease in the postprandial reaction of the pancreas, more pronounced disorders of the carbohydrate and lipid spectrum of the blood serum are noted. Diff use increase in thyroid in children with MS was recorded 2.5 times more often. A tendency to the formation of dysthyroidism with a multidirectional change in the levels of thyroid and thyroid- stimulating hormones has been established. In children with increased thyroid volume, the size of the pancreatic head on an empty stomach was significantly higher than in children with normal thyroid sizes. At the same time, more pronounced violations of the functional activity of the pancreas were recorded in the form of a decrease in the postprandial reaction.