Abstract
Introduction. During the last twenty-five years the occurrence of obesity in children and teenagers has increased significantly. Materials and methods. 110 adolescents of 12–17 years old, with alimentary-constitutional obesity and involvement of pancreas and without its injury, as compared to the 30 healthy children of control group, were examined. The research provided determination of the sizes and elasticity of pancreas. The detection of the total cholesterol, high density lipoproteins and leptin level was carried out. Intensity of clinical symptoms (spastic pain in epigastrium and left subcostal arc; abdominal pain without localization, vomit without relief, general weakness) have been made accordingly to sum of points (from 0 to 3 points). If sum of points makes from 0 to 2 – intensive character of abdominal pain is low, from 3 to 5 points – it is high, from 5 to 10 points – it is very high. Normal level of amylase in a blood serum (Karavey’s method) is 12–32 g/(hour l), аnd diastase in urine – 20–160 g/(hour l). We made a screening test for elastase-I level by ELISA test. Normal activity of this enzyme in feces is 200 мkg/g. We have used sonographic method for detection of pancreatic diseases in obese children due to echo-structure of parotid gland. The analysis and statistical data processing were made by computer program "Statistica 7.0" and MS Excel XP. Research data. Physical inspection of our patients confirms prevalence of І degree over II degree obesity (52.7 % and 47.3 %, respectively; Р < 0.05). We have confirmed valid risk factor of pancreatic lesion in obese children – presence of diabetes mellitus type I in close relatives (80 % and 65 %, χ2 = 2,05; Р < 0.05). The changes of exocrine function of the pancreas in children with the stage II obesity were established. Echographic signs of the pancreas lesion in teenagers with obesity indicate the presence of functional changes: edema of head or entire edema, partial increase of parenchymal echogenicity, insufficient enlargement of the duct of Wirsung.
Highlights
During the last twenty-five years the occurrence of obesity in children and teenagers has increased significantly
Показатели фекальной эластазы-1 в зависимости от степени ожирения у детей с коморбидной патологией по сравнению со здоровими детьми (М ± m)
Echographic signs of the pancreas lesion in teenagers with obesity indicate the presence of functional changes: edema of head or entire edema, partial increase of parenchymal echogenicity, insufficient enlargement of the duct of Wirsung
Summary
НАРУШЕНИЕ ЭКЗОКРИННОЙ ФУНКЦИИ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ У ДЕТЕЙ, БОЛЬНЫХ ОЖИРЕНИЕМ: ОСОБЕННОСТИ КЛИНИЧЕСКОЙ КАРТИНЫ И ДИАГНОСТИКИ. Обследовано 110 подростков в возрасте 12–17 лет, больных алиментарно-консти туционным ожирением в сочетании с поражением поджелудочной железы (ПЖ) и без его признаков, а также для сравнения 30 практически здоровых детей того же возраста (группа контроля). Ранние признаки поражения ПЖ наблюдались у 65,7 % мальчиков с ожирением, с продолжительностью основного заболевания 5–10 лет. Цель исследования – изучить особенности экзокринной функции подже лудочной железы у детей с ожирением. «Об утверждении протоколов ока зания медицинской помощи детям по специальности «Детская эндокринология», а сопутствующего функционального панкреатического расстройства – согласно приказу Минздрава Украины No 59 от 29.01.2014 г. Чаще всего ранние признаки поражения ПЖ наблюдались у 65,7 % маль чиков с ожирением, с продолжительностью основного заболевания от 5 до 10 лет
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