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The first experience of using beta-hydroxybutyrate analysis of capillary blood in the diagnosis of non-diabetic hypoglycemia in adults 首次应用β -羟基丁酸分析毛细管血诊断成人非糖尿病性低血糖
Pub Date : 2022-08-03 DOI: 10.14341/omet12822
M. Yukina, E. Troshina, N. Nuralieva, N. Mokrysheva
Background: The diagnostic threshold of β-hydroxybutyrate (BHB) at the moment of hypoglycemia in insulinoma was developed for venous blood many years ago, when there were no alternative ways to measure ketones. Number of works, mainly on patients with diabetes mellitus, found differences in the measurement of this indicator in venous and capillary blood, but the results were contradictory. Moreover, this study was not previously used in the diagnosis of non-diabetic hypoglycemia (NDH) in adults on the territory of the Russian Federation.Aim: To estimate the effectiveness of the method for determining BHB in capillary blood and its place in the diagnosis of NDH.Materials and methods: We conducted an experimental, cross-sectional, comparative study and included patients with suspected NDH who underwent a standard fast test. The BHB level in capillary blood was determined every 6 hours during the fast test and at its completion.Results: Based on the results of the fast test, the participants (n=154) were divided into groups: with hyperinsulinemic variant of NDH and IFRoma (n=98; group 1), with hypoinsulinemic variant of NDH /absence of NDH (n=56; group 2). When comparing the level of BHB at the moment of fasting completion, significant differences were obtained between groups 1 and 2 (p<0.001). According to the ROC analysis, the determination of BHB for differentiation the hyper- and hypoinsulinemic variants of hypoglycemia is characterized by excellent quality of model (AUC=99,1% [98,0%; 100,0%]). The BHB determination in capillary blood has the maximum diagnostic accuracy at a cut-off point of ≤ 1.4 mmol/L (Se 98.0%, Sp 96.4%, PPV 98.0%, NPV 96.4%, Ac 97.4%). Exceeding the diagnostic threshold of BHB was first recorded after 24h of fasting; at the same point, a significant difference was determined when comparing BHB indicators between two consecutive measurements (between 18h and 24h).Conclusion: The BHB determination in capillary blood is a highly sensitive and highly specific additional method for the differential diagnosis of NDH variants. The diagnostic threshold for BHB of capillary blood, which allows differentiating hyper- and hypoketonemic variants of NDH, is ≤1.4 mmol / L. It is advisable to initiate control of BHB in the blood no earlier than 18 hours after the start of the fast test.
背景:胰岛素瘤低血糖瞬间β-羟基丁酸(BHB)的诊断阈值是多年前针对静脉血制定的,当时没有替代的酮类检测方法。以糖尿病患者为研究对象的大量研究发现,该指标在静脉血和毛细血管中的测量存在差异,但结果却相互矛盾。此外,该研究此前未用于俄罗斯联邦境内成人非糖尿病性低血糖(NDH)的诊断。目的:评价毛细管血BHB测定方法的有效性及其在NDH诊断中的地位。材料和方法:我们进行了一项实验性、横断面、比较研究,纳入了疑似NDH的患者,并进行了标准的快速检测。在快速试验期间和试验结束时,每6小时测定一次毛细血管血BHB水平。结果:根据快速试验结果,将参与者(n=154)分为两组:高胰岛素型NDH和IFRoma组(n=98);组1),伴有低胰岛素血症型NDH / NDH缺失(n=56;组2)。当比较禁食完成时刻BHB水平时,组1和组2之间有显著差异(p<0.001)。根据ROC分析,测定BHB鉴别低血糖的高、低胰岛素变体具有良好的模型质量(AUC=99,1% [98,0%;100年,0%)。毛细管血BHB检测在≤1.4 mmol/L的临界值下诊断准确率最高(Se 98.0%, Sp 96.4%, PPV 98.0%, NPV 96.4%, Ac 97.4%)。超过BHB诊断阈值首次记录于禁食24h后;在同一点,对比两次连续测量(18h和24h)的BHB指标时,可以确定显着差异。结论:毛细管血BHB检测是鉴别诊断NDH变异的一种高灵敏度、高特异性的附加方法。毛细管血BHB的诊断阈值≤1.4 mmol / l,可区分NDH的高、低酮血症变体。建议在快速检测开始后不早于18小时开始控制血液中BHB。
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引用次数: 0
Clinical and pharmacological basis of the use of testosterone drugs for hormonal replacement therapy for hypogonadism in men 睾酮药物用于男性性腺功能减退激素替代治疗的临床和药理学基础
Pub Date : 2022-08-03 DOI: 10.14341/omet12850
N. Volkova, A. Safronenko, E. Gantsgorn, Y. Degtyareva
Hypogonadism is a condition associated with a decrease in the functional activity of the testicles, accompanied by a decrease in the level of androgens and (or) a violation of the process of spermatogenesis. It is known that androgens and their main representative, testosterone, are of fundamental importance for the development and maintenance of the reproductive and sexual functions of the male reproductive system. At the same time, low testosterone levels are associated with both reproductive and metabolic disorders, including phosphorus-calcium, fat, carbohydrate, and protein metabolism. In addition, to date, data have been accumulated on the correlation of hypogonadism with cardiovascular diseases, which once again emphasizes the problem of testosterone deficiency, especially for patients of the middle and older age groups. However, carrying out testosterone replacement therapy always requires a strict and competent choice of a «target audience» among patients from a specialist. Today, on the pharmaceutical market, there is a wide arsenal of testosterone-containing drugs in various forms for use, which have an unequal «efficacy-safety» profile. In this review, we have analyzed modern approaches to the diagnosis and treatment of hypogonadism, the selection of a target group of patients to obtain the most effective and safe treatment outcome and described testosterone preparations and their dosage forms with potential advantages and disadvantages. Thus, the information presented in the article is aimed at optimizing the management of men with hypogonadism.
性腺功能减退症是一种与睾丸功能活动减少相关的疾病,伴随着雄激素水平下降和(或)精子发生过程受到干扰。众所周知,雄激素及其主要代表睾酮对男性生殖系统的生殖和性功能的发展和维持具有根本重要性。同时,低睾酮水平与生殖和代谢紊乱有关,包括磷钙、脂肪、碳水化合物和蛋白质代谢。此外,迄今为止,已经积累了性腺功能减退与心血管疾病相关性的数据,这再次强调了睾酮缺乏的问题,尤其是对于中老年组的患者。然而,进行睾酮替代治疗总是需要从专家那里严格而有能力地从患者中选择“目标受众”。如今,在制药市场上,有大量各种形式的含睾酮药物可供使用,这些药物的“疗效-安全性”参差不齐。在这篇综述中,我们分析了性腺功能减退症的现代诊断和治疗方法,选择目标人群以获得最有效和安全的治疗结果,并描述了睾酮制剂及其剂型的潜在优势和劣势。因此,本文提供的信息旨在优化男性性腺功能减退症的管理。
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引用次数: 1
Obesity and functional bowel disorders in adolescents: a pilot study 青少年肥胖和功能性肠病:一项初步研究
Pub Date : 2022-08-03 DOI: 10.14341/omet12803
L. Rychkova, A. Pogodina, A. Romanitsa, M. Savelkaeva
Background: Studies of the relationship between obesity and functional bowel disorders, carried out in different age groups, provide conflicting results. It remains unclear what factors are responsible for the transition from a tendency to constipation in children to a tendency to diarrhea in adults with obesity.Aim: To establish factors related to stool consistency as a surrogate marker of colon transit in adolescents with obesity.Materials and methods: A single-center observational cross-sectional study was carried out. We consecutively recruited adolescents, aged 11–17 years with obesity. Socio-demographic characteristics, lifestyle and nutritional characteristics were assessed using questionnaires. Bowel symptoms were assessed using questionnaires and interviews. Stool consistency was assessed using the Bristol Stool Form Scale. Serum concentrations of ALT, AST, bilirubin, cholesterol, glucose, HbA1c, leptin, and insulin were determined. The HOMA-IR index was used to determine insulin resistance.Results: One hundred and ten adolescents with obesity were enrolled in the study. Of these, 69.1% had a pathological consistency of feces, with the prevalence of forms characterizing delayed gut transit (49.1%). The predominance of loose stools was reported by 5.5% of patients. The combination of different forms of stool (unstable stool) was described by 14.5% of adolescents. Hard stools were common among adolescents from single-parent families and adolescents who rarely consume dairy products. The presence of loose stools has been associated with insulin resistance.Conclusion: Most obese adolescents who do not have abdominal complaints have colon transit disorders. Medical professionals should actively ask these patients about stool frequency and properties. With constipation, dietary correction is justified. Research is needed to investigate in-depth gut microbiota as a possible link between obesity and diarrhea.
背景:在不同年龄组中进行的关于肥胖和功能性肠道疾病之间关系的研究提供了相互矛盾的结果。目前还不清楚是什么因素导致了从儿童便秘倾向到成人肥胖腹泻倾向的转变。目的:探讨青少年肥胖患者粪便黏稠度相关因素作为结肠转运的替代指标。材料与方法:采用单中心横断面观察性研究。我们连续招募了11-17岁的肥胖青少年。通过问卷调查评估社会人口特征、生活方式和营养特征。通过问卷调查和访谈对肠道症状进行评估。使用布里斯托大便形式量表评估大便一致性。测定血清ALT、AST、胆红素、胆固醇、葡萄糖、糖化血红蛋白、瘦素和胰岛素浓度。HOMA-IR指数测定胰岛素抵抗。结果:110名肥胖青少年被纳入研究。其中,69.1%的粪便具有病理一致性,以肠道运输延迟为特征的形式普遍存在(49.1%)。5.5%的患者以稀便为主。14.5%的青少年出现不同形式的大便(不稳定大便)。硬便在单亲家庭和很少食用乳制品的青少年中很常见。稀便的出现与胰岛素抵抗有关。结论:大多数没有腹部疾病的肥胖青少年都有结肠运输障碍。医务人员应积极询问这些患者大便的频率和性质。对于便秘,饮食矫正是合理的。需要深入研究肠道微生物群作为肥胖和腹泻之间可能的联系。
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引用次数: 0
Endothelial dysfunction of the mesenteric arteries of rats in the early obesity induced by high-fat diet 高脂饮食致早期肥胖大鼠肠系膜动脉内皮功能障碍
Pub Date : 2022-08-03 DOI: 10.14341/omet12842
M. N. Pankova
Background: Disturbance of the morphological and functional properties of the vascular bed in obesity are a serious clinical problem. Basis to their development is endothelial dysfunction. The developed models of obesity in animals using various diets indicate a change in vascular reactivity, however, questions about the stage at which this occurs and what mechanisms are involved in this process remain open, while they are decisive for choosing the correct tactics for correcting dysfunctions.Aim: The aim of the present study is to determine the changes in acetylcholine (ACh)-induced vasodilation of isolated arteries from rats after six weeks of administration of a high-fat diet (HFD).Materials and methods: The experiments were performed on  Sprague-Dawley males, which at the age of 8 weeks were divided into 2 experimental groups that were treated for the next 6 weeks in the following manner: 1 - control) with standard dry food; 2 - a group fed with a HFD, the total amount of fat in which was 50%. At finish of the diet, the degree of obesity, biochemical parameters in the blood, and blood pressure were measured. Intravital microscopy of the rat mesentery with video recording was used to study the reactivity of the vessels. The contractile and relaxant responses of the vessels were determined by changes in their diameter.Results: The rats after treatment with the HFD (n=15) had higher body weight and amount of visceral fat, significantly increased blood triglycerides, moderate increases in glucose level in blood and systolic pressure compared with the control (n=15). Relaxation responses of mesenteric arteries, having a diameter of 140 to 300 μm in PSS, were recorded after precontraction by phenylephrine. A decrease in ACh-induced vasorelaxation was obtained, which manifests itself before the development of significant changes in carbohydrate metabolism. Incubation of drugs with the inhibitor of endothelial NO synthase L-NAME led to a pronounced weakening of relaxation in animals on a standard diet, and had little effect on vasodilation in the arteries of rats with the HFD. Vasodilation induced by the administration of sodium nitroprusside (NO donor) did not differ significantly in control and experimental animals, which indicates that the sensitivity of vascular smooth muscle to NO remained practically unchanged. ACh-induced relaxation of arteries in dietary rats did not change when the cyclooxygenase pathway was blocked by diclofenac.Conclusion: Functional changes in the contractile activity of the mesenteric arteries, manifested in the form of a decrease in ACh-induced vasorelaxation, occur after treatment with the HFD when animals had an early stage of obesity development before the onset of pronounced disorders of carbohydrate metabolism. This decrease is mainly due to the disruption of the NO-dependent mechanism underlying ACh-induced relaxation in the norm.
背景:肥胖患者血管床形态和功能紊乱是一个严重的临床问题。其发展的基础是内皮功能障碍。使用不同饮食的动物肥胖模型表明血管反应性发生了变化,然而,关于这种变化发生的阶段和这一过程中涉及的机制的问题仍然是开放的,而它们对于选择正确的策略来纠正功能障碍是决定性的。目的:本研究的目的是确定大鼠高脂饮食(HFD)六周后乙酰胆碱(ACh)诱导的离体动脉血管舒张的变化。材料与方法:选取8周龄的Sprague-Dawley雄性雄性进行试验,随机分为2个试验组,在接下来的6周内按以下方式进行处理:1组(对照)饲喂标准干粮;2 -高脂肪饲料组,脂肪总量为50%。在饮食结束时,测量肥胖程度、血液生化参数和血压。采用大鼠肠系膜活体显微术和录像技术研究血管的反应性。血管的收缩和舒张反应由其直径的变化决定。结果:与对照组(n=15)相比,经HFD治疗的大鼠(n=15)体重和内脏脂肪量增加,血甘油三酯明显升高,血葡萄糖水平和收缩压中度升高。用苯肾上腺素预收缩PSS中直径为140 ~ 300 μm的肠系膜动脉后,记录其松弛反应。在碳水化合物代谢发生显著变化之前,乙酰胆碱引起的血管松弛有所减少。与内皮NO合成酶L-NAME抑制剂的药物孵育导致标准饮食动物的松弛明显减弱,并且对HFD大鼠动脉的血管舒张作用很小。硝普钠(NO供体)诱导的血管舒张在对照动物和实验动物中无显著差异,表明血管平滑肌对NO的敏感性基本保持不变。双氯芬酸阻断环氧化酶途径后,膳食大鼠的动脉松弛无明显变化。结论:在动物出现明显的碳水化合物代谢紊乱之前,当动物处于早期肥胖发展阶段时,用HFD治疗后,肠系膜动脉收缩活动的功能改变,表现为乙酰胆碱引起的血管松弛减少。这种减少主要是由于正常情况下乙酰胆碱引起的松弛所依赖的一氧化氮依赖机制被破坏。
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引用次数: 0
Endocrine disorders in the background of COVID-19 and postcovid syndrome 新冠肺炎及后综合征背景下的内分泌紊乱
Pub Date : 2022-07-15 DOI: 10.14341/omet12853
Александр Алексеевич Белоглазов, А. Яцков, Anastasia V. Klimchuk, V. Beloglazov, I. Yatskov, Y. V. Dvoryanchikov, S. Georgievsky
The SARS-CoV-2 virus that caused the 2019 new coronavirus infection (COVID-19) pandemic has posed an unprecedented challenge to the global health system and scientific community. As of this literature review, the infection has claimed more than 6 million lives, and more than 500 million people worldwide have already been infected with SARS-CoV-2. In addition to the basic, pulmonary manifestations of the disease, as well as the severe, life-threatening complications of acute COVID-19, the long-term changes that occur in the postcovid period also affect other systems: endocrine, cardiovascular, nervous, and musculoskeletal. In this literature review, using data from current scientific publications obtained by searching «covid-19 endocrine disorders», «postcovid endocrine disorders» and «postcovid syndrome endocrine disorders» in the MEDLINE (PubMed) database and «endocrine pathology and covid-19», «postcovid and endocrine pathology» and «postcovid syndrome and endocrine disorders» in the e-Library database, we focused on describing and discussing the complications and consequences that SARS-CoV-2 infection can have on the endocrine glands, including the adrenals, thyroid, pituitary, gonads and pancreas.
引发2019年新型冠状病毒感染(COVID-19)大流行的SARS-CoV-2病毒给全球卫生系统和科学界带来了前所未有的挑战。截至本文献综述,这种感染已经夺去了600多万人的生命,全球已有超过5亿人感染了SARS-CoV-2。除了基本的肺部表现以及严重的危及生命的急性COVID-19并发症外,COVID-19后期间发生的长期变化还会影响其他系统:内分泌、心血管、神经和肌肉骨骼。在本文献综述中,通过检索MEDLINE (PubMed)数据库中的“covid-19内分泌紊乱”、“covid-19后内分泌紊乱”和“covid-19后综合征内分泌紊乱”以及e-Library数据库中的“内分泌病理学和covid-19”、“covid-19后和内分泌病理”和“covid-19后综合征和内分泌紊乱”获得当前科学出版物的数据,我们重点描述和讨论了SARS-CoV-2感染对内分泌腺(包括肾上腺、甲状腺、垂体、性腺和胰腺)可能产生的并发症和后果。
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引用次数: 0
Comparison of the accuracy of resting energy expenditure assessment using bioimpedance analysis and indirect respiratory calorimetry in children with simple obesity 单纯性肥胖儿童静息能量消耗评价的生物阻抗分析与间接呼吸量热法的准确性比较
Pub Date : 2022-07-15 DOI: 10.14341/omet12823
P. Okorokov, O. Vasyukova, O. Bezlepkina
Background: Assessment of resting energy expenditure (REE) is necessary for the formation of a diet for obesity patients. The «gold standard» for assessment of resting energy expenditure (REE) is indirect respiratory calorimetry. Currently, bioimpedance analyzers are increasingly being used in clinical practice to assess energy consumption at rest, including in obese children. However, the accuracy of such an assessment remains unclear.Aims: To determine the accuracy of the assessment of resting energy expenditure using bioimpedance analysis in children with simple obesity compared with indirect respiratory calorimetry.Materials and methods: Resting energy expenditure was assessed by bioimpedance analysis, Harris-Benedict formula and indirect respiratory calorimetry in all obese children. Comparability of methods was assessed using the Bland-Altman analysis.Results: The study included 320 children aged 7 to 17 years with simple obesity.Resting energy expenditure assessed by bioimpedance analysis was on average 232 kcal lower than the actual. A significant CI (-448 to 912 kcal) was revealed, as well as a large LOA from -514 to 979 kcal. REE calculated by the Harris-Benedict formula on average corresponded to the actual one, and CI varied from -38 to 27 kcal. However, large LOA from -514 to 979 kcal, indicating a high individual variability of resting energy consumption.Conclusions: Bioimpedance analyzers underestimate REE in obese children compared to indirect respiratory calorimetry and the Harris-Benedict formula. Given the significant discrepancies in the accuracy of REE assessment, bioimpedance analysis cannot be considered as an alternative to indirect respiratory calorimetry to assess resting energy in children with simple obesity.
背景:评估静息能量消耗(REE)对于肥胖患者饮食的形成是必要的。评估静息能量消耗(REE)的“金标准”是间接呼吸量热法。目前,生物阻抗分析仪越来越多地用于临床实践,以评估休息时的能量消耗,包括肥胖儿童。然而,这种评估的准确性尚不清楚。目的:与间接呼吸量热法比较,确定单纯性肥胖儿童静息能量消耗的生物阻抗分析的准确性。材料和方法:采用生物阻抗分析、Harris-Benedict公式和间接呼吸量热法评估所有肥胖儿童的静息能量消耗。采用Bland-Altman分析评估方法的可比性。结果:该研究包括320名7至17岁的单纯性肥胖儿童。生物阻抗分析评估的静息能量消耗平均比实际低232千卡。在-448 ~ 912 kcal之间存在显著的CI值,LOA值在-514 ~ 979 kcal之间,根据Harris-Benedict公式计算的REE值与实际REE值基本一致,CI值在-38 ~ 27 kcal之间,但LOA值在-514 ~ 979 kcal之间存在较大的个体差异,表明静息能量消耗存在较大的个体差异。结论:与间接呼吸量热法和Harris-Benedict公式相比,生物阻抗分析仪低估了肥胖儿童的REE。鉴于REE评估的准确性存在显著差异,生物阻抗分析不能作为间接呼吸量热法评估单纯性肥胖儿童静息能量的替代方法。
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引用次数: 0
Fighting obesity as a direction of national health care development 与肥胖作斗争是国家医疗保健发展的方向
Pub Date : 2022-05-20 DOI: 10.14341/omet12865
N. Mokrysheva
.
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引用次数: 0
Fast food and obesity: risks to children and adolescents? 快餐与肥胖:对儿童和青少年的风险?
Pub Date : 2022-05-04 DOI: 10.14341/omet12755
A. S. Tsutiyeva, F. Dzgoeva
In the modern world, fast food is becoming part of the food culture; herewith, children and teenagers are no exception. A fairly busy lifestyle and lack of time contribute to an increasingly frequent appeal to fast food outlets. Given the national health policies of many countries, including those aimed at keeping up and supporting healthy lifestyles among children and adolescents, the researchers are increasingly focusing on the dependence of obesity on the younger generation’s fascination with fast food. In the proposed review, the authors have analyzed the published data represented in the studies at various levels and regarding a few problems. They are: the establishment of the relationship between a systematic intake of fast food and obesity among children and adolescents; the influence of the distance of fast food outlets from educational institutions on the occurrence and development of metabolic pathologies. Taking into consideration the relationship between fast food consumption by children and adolescents, parents and schools should strictly control their intake of unhealthy foods that leads to the weight gain and obesity-related diseases. Stopping marketing of junk food targeted at kids with eye-catching advertising personalities and gifts, could be one of the ways of childhood’s nutrition revitalizing. 
在现代世界,快餐正成为饮食文化的一部分;在这里,儿童和青少年也不例外。繁忙的生活方式和缺乏时间导致快餐店越来越受欢迎。鉴于许多国家的国家卫生政策,包括旨在保持和支持儿童和青少年健康生活方式的政策,研究人员越来越关注肥胖对年轻一代对快餐的迷恋的依赖。在拟议的综述中,作者分析了研究中代表的不同层次和几个问题的已发表数据。它们是:确定儿童和青少年系统性摄入快餐与肥胖之间的关系;快餐店与教育机构的距离对代谢疾病发生和发展的影响。考虑到儿童和青少年快餐消费之间的关系,家长和学校应严格控制不健康食品的摄入,这些食品会导致体重增加和肥胖相关疾病。停止针对具有引人注目的广告个性和礼物的儿童的垃圾食品营销,可能是振兴儿童营养的方法之一。
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引用次数: 0
Characteristics of blood pressure level in children with different body weight 不同体重儿童血压水平的特点
Pub Date : 2022-04-18 DOI: 10.14341/omet12721
T. V. Chubarov, V. Peterkova, G. Batischeva, O. Zhdanova, O. G. Sharshova, A. I. Artyushchenko, A. V. Bessonova
BACKGROUND: Essential arterial hypertension (AH) develops more often in children with accompanying risk factors — obesity, overweight, positive heredity and genetic predisposition.AIM: Study of peculiarities of arterial hypertension clinical course in adolescents with normal body weight, overweight and obesity.MATERIALS AND METHODS: The study was conducted on children with arterial hypertension who received treatment in two hospitals in Voronezh in 2016–2020. A retrospective analysis of the children’s case histories was carried out taking into account the anamnesis, clinical laboratory and instrumental examination data and the pharmacotherapy. Some children underwent polymerase chain reaction genetic testing to determine pathological alleles of genes regulating blood pressure (BP).RESULTS: 96 patients aged 9 to 17 took part in the study. The group with normal body weight included 38 children (39.6%), median age 16.4 (aged 10.7; 17.9), with overweight — 33 people (34.4%), median age 15.2 (aged 12.0; 17.9), with obesity — 25 children (26.0%), median age 14.5 (aged 9.2; 17.9). Obese children developed arterial hypertension at earlier age (p = 0.023). According to blood pressure daily monitoring (BPDM), pathological values of systolic blood pressure (SBP) during the day (above the 95th percentile) among children with normal body weight were observed in 17 patients (44.7%), with excess body weight — in 14 people (42.4%), with obesity — in 16 people (64%), p = 0.031. Accurate difference values between the groups were obtained in terms of time index (TI) of SBP at night (p = 0.006). Time index of diastolic BP during the day > 50% was observed only in the obese children group — 4 people (16%) (p = 0.042). Pathological alleles of the angiotensinogen gene (AGT: 704 T>C), aldosterone synthase gene (CYP11B2: -344 C>T) and endothelial nitrogen synthase type 3 (NOS3: -786 T> C) were identified most frequently during genetic testing in some patients.CONCLUSION: Children with obesity developed earlier arterial hypertension compared to the same-age children with normal body weight and more often had unfavorable type of arterial hypertension according to BPDM. These results can be used to choose individual therapy and to develop special attention as regards certain target organs damage. 
背景:原发性动脉高压(AH)更常见于伴有肥胖、超重、阳性遗传和遗传易感性等危险因素的儿童。目的:研究正常体重、超重和肥胖青少年动脉高压临床病程的特点。材料和方法:该研究针对2016年至2020年在沃罗涅日两家医院接受治疗的动脉高压儿童。对儿童的病史进行了回顾性分析,考虑了病史、临床实验室和仪器检查数据以及药物治疗。一些儿童接受聚合酶链式反应基因检测,以确定调节血压(BP)基因的病理等位基因。结果:96名年龄在9-17岁的患者参加了本研究。体重正常的组包括38名儿童(39.6%),中位年龄16.4岁(10.7岁;17.9岁),超重33人(34.4%)、中位年龄15.2岁(12.0岁;179岁)、肥胖25名儿童(26.0%)、中名年龄14.5岁(9.2岁;179.)。肥胖儿童在早期出现动脉高血压(p=0.023)。根据血压每日监测(BPDM),在体重正常的儿童中,观察到17例(44.7%)、14例(42.4%)超重儿童和16例(64%)肥胖儿童白天收缩压(SBP)的病理值(高于第95百分位),p=0.031。夜间SBP时间指数(TI)在两组之间获得了准确的差异值(p=0.006)。白天舒张压时间指数>50%仅在肥胖儿童组中观察到——4人(16%)(p=0.042)。血管紧张素原基因的病理等位基因(AGT:704 T>C),醛固酮合酶基因(CYP11B2:-344 C>T)和内皮氮合酶3型(NOS3:-786 T>C)在一些患者的基因检测中最常见。结论:与体重正常的同龄儿童相比,肥胖儿童患动脉高压的时间更早,根据BPDM,肥胖儿童更容易患上不良类型的动脉高压。这些结果可用于选择个体治疗,并对某些靶器官损伤给予特别关注。
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引用次数: 1
Association of rs7903146 TCF7L2, rs1042714 ADRB2 with the changes in body fat mass in different types of therapy of early carbohydrate metabolism disorders rs7903146 TCF7L2、rs1042714 ADRB2与早期碳水化合物代谢紊乱不同类型治疗中体脂质量变化的相关性
Pub Date : 2022-04-18 DOI: 10.14341/omet12807
F. Valeeva, M. S. Medvedeva, T. Kiseleva, K. B. Khasanova, G. F. Gabidinova
BACKGROUND: Depending on the polymorphism of genes that that are involved in metabolism, the response of patients to different types of therapy may differ. Despite the potential effect of rs7903146 TCF7L2 and rs1042712 ADRB2 on changes in body composition in different types of therapy of early carbohydrate metabolism disorders, these associations haven’t been studied yet. AIM: To study the influence of rs7903146 TCF7L2, rs1042714 ADRB2 on changes in body fat composition in different types of therapy of early carbohydrate metabolism disorders.MATERIALS AND METHODS: The study involved patients with overweight or obesity and risk factors for Type 2 Diabetes development. All patients underwent genotyping with the real-time polymerase chain reaction, oral glucose tolerance test and bioimpedancemetry. Further, the patients were divided into two groups. First group kept a diet with the exclusion of simple and limitation of complex carbohydrates and fats. Second group took metformin in addition to the diet. Three months after bioimpedancemetry was performed again.RESULTS: The research involved 73 patients (the mean age 48±12 y.o., the mean BMI 34,27±6,18 kg/m2 ). The diet therapy group consisted of 47 people. Other 26 patients took metformin in addition to the diet. In group of diet, T allele carriers of rs7903146 TCF7L2 were characterized with more decrease in fat mass compared with CC homozygotes (- 7.90 ± 9.46% vs. -1.54 ± 8.98%, p = 0.027). CC genotype carriers of rs7903146 TCF7L2 in group of metformin and the diet had a tendency for more decrease in hip circumference compared with T allele carriers (-4.95 ± 3.34% vs. — 2.5 ± 2.96%, p = 0.064). Carriers of C allele in homozygous state of rs1042714 ADRB2, who took metformin with the diet, demonstrated more decrease in hip circumference (- 5.81 ± 3.00% vs. -2.50 ± 2.7%, p = 0.009), the tendency for decrease in fat mass (-8.28 ± 8.86% vs. — 3.20 ± 5.09%, p = 0.068) and waist circumference (-5.91 ± 4.29% vs. -3.03 ± 4.01 %, p = 0.091) compared with G allele carriers. The association of rs7903146 TCF7L2 and rs1042714 ADRB2 with changes in total body weight was not observed (p> 0.05).CONCLUSION: Single nucleotide polymorphisms rs7903146 TCF7L2 and rs1042714 ADRB2 influence on body fat composition in patients with early carbohydrate metabolism disorders in various types of treatment. 
背景:根据参与代谢的基因的多态性,患者对不同类型治疗的反应可能不同。尽管rs7903146 TCF7L2和rs1042712 ADRB2在不同类型的早期碳水化合物代谢障碍治疗中对身体成分变化的潜在影响,但这些相关性尚未得到研究。目的:研究rs7903146 TCF7L2、rs1042714 ADRB2对早期碳水化合物代谢紊乱不同治疗方法中体脂组成变化的影响。材料和方法:该研究涉及超重或肥胖患者和2型糖尿病的危险因素。所有患者均采用实时聚合酶链式反应、口服葡萄糖耐量试验和生物阻抗测试进行基因分型。此外,将患者分为两组。第一组保持饮食,排除简单和限制复杂的碳水化合物和脂肪。第二组除饮食外还服用二甲双胍。再次进行生物阻抗测定三个月后。结果:研究涉及73名患者(平均年龄48±12岁,平均BMI 34,27±6,18 kg/m2)。饮食治疗组由47人组成。其他26名患者除饮食外还服用了二甲双胍。在饮食组中,与CC纯合子相比,rs7903146 TCF7L2的T等位基因携带者的脂肪量减少更多(-7.90±9.46%对-1.54±8.98%,p=0.027)。二甲双胍组和饮食组中rs7903146TCF7L2 CC基因型携带者的臀围比T等位素携带者有更大的下降趋势(-4.95±3.34%对-2.5±2.96%,p=0.064)与G等位基因携带者相比,rs1042714-ADRB2纯合状态的等位基因在饮食中服用二甲双胍时,显示出臀围(-5.81±3.00%对-2.50±2.7%,p=0.009)、脂肪量(-8.28±8.86%对-3.20±5.09%,p=0.068)和腰围(-5.91±4.29%对-3.03±4.01%,p=0.091)下降的趋势。rs7903146 TCF7L2和rs1042714 ADRB2与总体重变化无相关性(p>0.05)。
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Obesity and Metabolism-Milan
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