LABORATORY DIAGNOSTICS OF DISORDERS OF CARBOHYDRATE METABOLISM BEFORE THE ONSET OF CLINICAL SINGS AND COMPONENTS OF METABOLIC SYNDROME IN CHILDREN AT DIFFERENT STAGES OF OBESITY
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2020.1.10909Keywords:
metabolic syndrome, obesity, carbohydrate metabolism, glucose tolerance testAbstract
The cumulative metabolic disorders are the foundation for the formation of metabolic syndrome components in obese children. That fact is at the centre of the understanding of the critical role of child obesity in the development of pronounced clinical manifestations of metabolic syndrome in adults, although early signs can be detected and corrected in children.
The aim of the study – to determine disorders of carbohydrate metabolism before the onset of clinical signs and components of metabolic syndrome in children at different stages of obesity.
Materials and Methods. We’ve examined 37 children with a constitutional-exogenous obesity and metabolic syndrome. Laboratory tests of lipid metabolism, transaminases, oral glucose tolerance test (OGTT) and intravenous glucose tolerance test (IVGTT) have been conducted.
Results. According to the study in children in the early stages of obesity, there have already been significant changes in lipid metabolism, leading to the development of metabolic syndrome. А qualitative assessment of insulin resistance in children with obesity of the first and second degrees, the most pronounced changes were recorded. Statistically significant was the increase in ALT and AST at the first degree of obesity (p <0.05), which causes the strain on the heart and liver at early obesity, thus increasing the risk of pathologies leading to metabolic syndrome. In the group of persons with moderate impairment of carbohydrate metabolism, a decrease in the rate of hepatic glucose production was observed compared with the group of patients with obesity and normal carbohydrate metabolism. The decrease in the rate of elimination of glucose in the blood in the group with moderate impairment of carbohydrate metabolism was more pronounced and statistically significant compared with patients with obesity, but without these disorders (p <0.05) and the control group (p <0.05).
Conclusions. Patients showed high frequency of all components of metabolic syndrome. We found a high level of glycemia at the 20 minute of the test (degrees 3 and 4 of obesity), a decrease in the rate of decline in glucose level and a high postprandial blood glucose concentration in case of initial carbohydrate metabolic disturbances according to the IVGTT.
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