CLINICAL PORTRAIT OF A PUBERTY GIRL WITH NON-ALCOHOLIC FAT LIVER DISEASE AND METABOLIC UNHEALTHY OBESITY
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i4.11768Keywords:
obesity, non-alcoholic fatty liver disease, body composition, metabolic syndrome, liver enzymes, lipid metabolismAbstract
SUMMARY. In Ukraine, 10 % of the child population is overweight. One of the current topical issues of puberty in obese girls is diffuse liver disease, of which non-alcoholic fatty liver disease (NAFLD) is becoming one of the most common health problems.
The aim – to study the characteristics of clinical and metabolic parameters and sexual development in adolescent girls with NAFLD and metabolically unhealthy obesity.
Material and methods. The study included 120 girls aged 12–17 years with NAFLD and metabolically unhealthy obesity, as well as 180 conditionally healthy girls with normal sexual development and normal body weight. Anthropometric indicators, parameters of enzyme, lipid, carbohydrate, purine metabolism, secretion of adipocytokines, 25 (OH) D were studied, sexual development was assessed.
Results. For girls of puberty with NAFLD and obesity, the following were most characteristic: an increase in body mass index by 2.80 times (p<0.01), mainly due to an increase in adipose tissue index by 3.07 times (p<0.01), the ratio waist/hip circumference 1.26 times (p<0.01). The level of leptin significantly exceeded that in the control by 14.58 times, ALT – 2.17, glucose – 1.25, C-peptide – 1.77, HOMA index – 1.90, uric acid – 2.27, and the level of 25 (OH) D was reduced by 1.34 times (p<0.01). Girls with NAFLD were characterized by an earlier onset of menarche – (11.45±0.03) versus (12.43±0.04) years in the control, a higher score for sexual development according to L. G. Tumilovich – (10.89±0.16) versus (10.27±0.18) points, menstrual dysfunction with the presence of oligomenorrhea in 62.50 % of cases, amenorrhea – in 27.50 %, heavy menstruation – in 10.00 %, dysmenorrhea – in 14.17 %.
Conclusions. The clinical portrait of a pubertal girl with NAFLD and metabolically unhealthy obesity is characterized by impaired lipid, carbohydrate, purine metabolism, secretion of adicytopokinids, vitamin D deficiency or deficiency and earlier puberty, accelerated adrenarche, inverted puberty, and impaired menstrual function.
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