VACCINATION PARADOXES IN OBESITY

The review article discusses the problem of post-vaccination immune response in children obesity and adults with infections, in particular with COVID-19. Changes in various cellular and humoral immunity links in the experiment and in the clinic, associated with chronic inflammation and metabolic disregulation that accompanies obesity, are revealed. People with obesity, who are at higher risk of developing infections, may have an altered immune response to vaccination. Research is needed to study post-vaccination immunity in obesity, including an assessment of the possible impact of comorbidities on the vaccination of individual microbiota.

Pediatric and Adult Obesity Concern Female Health: A Mendelian Randomization Study

Purpose: Adulthood and childhood obesity are associated with female reproductive endocrinology and gynecological cancers. However, the causality of such association is yet to be identified. Independent of inverse bias and confounding, mendelian randomization is like a random control trial where genetic groups are settled during meiosis, which could be effective to examine the causality. Methods: We carried out several Mendelian randomization trials based on combined genetic scores of 75 adult-associated and 15 child-associated BMI single nucleotide polymorphisms (SNPs), diseases databases of several gynecological cancers and reproductive diseases from UK Biobank with 194,153 participants, using traditional inverse-variance weighted (IVW) method, Weighted Median (WM) approach, MR-Egger regression and updated MR-PRESSO analysis. Results: Elevated adult-associated BMI (effect:1.003;95%CI:1.001,1.004) and child-associated BMI (effect:1.003;95%CI:1.001,1.004) genetic scores were related to higher risk of PCOS incidence by using traditional IVW method. Random IVW method showed a negative causal association between the child-associated BMI and subsequent endometriosis attack(effect:0.995;95%CI:0.991,0.999). Conclusions: Consistent with observational consequences, our findings suggested that childhood and adulthood obesity may play roles in the development of PCOS, and children obesity can elevate the possibility of PCOS but decrease the incidence of endometriosis in later life. More researches need to be conducted for further validation and potential mechanisms.

Association of Obesity with Cardiovascular Risk Factors and Kidney Disease Outcomes in Primary Proteinuric Glomerulopathies

Background/Aims: Obesity is a known risk factor for cardiovascular disease and contributes to the development and progression of kidney disease. However, the specific influence of obesity on outcomes in primary glomerular disease has not been well characterized. Methods: In this prospective cohort study, data were from 541 participants enrolled in the Nephrotic Syndrome Study Network (NEPTUNE), between 2010 and 2019, at 23 sites across North America. Blood pressure, lipids, and kidney disease outcomes including complete proteinuria remission, kidney failure, and chronic kidney disease progression were evaluated. Data were analyzed using linear and logistic regression with generalized estimating equations and time-varying Cox regression with Kaplan-Meier plots. Results: The prevalence of obesity at baseline was 43.3% (N = 156) in adults and 37.6% (N = 68) in children. In adults, obesity was longitudinally associated with higher systolic BP (β = 6.49, 95% CI: 2.41, 10.56, p = 0.002), dyslipidemia (OR = 1.74, 95% CI: 1.30, 2.32, p < 0.001), triglycerides (β = 41.92, 95% CI: 17.12, 66.71, p = 0.001), and lower HDL (β = −6.92, 95% CI: −9.32, −4.51, p < 0.001). In children, obesity over time was associated with higher systolic BP index (β = 0.04, 95% CI: 0.02, 0.06, p < 0.001) and hypertension (OR = 1.43, 95% CI: 1.04, 1.98, p = 0.03). In both adults and children, obesity was associated with a significantly lower hazard of achieving complete remission of proteinuria (adult HR = 0.80, 95% CI: 0.69, 0.88, p < 0.001; pediatric HR = 0.72, 95% CI: 0.61, 0.84, p < 0.001). Conclusion: Obesity was associated with higher cardiovascular risk and less proteinuria remission from nephrotic syndrome in adults and children with proteinuric glomerulopathies. Weight-loss strategies may forestall cardiovascular disease and progressive kidney function decline in this high-risk patient group.

OBESITY IN CHILDREN AS A FACTOR OF MYOCARDIAL REMODELING

The epidemic of childhood obesity with the subsequent development of metabolic syndrome (MS), cardiovascular pathology and endocrine disorders causes the need for early diagnosis and timely treatment of children of this group, which allows us to consider this pathology the most urgent problem of modern medicine. 28 (28.6%) of the examined patients showed an increase in the content of IRI in the blood serum, 5 (5.1%) had fasting glycemia, 6 (6.1%) had impaired glucose tolerance, the excess of the HOMA index was observed in 56 (57.1%), an increase in CS in 6 (6.1%), TG in 18 (18.4%). The combination of these changes includes children under the age of 10 years in the risk group for MS in 84.6 %, and in children 10 years and older; it is possible to diagnose MS in 56.9 % of cases (IDF, 2007). Аctivation of neuro-humoral mechanisms and violation of metabolic processes contributed to the development of arterial hypertension in 24 (24.5%) children, concentric LV remodeling in 18 (18.4%), concentric LV hypertrophy in 8 (8.2%) and eccentric LV hypertrophy in 7 (7.1%) children according to the results of ECHO-KG. Keywords: children, obesity, cardiovascular pathology, remodeling

Psychological intervention programs for children with overweight and obesity: Systematic review

Currently obesity is a public health problem that is characterized by being a chronic disease, caused by various factors ranging from genetic, metabolic or sociocultural problems. Objective: To analyze psychological interventions for overweight and obesity, in children, with favorable results in the participants. Method: A systematic review was carried out on the internet based on articles published in Crossref and PubMed by using keywords such as “interventions for overweight children”, “Children obesity interventions”, “psychological interventions in children”. Results: In a first revision, 79 psychological programs applied in children were found, when reviewing the programs, it was found that only 19 had favourable results in the participants. Conclusion: The interventions had positive results; however, it will be necessary to design more adequate interventions for obese and overweight people, and contribute more to the solution of these public health problems.

PRIORITY RECOMMENDATIONS FOR SOLVING THE PROBLEM OF CHILDREN OBESITY BASED ON THE RESULTS OF THE RESEARCH

The aim: Of the work was to study and evaluate the risk factors and the level of primary medical care for children with overweight and obesity. Materials and methods: A sociological survey was conducted in main (413 persons) and control group (396 persons) and the copying from the history of the child’s development (f.112/a) of 280 obese children was conducted. Results: It was defined that on the development of excess weight in children and adolescents, biological and social and hygienic factors had a significant impact (η ≥ 3%; p<0,001) and that the level of primary medical care for obese children (proved diagnosis of obesity in the history of the child (f. №.112/а) had only 61,7±2,7% of patients) was insufficient. Conclusions: Identification of comprehensive priority activities for solving problem of children overweight and obesity based on the results of conducted research were done.

CHILDHOOD OBESITY IN THE PERCEPTION OF CHILDREN, FAMILIES AND HEALTH AND EDUCATION PROFESSIONALS

ABSTRACT Objective: to understand the perspective of children, families and health and education professionals about childhood obesity. Method: a qualitative research study with the participation of 13 children, 12 family members, seven health professionals in primary care and seven education professionals, all linked to the Health at School Program. Data was collected through semi-structured interviews, using recreational resources and applying a scale of silhouettes with children, during the period from April 2017 to March 2018. The analysis was based on the assumptions of thematic content analysis. Results: three categories were identified: Multifactoriality of childhood obesity; Body image by the child, by family members and bullying at school; Perspectives and actions associated with childhood obesity. For the study participants, childhood obesity is conditioned by overeating, with a low nutritional value, in addition to insufficient physical activity. They also understand that the actions to combat obesity proved to be incipient or insufficient. For children, obesity implies dissatisfaction with body image and bullying at school. Conclusion: according to the perspective of the participants, there is a need for integrated actions between health and education professionals, including children and family members, to prevent and combat childhood obesity; in addition to governmental actions to strengthen public policies that consider health promotion and prevention of harms to the child population.