Impairment of carbohydrate metabolism in children and adolescents with obesity

Obesity is one of the socially significant diseases of our time and is a generally recognized risk factor for the development of carbohydrate metabolism disorders, including type 2 diabetes mellitus (DM), the prevalence of which in the pediatric population is rapidly increasing.Aim of the study. To demonstrate the most frequent types of carbohydrate metabolism disorders in children and adolescents with obesity.Materials and methods. 123 obese patients under 18 years old were examined and the structure of obesity complications was analyzed.Results. Carbohydrate metabolism disorders were identified in 24 patients (19%): impaired fasting glycemia (IFG) (8 girls, 6 boys (11%)), type 2 DM (6 girls, 3 boys (7%)), and type 1 DM (1 boy (1%)). Descriptions of 4 clinical cases are given: 1) patient, 17 years old, with constitutional-exogenous obesity of 3rd degree, arterial hypertension (AH), dyslipidemia and nonalcoholic fatty liver disease (NAFLD) and a history of transient IFG; 2) patient, 16 years old, with morbid obesity, NAFLD, AH, polycystic ovarian syndrome (PCOS), type 2 DM, compensated on metformin therapy; 3) patient, 17 years old, with constitutional-exogenous obesity of the 3rd degree, AH, dyslipidemia, NAFLD, type 2 DM (on insulin pump therapy), complicated by diabetic nephropathy and diabetic polyneuropathy; 4) patient, 12 years old, with type 1 DM, manifested against the background of obesity.Conclusion. When screening for obesity complications in children and adolescents, carbohydrate metabolism disorders may be detected in one in five patients. Prediabetes in childhood can be transient. When a child with obesity is identified, differential diagnosis of type 1 and type 2 DM should be made. It is necessary to teach patients with type 2 DM the skills of self-monitoring on a par with patients with type 1 DM and motivate them to control glycemia regularly at home.

Role of leptin in pathogenesis of hepatic steatosis, steatohepatitis and endothelial dysfunction in obesity: literature review

According to the latest WHO data, in the world there are 2 billion adults and 381 million children and adolescents from 0 to 19 years old, who are overweight or obese. This is due to the presence of many factors affecting the occurrence and development of this disease. One of the important links in the pathogenesis of obesity is hyperleptinemia in combination with leptin resistance. In this article, we attempted to summarize the information on the role of leptin in the pathogenesis of obesity complications such as liver steatosis, steatohepatitis and endothelial dysfunction. Parallels have been drawn between insulin resistance and leptin resistance. The relationship of leptin and insulin was analyzed, and data on the effect of these hormones on carbohydrate and fat metabolism are also presented.

Adult obesity complications: challenges and clinical impact

The complications associated with adult obesity are overwhelming national healthcare systems. No country has yet implemented a successful population-level strategy to reverse the rising trends of obesity. This article presents epidemiological data on the complications of adult obesity and discusses some of the challenges associated with managing this disease at a population and individual level.