| Popis: |
The age-dependent nutritional status and resting metabolism in overweight and obese children have been examined. The study included 625 children of 2.5-17 years old. Patients were divided into three groups: 1st--2.5-7 years old (n = 49), 2nd--8-12 years old (n = 204), 3rd--13-17 years old (n = 372). The diagnosis of overweight and obesity was based on CDC criteria: children with 85-94 BMI percentile according to age and gender had overweight, BMI 295 percentile--obesity. Anthropometry, bioelectric impedance analysis and indirect respiratory calorimetry were performed; lipid and carbohydrate parameters were measured. The fat mass percentages in children of studed groups were 41.3 ± 1.9, 39.8 ± 0.7 and 42.3 ± 0.4%, the mean percent of fat mass excess--163.6 ± 26.2, 113.7 ± 8.3 and 134.9 ± 8.2% respectively, p0.05. Prevalence of dyslipidemia in children increased with age: lipid metabolism disorders were revealed in 28.6, 49.0 u 53.2% children of the 1st, 2nd and 3rd groups respectively. The mean HDL level in the 1st and 2nd groups was significantly higher, and triglycerides--lower than in the 3rd group. The correlation of HDL level and breastfeeding duration (r1 = 0.94, p0.05) was found in the 1st group of children. Increased insulin level was revealed in 38.8% children in the 1st group (mean 12.8 ± 1.4 μIU/ml), 62.2% children in the 2nd group (21.1 ± 0.7 μIU/ml) and 64.8% children in the 3rd group (25.1 ± 0.9 μIU/ml); increased HOMA--in 36.7% (4.32 ± 0.6), 62.2% (4.65 ± 0.17) and 59.1% (5.56 ± 0.21) respectively. The negative correlation of insulin and HOMA level with breastfeeding duration (r1 = -0.38 and -0.37, respectively, p0.05) was found in the 1st group of children. Prevalence of hyperuricemia increased from 13% in the 1st group to 21.1% in the 2nd and 44.1% in the 3rd group. Prevalence and degree of resting metabolism changes increased with age and had tendency to the shift of proportion of energy-intensive substrates (fats and carbohydrates) to deceleration of carbohydrate oxidation (in 32, 50, 55.1% of children) and compensatory fat oxidation acceleration (8, 28.4 and 34.7% respectively). Mean fat oxidation rate levels significantly differed between groups and increased with age (48.38 ± 7.14, 54.29 ± 3.06 and 78.43 ± 2.89 g/day in children of the 1st, 2nd and 3rd groups respectively, p0.001). The mean level of carbohydrate oxidation rate in the 3rd group of children was lower than normal value (p0.01). Resting energy expenditure was lower in the 2nd and 3rd groups of children. |
