Oleksyk O. Hormonal-metabolic disturbances in youths with a hypothalamic syndrome and obesity and correction of them

The dissertation is dedicated to the study of peculiarities of metabolic and hormonal disorders in youth with hypothalamic syndrome and obesity, and to the optimization of treatment for these patients. The object of this study is metabolic and hormonal disorders in young men. In the course of this study, 122 young male patients aged 17-21 years with obesity were inspected. Control measurements were obtained from 22 healthy people and from 25 young men with alimentary-constitutional obesity. We studied anthropometric and hemodynamic parameters, the state of hydrocarbon and lipid metabolism, the presence of insulin resistance, and determined the activity of ATPase in the membranes of erythrocytes. We used anthropometric, clinic and laboratory and statistical methods of investigations. In young men with the hypothalamic syndrome and obesity, we observed changes in hormone levels in blood, tissue sensitivity to insulin, lipid metabolism, and enzyme activity of ATPase in membranes of erythrocytes that were more pronounced than in control groups. We established that in young men with hypothalamic syndrome and obesity, there was a significant correlation between rates of BMI, insulin and cortisol in blood, and between the level оf triglycerides in blood аnd the index HOMA-IR. We conducted an analysis of effectiveness of inclusion of metformin and pyoglitazone in the treatment of 59 young men with the HS and obesity. Patients were divided into four groups: (A) received only the hypocaloric diet, (B) metformin 1000 mg/day, (C) pyoglitazone in 30 mg/day dose, and (D) pyoglitazone at 30 mg/day + metformin at a dose of 1000 mg/day, three months. We were first to demonstrate that combined use of metformin and pyoglitazone in the treatment of young men with the hypothalamic syndrome and obesity contributes to reduction of expressive BMI, normalization of blood pressure, lipid metabolism, membrane-binding enzyme activity and improve tissue sensitivity to insulin, as well as to the correction of other hormonal and metabolic disorders.