Pugach M. Clinical pathogenic characteristics of vitamin D-deficient rickets in infants with obesity.

The thesis is devoted to the actual issue of modern pediatrics - study of complex pathogenic mechanisms of vitamin D-deficient rickets in infants with obesity by determination of vitamin D status indicators, bone metabolism, lipid metabolism, the role of mononucleotide Bsm I VDR gene polymorphism. It has been proved that vitamin D-deficient rickets in infants with obesity is characterized by medium-severe disease degree, which is associated with bone hyperplasia. Possible reverse correlations have been established between the level of 25 (OH) D in the blood serum and body mass index in infants suffering from vitamin D-deficient rickets with maximum values in children who were obese. Reasonability of osteocalcin estimation in blood serum was demonstrated for the diagnosis of bone metabolism disorder and as a severity criterion of vitamin D-deficient rickets in infants with obesity. The violation of lipid profile has been stated depending on the reduction degree of serum hydroxyvitamin D in infants suffering from rickets. The most tight correlation was found between the 25(OH)D level in the blood serum and HDL cholesterol (r = 0,29, p <0.05) and Atherogenic factor (r = -0,23, p <0.05) in children who were obese. In the thesis we have analyzed the association of alleles and Bsm I genotypes VDR gene polymorphism with clinical and laboratory features of vitamin D-deficient rickets. The influence of mononycleotide VDR gene polymorphism on the effectiveness of specific therapy of the osteopathy in infants has been under research.