Object of research: obesity in children and adolescents. The goal is to prevent the complicated course of obesity in children by identifying clinical, metabolic, hormonal factors in the formation of thyropathies and improving their diagnosis and treatment in patients with pre-pubertal age. Methods of research: general-clinical - for the assessment of physical and sexual development, the presence of obesity and pathology of thyroid gland; biochemicals - for evaluation of carbohydrate metabolism and lipid spectrum of blood (Photometer «Cormey Multi»); immune enzymes - determination of immunoreactive insulin levels, thyroid stimulating hormone pituitary, free thyroxine, free triiodothyronine, thyroid peroxidase antibodies, thyroglobulin antibodies, C-reactive protein, interleukin-1β, interleukin-6 («Humareader» photometer); instrumental - ultrasound (ultrasound); statistical methods. In the course of the work, the problem of the relationship between obesity and pathology of the thyroid gland in children with obesity and the connections of these two pathological states with the formation of carbohydrate, lipid metabolism and low intensity inflammation activity in obese children was further developed. New data were obtained on the age and sexual characteristics of the formation of thyroid abnormalities in obese children. It has been established that the most common pathology of thyroid gland in children with obesity is diffuse nontoxic goiter, diagnosis of autoimmune thyroiditis is much less common, as well as minimal changes in the structure of the thyroid gland and ultrasound data (heterogeneity, echogenicity reduction and capsule sealing) without its increase and the presence of anti-thyroid antibodies). It was found that among the pathological changes in the indicators of the functional state of thyroid in children with obesity most often was hyperthyrotropinemia, the frequency of which decreases with an increase in the stage of sexual maturity of patients. The negative influence of reduced insulin sensitivity on the development of thyroid gland pathology in obese children with significant gender differences is demonstrated - a decrease in the function of the thyroid gland with less pronounced insulin resistance and a greater tendency to develop AIT in male obese patients. It was found that pathological changes in the lipid profile of blood in obese children are closely related to the presence of concomitant thyroid disease, and the nature of dislipidemia depends on the presence of thyroid pathology (primarily AIT) and on the functional state of thyroid gland (thyroid failure - subclinical hypothyroidism and minimal thyroid insufficiency). In children with obesity, gender differences in atherogenically directed changes in the lipid profile of the blood with more distinct disorders in boys with concomitant thyroid pathology and thyroid abnormality have been identified. In children with obesity, the presence of low intensity inflammation is confirmed, which is closely related to the formation of thyropathies and has significant gender differences: in boys, elevated levels C-reactive protein is associated mainly with the development of the DNG, as well in girls - with the development of AIT. The most distinctive pathological changes characterizing low intensity inflammation are observed in boys before and after puberty, and girls are actually puberty. It has been established that treatment of children with obesity with signs of thyroid gland pathology requires, first and foremost, the correction of insulin resistance, which largely determines the formation of thyropathies due to low intensity inflammation. The practical value of the results. The work substantiates the necessity of continuous monitoring of the thyroid condition in children obese, especially in prepubertal and early pubertal age, which allows for the timely treatment of detected thyropathies (in particular, DNG and AIT) and, thus, to prevent the development of metabolic disorders and other negative consequences of the combination two pathological states. The algorithm for diagnosing and treating children and adolescents with obesity and associated thyreopathies, developed on the basis of research results, is characterized by a complex and differentiated approach and allows the practitioner to more effectively carry out medical support for patients with a combined pathology. The degree of implementation. The information letter "Diagnosis of thyropathies in obesity in children of prepubertal age (6-9 years)" was developed and implemented in practice. The results of the study were introduced into the practical work of physicians of pediatricians, children's endocrinologists and general practitioners in the work of the Kharkiv sanatorium educational complex №1, Khmelnytsky city children's hospital, the Chortkiv central communal district hospital, the Kharkiv Institute of Children's Health and adolescents of National Academy of Medical Sciences of Uk
