Khyzhnyak O. Clinico-pathogenetic peculiarities in the course of hypothalamic syndrome of puberty in male adolescents

The thesis is aimed at determining risk factors and key mechanisms in formation of hypothalamic syndrome of puberty (HSP) in male persons, as well as at studying the character of hormonal and metabolic disorders that stipulate the clinical manifestation and the course of the disease. On the basis of an integrated examination we proved the fact of clinical polymorphism of HPS and substantiated the expediency of the disease being subdivided into four variants; the first variant (the typical form) being characterized by maximal manifestation of all major clinical signs; the second HPS variant having obesity as one of its characteristic symptoms; the third variant having arterial hypertension as the leading symptom, and the fourth variant being the vague form of the disease. Mathematical models of hormonal-metabolic conversions, taking into account the age of the examined persons and the clinical variant of the disease were worked out. A considerable rise in leptin content not depending upon the age and the character of sexual maturation was determined in the patients. There was suggested and substantiated a concept of the role of epiphyseal hormone melatonin in formation of atherogenic dyslipoproteinemies in patients with HPS. The role of carbohydrate and lipid metabolism disorders, as well as the significance of proteolytic ferment activity in the progress of the disease, were demonstrated. The most informative clinico-anamnestic and hormonal-metabolic criteria concerning prognosis of HPS course were defined. The use of medication that can eliminate metabolism disorders was scientifically substantiated.