The thesis has devoted to the theoretical generalization and a new solution for the actual scientific and practical pediatrician problem, which consists in improving the early diagnostics and prediction of cardiometabolic disorders and vitamin D status in overweight and obese adolescents, by determining the main predictors of their formation.
60 overweight, 76 obese children, and 60 children with normal body weight, aged 12 to 17 years, were examined. Epidemiological, clinical, anthropometric, laboratory, instrumental and statistical research methods have been used in the study.
A comprehensive basis epidemiological, clinical, anamnestic, laboratory, and instrumental examination, has shown that adolescents were characterized by a low level of vitamin D, which was most pronounced in obese children. Such predictors as income per family member, daily servings of milk, vitamin D supplementation(or vitamin D supplemented fish oil), physical activity, and time spent watching TV or using a computer, have been defined as risk factors for vitamin D deficiency. A method was developed for determining the vitamin D status using clinical and anamnestic data, and anthropometric measurements, with the help of which vitamin D status can be predicted. The depth of cardiometabolic disorders development depends on vitamin D status has been established. It has been proven that with vitamin D deficiency increases amount of atherogenic lipids and decreases amount of anti-atherogenic lipids. The increase in the level of atherogenic lipids, blood pressure was accompanied by insulinemia and insulin resistance. It has been established that additional factors in the development of cardiometabolic disorders that grow with vitamin D deficiency are an increase in PTH and leptin levels and a decrease in adiponectin levels. In overweight and obese adolescents it was found that a change in the activity of the autonomic nervous system was determined in the form of a decreased activity of the parasympathetic nervous system and increased activity of the sympathetic nervous system, which depend on vitamin D status. A diagnostic algorithm for cardiometabolic disorders was proposed, what include the determination of vitamin D status, abdominal obesity, basal glucose, activity of the sympathetic and parasympathetic divisions of the autonomic nervous system, blood pressure levels, parathyroid hormone, leptin, adiponectin, basal insulin, HDL-C, LDL-C, atherogenic index of plasma, triglycerides. A model for predicting the development of cardiometabolic disorders in overweight and obese adolescents with vitamin D deficiency was developed, which is based on the main criteria of the diagnostic algorithm. Also, a method for assessing the quality of this model was proposed.
