medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-355medsovet-8729Research ArticleШКОЛА ПЕДИАТРАPEDIATRICIAN SCHOOLОсобенности индексов жирных кислот в оценке метаболических нарушений у подростков с ожирениемFeatures of fatty acid indices in the assessment of metabolic disorders in obese adolescentshttps://orcid.org/0000-0002-2915-384XОлейникО. А.OleynikO. A.

Олейник Оксана Алексеевна - к.м.н., доцент кафедры педиатрии с курсом эндокринологии, доцент кафедры факультетской терапии с курсом клинической фармакологии, эксперт центра клинических исследований, Сибирский ГМУ; главный внештатный специалист, ДЗ Томской области по организации специализированной медицинской помощи по профилю «эндокринология».

634050, Томск, Московский тракт, д. 2; 634041, Томск, пр. Кирова, д. 41

Oksana A. Oleynik - Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics with a Course of Endocrinology, Associate Professor of the Department of Internal Medicine with a Course of Clinical Pharmacology, Expert of the Center for Clinical Monarch, Siberian SMU; Chief Freelance Specialist, Department Healthcare of the TRfor the Organization of High-tech Medical Care in the Profile ”Endocrinology”

2, Moskovsky Trakt, Tomsk, 634050; 41, Kirov Ave., Tomsk, 634041

oleynikoa@mail.ruhttps://orcid.org/0000-0002-2667-4842СамойловаЮ. Г.SamoilovaIu. G.

Самойлова Юлия Геннадьевна - д.м.н., заведующий кафедрой педиатрии с курсом эндокринологии, профессор кафедры факультетской терапии с курсом клинической фармакологии, руководитель центра клинических исследований, Сибирский ГМУ; главный внештатный специалист, ДЗ Томской области по медицинской профилактике

634050, Томск, Московский тракт, д. 2; 634041, Томск, пр. Кирова, д. 41

Iuliia G. Samoilova - Dr. Sci. (Med.), Head of the Department of Pediatrics with a Course of Endocrinology, Professor of the Department of Internal Medicine with a Course of Clinical Pharmacology; Head of the Center for Clinical Research, Siberian SMU; Chief Freelance Specialist, Department Healthcare of the TR for the Organization of High-tech Medical Care in the Profile ”Endocrinology”,

2, Moskovsky Trakt, Tomsk, 634050; 41, Kirov Ave., Tomsk, 634041

samoilova_y@inbox.ruhttps://orcid.org/0000-0001-9966-6686МатвееваМ. В.MatveevaM. V.

Матвеева Мария Владимировна, д.м.н., профессор кафедры педиатрии с курсом эндокринологии, Сибирский ГМУ.

634050, Томск, Московский тракт, д. 2

Mariia V. Matveeva - Dr. Sci. (Med.), Professor, of the Department of Pediatrics with the course of Endocrinology.

2, Moskovsky Trakt, Tomsk, 634050

matveeva.mariia@yandex.ruhttps://orcid.org/0000-0001-6212-4568ПодчиненоваД. В.PodchinenovaD. V.

Подчиненова Дарья Васильевна, к.м.н., доцент кафедры педиатрии с курсом эндокринологии.

634050, Томск, Московский тракт, д. 2

Daria V. Podchinenova - Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics with the course of Endocrinology.

2, Moskovsky Trakt, Tomsk, 634050

darvas_42@mail.ruhttps://orcid.org/0000-0001-5299-2097ШуликоЛ. М.ShulikoL. M.

Шулико Людмила Михайловна - студент лечебного факультета.

634050, Томск, Московский тракт, д. 2

Lyudmila M. Shuliko - Student of Faculty of Medicine.2, Moskovsky Trakt, Tomsk, 634050

ludmila.shuliko.15@gmail.comСибирский государственный медицинский университет; Департамент здравоохранения Томской области по организации специализированной медицинской помощи по профилю «эндокринология»РоссияSiberian State Medical University; Department Healthcare of the Tomsk Region for the Organization of High-tech Medical Care in the Profile ”Endocrinology”Russian FederationСибирский государственный медицинский университетРоссияSiberian State Medical UniversityRussian Federation202428112024019236244Copyright © Олейник О.А., Самойлова Ю.Г., Матвеева М.В., Подчиненова Д.В., Шулико Л.М., 20242024Олейник О.А., Самойлова Ю.Г., Матвеева М.В., Подчиненова Д.В., Шулико Л.М.Oleynik O.A., Samoilova I.G., Matveeva M.V., Podchinenova D.V., Shuliko L.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8729Введение

Введение. Популяционная стратегия современного здравоохранения направлена на профилактику ожирения и его осложнений. Исследование спектра жирных кислот является прогрессивным направлением липидомики в диагностике метаболических нарушений.

Цель

Цель. Оценить возможности расчетных индексов жирных кислот в определении риска метаболических нарушений у подростков с ожирением.

Материалы и методы

Материалы и методы. Проведено одноцентровое обсервационное одномоментное сравнительное исследование. Изучаемая выборка состояла из 155 подростков в возрасте 10–15 лет. В основной группе был 101 ребенок – 45 мальчиков и 56 девочек с диагностированным ожирением экзогенно-конституционального типа, 1–2-й степени (SDS ИМТ +2,0–+3,0). В группу контроля вошли 54 здоровых ребенка с -1 < SDS ИМТ < 1: 28 девочек и 26 мальчиков. Расчет SDS ИМТ проводился с использованием компьютерной программы ВОЗ «Anthro Plus». Уровни жирных кислот в сыворотке крови определяли методом хромато-масс-спектрометрии. Полученные показатели использовали для расчета ω-3 индекса для цельной крови и для эритроцитарных клеточных мембран, ω-6/ω-3 ЖК индекса, индекса риска развития субинтимальной воспалительной реакции (%AA / %EPA индекс), а также индекса вязкости, текучести и проницаемости клеточных мембран (%ПНЖК / %НЖК).

Результаты

Результаты. У подростков с ожирением прослеживались значимо более низкие уровни полиненасыщенных жирных кислот и более высокое содержание некоторых мононенасыщенных ω-7 и ω-9 жирных кислот, а также основных представителей семейства насыщенных жирных кислот. Показатели ω-3 индекса как для цельной крови, так и для мембран эритроцитов были статистически значимо снижены в основной группе. Индекс риска развития субинтимальной воспалительной реакции и индекс %ПНЖК/%НЖК имели высокие значения у мальчиков и у девочек обеих групп. ω-6/ω-3 индекс на фоне ожирения был повышен только у мальчиков. Активность дельта-6-десатуразы статистически значимо между группами не различалась.

Выводы

Выводы. Представленные индексы (-3 индекс, индекс риска развития субинтимальной воспалительной реакции, ω-6/ω-3 индекс, индекс полиненасыщенные / насыщенные ЖК, индекс ω-6 десатуразной активности) требуют дополнительного изучения и конкретизации условий применения, референсных значений и правил интерпретации, особенно в детской популяции.

Introduction

Introduction. The population strategy of modern healthcare is aimed at preventing obesity and its complications. The study of the spectrum of fatty acids is a progressive direction of lipidomics in the diagnosis of metabolic disorders.

Aim

Aim. To evaluate the possibilities of calculated fatty acid indices in determining the risk of metabolic disorders in obese adolescents.

Materials and methods

Materials and methods. Single-center observational single-stage comparative study. The study sample consisted of 155 adolescents aged 10–15 years. The main group was represented by 101 participants – 45 boys and 56 girls with diagnosed obesity of exogenous constitutional type, 1–2 degrees (SDS BMI +2,0–+3,0 ). The control group included 54 healthy children with -1<SDS BMI <1: 28 girls and 26 boys. The calculation of SDS BMI was carried out using the WHO computer program “Anthro Plus” for the age category from 5 to 19 years. The levels of fatty acids in the blood serum were determined by chromatomass spectrometry.

Results

Results. Significantly lower levels of polyunsaturated fatty acids and higher content of some monounsaturated ω-7 and ω-9 fatty acids, as well as the main representatives of the saturated fatty acid family, were observed in obese adolescents. The values of the ω-3 index, both for whole blood and for erythrocyte membranes, were statistically significantly reduced in the main group. Subintimal inflammatory reaction risk index and PUFA % index/%NLC had high values in boys and girls of both groups. The ω-6/ω-3 index on the background of obesity was increased only in boys. The activity of delta-6-desaturase did not differ statistically significantly between the groups.

Conclusions

Conclusions. The presented indices (ω-3 index, risk index of subintimal inflammatory reaction, ω-6/ω-3 index, polyunsaturated/saturated LC index, ω-6 desaturase activity index) require additional study and specification of application conditions, reference values and interpretation rules, especially in the pediatric population.

жирные кислотыомега-3 индексдетиожирениеэйкозапентаеновая кислотаарахидоновая кислотаметаболические нарушенияfatty acidsomega-3 indexchildrenobesityeicosapentaenoic acidarachidonic acidmetabolic disordersРабота поддержана грантом Российского научного фонда в рамках конкурса 2023 года «Проведение инициативных исследований молодыми учеными» Президентской программы исследовательских проектов, реализуемых ведущими учеными, в том числе молодыми учеными по соглашению № 23-75-01034 от 14.08.2023 по теме «Использование профилей липидомики для создания прогностической модели реализации фенотипа ожирения у детей и подростков» (руководитель проекта – к.м.н., научный сотрудник центральной научно-исследовательской лаборатории Д.В. 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The authors declare that there are no conflicts of interest present.