Analiza faktora rizika za nastanak metaboličkog sindroma kod dece i adolescenata

Abstract

Visoka prevalencija metaboličkog sindroma kod dece i adolescenata zabrinjavajući je problem savremenog društva. Cilj istraživanja bio je da se utvrdi korelacija ranije ispitivanih, ali i potencijalno novih faktora rizika za razvoj metaboličkog sindroma kod dece i adolescenata. Sprovedena je klinička opservaciona studija tipa slučaj-kontrola u kojoj su učestvovala deca i adolescenti sa gojaznošću/metaboličkim sindromom, bolnički lečena u periodu od januara 2008. do januara 2012. godine na Klinici za pedijatriju Kliničkog centra Kragujevac. Grupu slučajeva (n=28) činili su pacijenti starosne dobi od 6-18 godina sa dijagnostikovanim metaboličkim sindromom po International Diabetes Federation (IDF) kriterijumima, dok je kontrolnu grupu činilo dvostruko više gojaznih pacijenata (n=56) sličnih karakteristika pacijentima iz komparirane grupe. Utvrđeno je da se signifikantnim faktorima rizika za razvoj metaboličkog sindroma kod gojazne dece i adolescenata mogu smatrati gestacijski dijabetes majke, odnosno izostanak ishrane majčinim mlekom u prvih šest i više meseci života deteta. Takođe, rezultati istraživanja takođe idu u prilog mikroalbuminurije kao značajnog markera ranog dijagnostikovanja metaboličkog sindroma kod gojazne dece i adolescenata. Sagledavanje pomenutih činilaca može poboljšati kvalitet rane identifikacije dece i adolescenta sa rizikom za razvoj metaboličkog sindroma i posebno imati praktični značaj za pedijatre u kreiranju strategije primene preventivnih i pravovremenih korektivnih mera za sprečavanje nastanka pomenutog sindroma odnosno razvoja potencijalnih komplikacija u kasnijem, odraslom životnom dobu.

High prevalence of metabolic syndrome in children and adolescents is worrisome problem of modern society. The aim of this research was to determine the correlation of the previously studied and potentially new risk factors for development of the metabolic syndrome in children and adolescents. We performed a case-control clinical study, which was involved children and adolescents with obesity/metabolic syndrome, hospitalized during the period from January 2008 to January 2012 at the Pediatric Clinic of Clinical Center Kragujevac. There were 28 patients, aged 6-18 years, classified as „cases“ who had diagnosed metabolic syndrome according to International Diabetes Federation (IDF) criteria, while the 56 control patients were obese patients, matched to the cases. It was found that gestational diabetes of the mother and artificial nutrition during the first six and more months of the child’s life can be considered as significant risk factors for the development of the metabolic syndrome in obese children and adolescents. In addition, the results of this trial also support the microalbuminuria as an relevant marker of early diagnosis of metabolic syndrome in obese children and adolescents. The consideration of these factors may improve the quality of early identification of children and adolescents who are at risk for metabolic syndrome developing, and especially to have practical importance for pediatricians in creating the strategy of prevention and timely implementation of corrective measures to prevent the occurrence of the aforementioned syndrome and development of potential complications in later, adult life.