Semizlik va arterial gipertenziyasi bo‘lgan bolalarning kompleks klinik va metabolik baholanishi
Annotatsiya
Kirish. Bolalar va o‘smirlar orasida semizlik zamonaviy pediatriya va bolalar kardiologiyasining eng dolzarb tibbiy-ijtimoiy muammolaridan biridir. Abdominal semizlikning tobora keng tarqalishi arterial gipertenziya, insulinrezistentlik, dislipidemiya hamda yurak-qon tomir tizimining erta shikastlanishlari rivojlanish xavfining ortishi bilan kechadi. Mazkur yo‘nalishda ko‘plab ilmiy tadqiqotlar olib borilganiga qaramay, semizlik bilan og‘rigan bolalarda klinik, metabolik va yurak-qon tomir tizimidagi o‘zgarishlarning o‘zaro bog‘liqligi yetarli darajada o‘rganilmagan. Bu esa kardiometabolik xavf omillarini kompleks baholash zarurligini belgilaydi. Tadqiqot maqsadi semizlik bilan og‘rigan bolalarning klinik va metabolik xususiyatlarini o‘rganish, antropometrik ko‘rsatkichlar, uglevod va lipid almashinuvi buzilishlari, arterial gipertenziya hamda yurak-qon tomir tizimidagi o‘zgarishlar o‘rtasidagi bog‘liqlikni baholash, shuningdek, bolalarda metabolik sindrom komponentlari tuzilishini aniqlash. Material va usullar. Tadqiqotga 10–18 yoshdagi ekzogen-konstitutsional semizlik bilan og‘rigan 55 nafar bola jalb qilindi. Nazorat guruhini yoshi mos keluvchi 20 nafar amaliy sog‘lom bola tashkil etdi. Barcha ishtirokchilarda klinik tekshiruv, antropometrik baholash, tana massa indeksini hisoblash, bel aylanasi va bel/son nisbatini aniqlash, arterial qon bosimini o‘lchash, elektrokardiografiya hamda uglevod va lipid almashinuvi ko‘rsatkichlari, siydik kislotasi, immunoreaktiv insulin va HOMA-IR indeksini aniqlashni o‘z ichiga olgan biokimyoviy tekshiruvlar o‘tkazildi. Statistik ishlov berishda klinik va laborator ko‘rsatkichlar o‘rtasidagi korrelyatsion tahlil amalga oshirildi. Natijalar va muhokama. Abdominal semizlik va arterial gipertenziyaga ega bolalarda kasallikning erta boshlanishi, jismoniy hamda jinsiy rivojlanishning tezlashishi, yurak-qon tomir tizimining funksional buzilishlari va arterial qon bosimining barqaror oshishi kuzatildi. Uglevod almashinuvi buzilishlari bemorlarning qariyb uchdan bir qismida aniqlanib, HOMA-IR indeksining oshishi insulinrezistentlik mavjudligini tasdiqladi. Abdominal semizlik bilan og‘rigan bolalarda gipertrigliseridemiya, umumiy xolesterin va past zichlikdagi lipoproteinlar xolesterinining oshishi, yuqori zichlikdagi lipoproteinlar xolesterinining esa pasayishi sezilarli darajada ko‘proq uchradi. Siydik kislotasi miqdori oshgan bo‘lib, u tana massa indeksi va arterial qon bosimi bilan ishonchli musbat korrelyatsiyani namoyon etdi. Korrelyatsion tahlil semizlik darajasi, uglevod va lipid almashinuvi buzilishlari, giperurikemiya hamda yurak-qon tomir tizimidagi o‘zgarishlar o‘rtasida yaqin bog‘liqlik mavjudligini ko‘rsatdi, bu esa metabolik sindrom va yurak-qon tomir patologiyasining umumiy patogenetik mexanizmlarini tasdiqlaydi. Xulosa. Abdominal semizlik, ayniqsa arterial gipertenziya bilan birga kechgan hollarda, bolalarda eng yaqqol klinik, metabolik va yurak-qon tomir buzilishlari kuzatiladi. Insulinrezistentlik, dislipidemiya, giperurikemiya va yurak-qon tomir tizimidagi funksional o‘zgarishlarning rivojlanishi semizlik darajasining ortishi hamda arterial qon bosimining yuqorilashi bilan chambarchas bog‘liq. Olingan natijalar semizlik bilan og‘rigan bolalarda uzoq muddatli yurak-qon tomir asoratlarining oldini olish maqsadida metabolik sindrom komponentlarini erta aniqlash va kardiometabolik xavf omillarini kompleks baholash zarurligini tasdiqlaydi.
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