Thyroiditis in children are important issues of pediatric endocrinology due to their widespread occurrence. They differ in etiology, pathogenesis, and their clinical manifestations. Updated clinical guidelines in 2024 are the main working tool of physicians. They briefly and structurally present the main information about epidemiology and modern classification of thyroiditis, methods of diagnosis and treatment based on the principles of evidence-based medicine.

Purpose: to evaluate the quantitative and qualitative features of the metabolic activity of the intestinal microbiota in patients with obesity. Materials and methods: a comprehensive clinical, laboratory and instrumental examination of 60 children aged 12-16 years was carried out. The main group (n=30) - patients with exogenous constitutional obesity, the comparison group (n=30) - adolescents with normal body weight. The metabolic activity of the intestinal microbiota was assessed by gas-liquid chromatography of a fecal sample with the determination of the relative and absolute values of short-chain fatty acids (SCFAs). Results: All patients with obesity showed a decrease in the concentration of SCFA compared with the comparison group, which indicated a decrease in the metabolic activity of the obligate lactic acid flora and the predominance of the fraction of non-proteolytic anaerobic microorganisms. When assessing the relationship between the lipid spectrum and individual SCFAs and their indices, numerous positive relationships of moderate strength were obtained, which indirectly may indicate the progression of the imbalance of aerobes and anaerobes of the intestinal microbiome with an increase in the degree of metabolic disorders in obese patients. Conclusion: The identified qualitative and quantitative disorders of the intestinal microbiota in obese children are associated with the development of insulin resistance and are a reflection of metabolic endotoxinemia associated with the maintenance of chronic sluggish inflammation in overweight children.

Cryptorchidism is the most frequent congenital disorders of the reproductive system, is present in 2-3% of term newborn boys. Genes involved in embryonic testicular migration are known but their role in cryptorchidism development are not investigated enough. Genetical causes of cryptorchidism are identified in 5-7% of patients. The article contains data on the role of insulin-like peptide 3 and its receptor, anti-Müllerian hormone, gonadotropins, androgens in embryonic testicular migration. INSL3 and AMH are presented as markers of testicular dysfunction associated with cryptorchidism. Hypogonadotropic hypogonadism is also associated with cryptorchidism and can be diagnosed based on it. Results of modern investigations determine the necessary of hormonal and genetical examination of patients with isolated cryptorchidism to detect causes of cryptorchidism and manage of patients.

Bibliographical review representing the modern approach to the features of the taxonomic composition of the microbiota of the gastrointestinal tract as the largest microbiome of the human body. Modern views on the relationship in the “intestine-microbiota-brain” system are given. The main theories concerning the relationship and the role of macro- and microorganisms in the formation of metabolic disorders, in particular, in the pathogenesis of obesity, are considered as well.

The state of renal function in children with type 1 diabetes mellitus and small, up to 5 years old, disease experience was studied. The aim of the study was to determine the indicators of the initial stages of the formation of diabetic nephropathy and chronic kidney disease. A prospective cohort study of a group of 46 prepubertal patients with type 1 diabetes mellitus and less than 5 years of illness was carried out. Diabetic nephropathy at the stage of microalbuminuria was detected already in 8% of children. Signs of the first, preclinical stage of chronic kidney disease, manifested by hyperfiltration, were found in 20% of patients, impaired tubular functions — in 28%. A moderate decrease in glomerular filtration rate corresponding to stage 2 of chronic kidney disease was observed in 4% of children with diabetes. An increase in the concentration of endothelial growth factor in the blood serum and the morning portion of urine, as well as monocyte chemoattractant protein-1 in the blood serum are sensitive highly specific markers of the formation of chronic kidney disease in patients of prepubertal age with a history of diabetes mellitus of less than 5 years. The relationship between the characteristics of the course of diabetes mellitus with endothelial growth factor and monocyte chemoattractant protein-1 was not revealed, which reflects the independent mechanism of the influence of neoangiogenesis and the reaction of non-infectious inflammation on the formation of diabetic nephropathy and chronic kidney disease. The relationship between vascular endothelial growth factor and monocyte chemoattractant protein-1 with the formation of early signs of chronic kidney disease and diabetic nephropathy has been revealed. The results obtained can be used for early diagnosis of diabetic nephropathy and the formation of a risk group for kidney damage in children with diabetes mellitus.

ОЦЕНКА ЭФФЕКТИВНОСТИ ПРОГРАММЫ СНИЖЕНИЯ МАССЫ ТЕЛА У ДЕТЕЙ С ОЖИРЕНИЕМКомпаниец О .В ., Болотова Н

Objective. To evaluate the effectiveness of Weight Loss School for children aged 10–17 years. Patients and methods. Between 2019 and 2021, we examined 853 children aged 10 to 17 years with exogenous constitutional obesity. All children were offered to attend Weight Loss School. One hundred and seventy-five children (20.5%) started the course and 110 of them (65%) completed it. The School lasted for 6 months and included 5 classes on nutrition and physical activity, physiotherapy, and monthly examination by an endocrinologist. Results. A total of 87% of children reported reduced appetite after the completion of the program. A decrease in median ΔSDS BMI by 0.2 confirmed clinically significant weight loss. Interviewing of participants 6 months following program completion showed that only 46.4% of children managed to maintain their body weight or continue weight loss, whereas 63.6% of children resumed gaining weight. The most common reasons for non-adhering to recommendations included uncontrollable hunger and difficulty of modifying a habitual lifestyle with no external control by a doctor. Conclusion. Our study demonstrated low adherence of children and their parents to obesity treatment. Nutrition education is a necessary component of obesity treatment; however, it has short-term effectiveness. In addition to patient education, administration of liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist (Saxenda), can be the most promising. GLP-1 affects anorexigenic and orexigenic systems of the hypothalamus and decreases appetite by slowing gastric emptying and gastrointestinal motility. Key words: obesity, weight loss school, eating disorder, liraglutide.

The purpose — to evaluate the metabolic status of patients with constitutional growth and puberty retardation in comparison with healthy peers. Material and methods. The study included 100 teenage boys aged 15 y. o.: the main group (n = 70) — patients with constitutional growth and puberty retardation, the comparison group (n = 30) — healthy adolescents. The indicators of the metabolic status of adolescents were evaluated clinically and by laboratory indices. It was shown that patients with CGPR with androgen deficiency have significant deviations in the metabolic status, manifested by a negative nitrogen balance, dyslipidemia, and the formation of presarcopenic syndrome.

В современной диетологии и нутрициологии детского возраста особая роль отводится изучению отклонений элементного гомеостаза как одному из этиологических факторов нарушения нутритивного статуса у детей и подростков. Высокий процент распространенности расстройства питания в детской популяции диктует необходимость исследования одного из предрасполагающих факторов нарушения метаболизма – микроэлементного состава. Цель работы – оценка особенностей минералограммы у детей с различным нутритивным статусом. Обследованы 60 детей (мальчики, девочки) в возрасте от 8 до 15 лет: из них в группу 1 вошло 20 детей с избытком массы тела, в группу 2 – 20 детей с дефицитом массы тела, в группу сравнения – 20 детей с нормальной массой тела и незначительными функциональными нарушениями здоровья. В процессе исследования выявлен спектр микроэлементозов у детей с избытком и дефицитом массы тела, полученные данные соотнесены с данными минералограммы здоровых детей того же возраста и пола. По результатам обследования в группе детей с ожирением были получены эссенциальные полидефициты по уровню йода 50% (10), калия 40% (8) и марганца 40% (8). У пациентов с белково-энергетической недостаточностью отмечен дефицит йода 50% (10), калия 40% (8), натрия 40% (8) и марганца 30% (6), а также высокая степень накопления токсических элементов: алюминия, бария и галлия 10% (2). Пациенты группы сравнения имели сходный спектр дефицита эссенциальных микроэлементов, однако степень дефицита была несколько ниже, чем у пациентов с нарушением нутритивного статуса.

УДОВЛЕТВОРЕННОСТЬ И ПРИВЕРЖЕННОСТЬ ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 1 ТИПА ПРИ ПРИМЕНЕНИИ СОВРЕМЕННЫХ ТЕХНОЛОГИЙ НЕПРЕРЫВНОГО МОНИТОРИНГА ГЛИКЕМИИФилина Н .Ю

XXVIII) НАЦИОНАЛЬНЫЙ ДИАБЕТОЛОГИЧЕСКИЙ КОНГРЕСС С МЕЖДУНАРОДНЫМ УЧАСТИЕМ «САХАРНЫЙ ДИАБЕТ И ОЖИРЕНИЕ -НЕИНФЕКЦИОННЫЕ МЕЖДИСЦИПЛИНАРНЫЕ ПАНДЕМИИ XXI ВЕКА» СБОРНИК ТЕЗИСОВ 38 ОПЫТ ПРИМЕНЕНИЯ ПРЕПАРАТА ЛИРАГЛУТИД 3,0 МГ В КОМПЛЕКСНОЙ ТЕРАПИИ ОЖИРЕНИЯ У ПОДРОСТКОВ Болотова Н .В

СБОРНИК ТЕЗИСОВ XVII Российская научно-практическая конференция детских эндокринологов «Достижения науки в практику детского СРАВНИТЕЛЬНЫЙ АНАЛИЗ ЭФФЕКТИВНОСТИ РАЗЛИЧНЫХ ВАРИАНТОВ МЕДИКАМЕНТОЗНОЙ ТЕРАПИИ МАЛЬЧИКОВ С КОНСТИТУЦИОНАЛЬНОЙ ЗАДЕРЖКОЙ РОСТА И ПУБЕРТАТА Н.Ю.Филина, Н.В.Болотова, К

11β-hydroxylase deficiency is a rare autosomal recessive disorder due to impaired steroidogenesis in the adrenal cortex caused by pathogenic mutations in the CYP11B1 gene. The main clinical manifestations are determined by a deficiency of cortisol, ACTH hyperproduction, excessive androgens secretion and the accumulation of 11-deoxycorticosterone, which leads to the development of arterial hypertension. In the diagnostic search, it is important to take into account the ethnicity of the patient, since the frequency of the disease and the prevalence of mutations differ between ethnic groups. The article presents a clinical case of 11β-hydroxylase deficiency as the result of compound heterozygous mutations in the CYP11B1 gene in a patient of Turkic origin. This case shows the clinical manifestations and the development of complications of 11β-hydroxylase deficiency, the stages of differential diagnosis of patients with 21-hydroxylase deficiency.

13 июня 2021 г.СБОРНИК ТЕЗИСОВ XVII Российская научно-практическая конференция детских эндокринологов «Достижения науки в практику детского эндокринолога» СИНДРОМ ИНСУЛИНОРЕЗИСТЕНТНОСТИ ТИПА А У ПАЦИЕНТКИ 15 ЛЕТ Н.В.Болотова, Н.Ю.Райгородская, О.А.Великоцкая, В

The precocious puberty is an urgent problem of pediatric endocrinology characterized by clinical and pathogenetic heterogeneity. The appearance of secondary sex characteristics before the age of 8 years in girls and 9 years in boys requires timely diagnosis and the appointment of pathogenetically justified treatment in order to achieve the target indicators of final growth and prevent social deprivation. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of рrecocious puberty, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

11β-hydroxylase deficiency is a rare autosomal recessive disorder due to impaired steroidogenesis in the adrenal cortex caused by pathogenic mutations in the CYP11B1 gene. The main clinical manifestations are determined by a deficiency of cortisol, ACTH hyperproduction, excessive androgens secretion and the accumulation of 11-deoxycorticosterone, which leads to the development of arterial hypertension. In the diagnostic search, it is important to take into account the ethnicity of the patient, since the frequency of the disease and the prevalence of mutations differ between ethnic groups. The article presents a clinical case of 11β-hydroxylase deficiency as the result of compound heterozygous mutations in the CYP11B1 gene in a patient of Turkic origin. This case shows the clinical manifestations and the development of complications of 11β-hydroxylase deficiency, the stages of differential diagnosis of patients with 21-hydroxylase deficiency.