Childhood obesity is an urgent problem of pediatric endocrinology due to the widespread occurrence, the development of metabolic complications and their steady tracking into adulthood. 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 obesity, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

Pseudohypoparathyroidism (PHP) is a clinically heterogeneous group of rare inherited bone diseases characterized by resistance of target organs to the action of parathormone (PTH) as result of an epi/genetic disorder.This article describes patients with the phenotype of pseudohypoparathyroidism type 1a in whom two previously undescribed variants in the GNAS gene were identified: NM_000516.7(GNAS):c.586-18_591del, which captures intron 7, exon 8 acceptor splice site and exon 8 splice site resulting in a 24 nucleotide deletion, and NM_000516.7(GNAS):c.201del p.Phe68LeufsTer32 resulting in a reading frame shift and a premature termination codon in two unrelated children with progressive weight gain from birth. According to the pathogenicity evaluation criteria, both variants are categorized as likely pathogenic variants

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.

The recombinant technologies era, which began in the second half of the XX century, made it possible to produce recombinant growth hormone (rGH) necessary for the treatment of stunting of various genesis. The time of practically unlimited possibilities of rGH production has come, which served as a stimulus for studying the efficacy and safety of rGH application, searching for optimal ways of its use and dosing regimes. Many years of experience in the use of somatropin in clinical practice allowed us to obtain data on its effectiveness primarily in somatotropic insufficiency in children, to study its effect on the functional state of various organs and systems, and to expand the indications for the use of RGR.

BACKGROUND:Type 1 diabetes mellitus (T1DM) is the most common form of diabetes mellitus in childhood, where, unlike in adults, it accounts for more than 90% of all cases of diabetes. The constant change in the epidemiology of T1DM with significant differences in populations and regions requires systematic data collection and analysis for timely monitoring of T1DM trends. AIM:Analysis of the main epidemiological indicators of T1DM in children in the Russian Federation over the past 10 years - from 2014 to 2023. MATERIALS AND METHODS:The object of the study was the data obtained from the federal statistical observation form No. 12 «Information on the number of diseases registered in patients living in the service area of a medical organization» for the period from 2014 to 2023. The prevalence (total number of registered cases) and incidence (cases with a diagnosis established for the first time) of T1DM (ICD-10 code: E10) were analyzed in children in three age groups: from 0 to 14 years, from 15 to 17 years, and combined from 0 to 17 years (inclusive). RESULTS:Over the analyzed period, the prevalence of T1DM increased steadily from 238.6 in 2014 to 374.2 cases per 100,000 children in 2023. The prevalence of T1DM in adolescents from 15 to 17 years was higher than in children and amounted to 120.3-203.2 cases per 100,000 adolescents, while in children under 14 years of age, the prevalence was 100.1-172.2 cases per 100,000 children. The annual increase in the prevalence of T1DM averaged 6.3% (95% CI 4.9-7.8). The incidence of T1DM during the analyzed period was 19.1-27.2 cases per 100,000 children and also had a general tendency toward an annual increase in new cases. At the same time, over the past three years, there has been a relative stabilization of incidence rates at 26.5-27.2 per 100,000 children. The annual increase in incidence averaged 4.9% (95% CI 0.9-8.9). The greatest increase in the incidence of T1DM was observed in regions with low incidence. CONCLUSION:The epidemiology of T1DM in the Russian Federation is characterized by significant regional and dynamic changes. Over the period 2014-2023, the incidence of type 1 diabetes in children has increased significantly, increasing annually by an average of 5%, while there has been a relative stabilization of incidence rates over the past three years.

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders requiring lifelong glucocorticoid replacement (GC) therapy. Lack of GC therapy leads to precocious puberty in boys, heterosexual development in girls, accelerated bone maturation and short final height in both sexes. In adolescence, the lack of GC therapy is the cause of menstrual disorders in girls and the development of TART in boys, as a result reducing the reproductive potential in both sexes. On the other hand, an overdose of GC leads to drug-induced Itsenko-Cushing’s syndrome. In order to select adequate doses of GC in childhood and adolescence, multiple determinations of 17-hydroxyprogesterone, androstenedione, and testosterone in blood plasma, and thus multiple venous blood sampling are required. The blood sampling requires specially trained medical staff and can effect on the results due to stress reaction especially in young patients. Hence, the development and implementation of a non-invasive method for determining the steroid profile is extremely important in monitoring GC therapy in children. In addition, the currently used immunofluorescence assay cannot determine other adrenal steroids, has a high variation due to the «cross-reaction» of steroids that are similar in structure, which inflates the results. Unlike immunofluorescence assay, liquid chromatography and tandem mass spectrometry is more preferable method, since it is more specific and accurate. In this literature review, saliva presented as an alternative substrate and the non-invasive method for determining the steroid profile. This method can solve the above disadvantages, simplify and make more accurate the selection of GC therapy in patients with CAH, which is especially important in childhood.

Cowden disease (Cowden syndrome) refers to PTEN-associated hamartoma tumor syndromes. It arises due to a mutation in the phosphatase and tensin homolog gene, one of the main functions of which is cell cycle regulation. The presence of a mutation in the gene leads to uncontrolled cell growth, and patients have a lifelong increased risk of neoplasms of various degrees of malignancy. This article presents a clinical case of Cowden syndrome with an early debut at the age of 7 years. The combination of macrocephaly (SDS of head circumference >2) with various skin manifestations (facial trichilemmomas, acral keratosis, papillomatous papules) and the presence of benign and/or malignant neoplasms are pathognomonic for Cowden syndrome. Of the malignancies, breast and thyroid cancer, colorectal cancer, renal cell carcinoma, and endometrial cancer are the most common. Thyroid carcinoma has been shown to have an earlier age of manifestation and often occurs already in childhood. This determines the need to screen patients with a proven mutation in the PTEN gene for nodal neoplasms from an early age. If surgical treatment is necessary, thyroidectomy remains preferable due to the frequent recurrence of nodules, as well as the uncertain potential for malignancy due to the low study of thyroid nodules in patients with mutations in the PTEN gene.

Ежегодно в Институт детской эндокринологии ГНЦ ФГБУ «НМИЦ эндокринологии» Минздрава России госпитализируется более 5,5 тысяч детей и подростков из всех регионов РФ с различными эндокринными заболеваниями. С целью аккумуляции уникальных данных для дальнейшего клинико-эпидемиологического мониторинга этих пациентов разработана структура единой ЭНДОКАРТЫ учета 7 нозологий, внедренная в медицинскую информационную систему (МИС) ГНЦ ФГБУ «НМИЦ эндокринологии»: опухоли гипоталамо- гипофизарной области, первичный гиперпаратиреоз, хронический гипопаратиреоз, гипогликемический синдром, гонадотропинзависимое преждевременное половое развитие, низкорослость и врожденная дисфункция коры надпочечников (ВДКН). ЦЕЛЬ: оценить структуру патологии редких эндокринных заболеваний у лиц детского возраста (менее 18 лет), госпитализированных в ГНЦ ФГБУ «НМИЦ эндокринологии». МАТЕРИАЛЫ И МЕТОДЫ: объект исследования - база данных ГНЦ ФГБУ «НМИЦ эндокринологии» Минздрава России детей в возрасте от 0 до 18 лет. Детская Эндокарта начала функционировать с декабря 2020 года. Анализ выполнен по данным выгрузки от 15.01.2023. РЕЗУЛЬТАТЫ: регистр первичного гиперпаратиреоза включает 18 детей (8 мальчиков, 10 девочек), средний возраст составляет 16 лет. При первичном обращении у 8 детей (44,5%) наблюдалось мани- фестное течение первичного гиперпаратиреоза, у 10 (55,5%) пациентов мягкое течение. В группе па- циентов в активной фазе заболевания медианы паратгормона и общего кальция составили 131,7 пг/мл и 2,89 ммоль/л соответственно. Всем детям было проведено хирургическое лечение и достигнута ремиссия. Регистр опухолей гипоталамо-гипофизарной области включает данные о 38 детях (17 мальчиков, 21 де- вочка), средний возраст 14 лет. Болезнь Иценко-Кушинга имелась у 11 (29%) пациентов, другие аденомы гипофиза (пролактиномы, СТГ-продуцирующие аденомы и другие) встречались у 27 (71%) пациентов, из них большая часть составили пролактиномы – 22 ребенка. Регистр хронического гипопаратиреоза содержит сведения о 19 пациентах (12 мальчиков, 7 девочек), средний возраст 11 лет, из данной группы пациентов АПС 1 типа имелся у 5 (26%) детей, послеоперацион- ный гипопаратиреоз и наследственный гипопаратиреоз (за исключением АПС 1 типа) - у 4 (21%) пациентов и 3 (16%) пациентов соотвественно . Регистр детей с гипогликемиями включает сведения о 192 ребенке (106 мальчиков, 86 девочек), сред- ний возраст 4 года. Из них у 107 (56%) пациентов имелся врожденный гиперинсулинизм, подтвержденный молекулярно-генетическим исследованием. Регистр гонадотропинзависимого преждевременного полового развития включает данные 130 детей (28 мальчика, 102 девочки), средний возраст 8 лет. Средний возраст начала заболевания - 6 лет. Терапию аналогами ЛГ-РГ получают 76 детей (58,6 %), костный возраст которых статистически значимо опережал хронологический (10 лет vs. 6 лет, p<0,001). Регистр низкорослости включает данные о 354 пациентах (240 мальчик, 114 девочек), средний возраст 11 лет. Структура нозологии: гипопитуитаризм – 217 (61%) пациентов, другие варианты низкорослости (в том числе идиопатическая задержка роста, синдром Шерешевского-Тернера и другие синдромальные формы) – 137 (39%) пациент. Регистр пациентов с ВДКН включает 82 ребенка (29 мальчиков, 53 девочки), средний возраст 5 лет. В 80,5 % (n = 66) заболевание связано с дефицитом 21-гидроксилазы, у 19,5 % (n = 16) детей ВДКН ассоциирована с нарушением синтеза других ферментов стероидогенеза (11b-гидроксилазы, 3b-гидроксистероиддегидрогеназы и пр.).ВЫВОДЫ: ГНЦ ФГБУ «НМИЦ эндокринологии» Минздрава России аккумулирует экспертное мне- ние по проблеме орфанных эндокринных заболеваний детского возраста в Российской Федерации. Организация структуры системы учета редких эндокринопатий позволит оценить структуру и клинико- эпидемиологические характеристики данных нозологий, распределение по регионам РФ, провести ана- лиз эффективности терапии, что послужит научно-практической основой совершенствования оказания помощи по профилю «детская эндокринология».

BACKGROUND : Gonadotropin therapy in boys with congenital isolated hypogonadotropic hypogonadism helps to increase testes volume and induce spermatogenesis in comparison with testosterone therapy. However, difficulties with dose titration, partial therapy success, absence of generally accepted regimen protocols don’t allow to use this therapy in order to induce puberty in adolescents with Kallmann syndrome or normosmic hypogonadotropic hypogonadism. AIM : To assess the effectiveness of combination hormonal replacement therapy via human chorionic gonadotropin and recombinant follicle stimulation hormone in adolescents with congenital isolated normosmic hypogonadotropic hypogonadism and with Kallmann syndrome MATERIALS AND METHODS : This is an open single-center prospective non-controlled study. Boys with hypogonadotropic hypogonadism were receiving hormonal replacement therapy for 12 months. Initial dose of human chorionic gonadotropin was 500 IU per week. Initial dose of recombinant follicle stimulation hormone was 37.5 IU per week. Doses were doubled in 6 months. Antropometric data, Tanner stage, testes volumes, inhibin B and anti-Mullerian hormone (AMH) levels were evaluated in all the patients before the treatment, after 6 and 12 months of the therapy. RESULTS : 8 boys with hypogonadotropic hypogonadism were included into the study. Median age before therapy initiation was 15.7 years [15.33; 16.41]. In 12 months after the therapy initiation puberty development, testosterone increase from 0.44 [0.34;0.62] to 4.39 [0.88;10.51] nmol/l (p=0.012), AMH decrease from 35.70 [18.00;59.00] to 14.41 [11.60;16.65] ng/ml were noted in all the patients (p=0.017). Testes volumes increase and inhibin B level increase were not statistically significant. CONCLUSION : Gonadotropin therapy is effective in order to puberty initiation in adolescents with congenital hypogonadotropic hypogonadism. In helps to achieve not only androgenization, but also to Sertoli cells maturation.

BACKGROUND: The majority of Kallmann patients have anosmia or hyposmia. This is how the disease is diagnosed. Some of them don’t have such complaints but olfactory dysfunction is diagnosed via olfactometry. Nowadays there is the lack of information about correlation between olfactometry results and subjective complaints. Correlation between olfactory bulbs size and olfactory dysfunction has been little studied. AIM: To explore olfactory bulb size and olfactory function in patients with congenital isolated hypogonadotropic hypogonadism. To correlate olfactory bulb sizes and smell test scores. MATERIALS AND METHODS : Single-centre comparative study. 34 patients were included. The main group consisted of 19 patients with hypogonadotropic (15 –with Kallmann syndrome, 4 — with normosmic hypogonadism). Olfactory bulbs MRI were provided to all the patients, olfactory test (Sniffin’ Sticks Test) and molecular-genetic studies were provided in all patients with hypogonadism. Control group consisted of 15 patients who were provided with orbits MRI. Olfactory bulbs were evaluated additionally in them. RESULTS: Normal size of olfactory bulbs were only in 1 patient with hypogonadism. Olfactory bulbs height and width were significantly smaller in patients with hypogonadism in comparison with control group (p<0.01). Height median of right bulb was 1.0 mm [0.2; 1.8] in patients from the main group vs. 3.0 [2.5; 3.2] in controls, width median of right bulb was 1.0 mm [0.2; 1.9] in patients from the main group vs. 2.5 [2.0; 3.0] in controls. Height median of left bulb was 0.8 mm [0.0; 1.2] in patients from the main group vs. 3.0 [2.7; 3.2] in controls, width median of left bulb was 0.8 mm [0.0; 1.2] in patients from the main group vs. 2.5 [2.0; 3.0] in controls. Correlation has been established between left bulb height (r=0.59) and width (r=0.67) and olfactometry results (p<0.05). 4 patients had no anosmia complaints but had olfactory dysfunction according to Sniffin’ Sticks Tests. CONCLUSION: Olfactometry was able to diagnose olfactory dysfunction in 78.5% (i.e. in 15 out of 19 patients with congenital isolated hypogonadotropic hypogonadism. However, anosmia complaints had only 11 out of 19 patients. It is the first results of olfactory bulb sizes in patients with hypogonadotropic hypogonadism in Russia. Uni — or bilateral hypoor aplasia were diagnosed in 94.7% patients with hypogonadism regardless of olfactory dysfunction. Bilateral olfactory bulbs hypoplasia were the most common MRI-finding (36.8%). Unilateral hypoor aplasia was diagnosed in 31.6% patients.

Therapeutic training is an integral part of the treatment of chronic diseases such as diabetes mellitus. It makes patients aware of the importance of living well and taking care of their health. It is not possible to successfully control a chronic disease even with the successful use of all medical gadgets of modern medicine without the active participation of the patient. Diabetes mellitus is a prime example of a disease where the success of treatment depends on the patient's active participation. He must not only agree with the doctor's instructions, but also constantly monitor his condition and make decisions related to nutrition, physical activity, health. Managing your health requires specialized training that can be obtained from doctors and other medical professionals. This training program will help the patient to better understand their disease and learn to successfully control it in various life situations. It is important not only to communicate information, but also to help patients make the right decisions and find motivation to change their habits. Education should be tailored to the individual needs of each patient and take into account their psychological characteristics. All this requires serious training of specialists and continuous improvement of methods of schools for patients with diabetes mellitus. The issue of social support for patients is also an important element of diabetes education. The WHO Resolution notes the need to provide patients with access to social and psychological support as it helps them to cope with the psychosocial problems associated with their illness and increases the effectiveness of therapy.

Telemedicine technologies in pediatric patients with type 1 diabetes mellitus (T1D) is an effective approach that have begun to be used recently. The purpose of this research was to evaluate the possibility and effectiveness of remote observation and training of children with newly diagnosed T1D in selected Russia regions. Materials and methods used: a multicenter prospective open uncontrolled experimental clinical study involved 92 children aged 1 to 18 y/o with T1D receiving intensified insulin therapy who were divided into two groups: G1 of 60 patients with T1D manifestation of less than 12 weeks prior to the inclusion in the study, and G2 of 32 children with T1D manifestation lasting over 12 weeks prior to the inclusion with poor disease control (glycated hemoglobin at 8% and above) from troubled families. The main indicator for evaluating the effectiveness was the glycated hemoglobin (HbA1c) level. Results: median age was 9.2 (6.2-11.2) y/o, 47 boys/45 girls. A total of 401 remote consultations had been carried out in various forms. The HbA1c level decreased statistically significantly by the end of the study by 3.5% and 0.6% (p<0.001) in G1 and G2, respectively. Statistically significant (p<0.001) increase in the number of patients with HbA1c at the level of less than 7% was reached, with most of them (52%) reaching the target glycemic control parameters. Telemedicine technologies therefore represent the effective (in terms of glycemic control) addition to the traditional dispensary observation, which in its turn increases the availability of medical care for children with endocrine diseases.

BACKGROUND:X-linked adrenoleukodystrophy (X-ALD) is a severe neurodegenerative metabolic disease with a frequency 1:17,000 in newborn boys. Being a major part of X-ALD with an incidence of 70-80% of patients, adrenal insufficiency (AI) is a life-threatening condition without timely treatment. The possibility of developing AI during the whole disease duration and the absence of any predictive factor for AI joining shows the necessity of studying AI in X-ALD patients to optimize current diagnostic and treatment algorithms. AIM:To study diagnostic and therapeutic features of primary adrenal insufficiency due to X-ALD. MATERIALS AND METHODS:A retrospective observational comparative study was conducted in 66 male patients, examined and treated in the Pediatric endocrinology department of Endocrinology Research Centre, Research Centre for Medical Genetics, Research and Clinical Institute for Pediatrics of the Pirogov Russian National Research Medical University Detached Structural Unit Russian Children's Clinical Hospital (Moscow, Russia) for 2014-2022. All of patients were diagnosed with primary AI and a genetically confirmed X-ALD. RESULTS:The median age of X-ALD manifestation was 6.6 years [4.7; 11.1]. The earliest age of AI diagnosis was 1.5 years at the preclinical stage and 1 year 8 months with clinical symptoms. The renin level was studied in 22.7% at the manifestation of AI (15/66 patients), mineralocorticoid deficiency was found in 7 patients. Family history was positive in 39.4% of patients (n=66), only in 15.1% (10/66 patients) of patients the disease was established at the preclinical stage. In 59.1% (n=66) the cerebral form of the disease (cALD) was established, in 16.6% - adrenomyeloneuropathy (AMN), and in 24.2% - isolated adrenal insufficiency (PAI). Age of AI establishment in the group of patients with AMN (15.6 years) significantly differs from the establishment of AI in patients with cALD (7.4 years, p=0.001) and PAI (5.6 years, p = 0.000). Mineralocorticoid therapy was prescribed simultaneously with glucocorticoid therapy in patients with cALD, in AMN and PAI patients it was added after 11 and 7 months, respectively (the differences between AMN and PAI groups were insignificant). Combined hormonal therapy receive 41% of patients with cALD, 54.5% of patients with AMN and 60% of patients with PAI. CONCLUSION:It is necessary to examine all male patients with AI regardless of the manifestation age to exclude adrenoleukodystrophy, and it is also important to examine patients for the presence of AI regardless of X-ALD manifestation age. The assessment of renin level in the manifestation of AI is also needed to prescribe mineralcorticoid therapy timely. Studying family history is the main method to detect X-ALD at the preclinical stage.

ОБОСНОВАНИЕ ОБОСНОВАНИЕ. В подавляющем большинстве пациенты с синдромом Кальмана отмечают неспособность различать запахи, что помогает своевременно установить диагноз. Некоторые из пациентов с синдромом Кальмана не предъявляют подобных жалоб, но при помощи ольфактометрии с использованием специальных наборов пахучих веществ у них выявляются нарушения обоняния. Нарушения обоняния часто отмечаются у пациентов с гипоплазией или аплазией одной или обеих обонятельных луковиц (ОЛ). Характер взаимосвязи размеров обонятельных луковиц и гипоили аносмии по результатам ольфактометрии у пациентов с ВИГГ в настоящее время мало изучен. ЦЕЛЬ ЦЕЛЬ. Изучить размеры ОЛ и обонятельную функцию у детей с ВИГГ. Установить наличие взаимосвязи между размерами ОЛ и обонятельной функцией. МАТЕРИАЛЫ И МЕТОДЫ МАТЕРИАЛЫ И МЕТОДЫ. Одноцентровое одномоментное сравнительное исследование. В исследование включены 34 пациента. Основную группу составили 19 детей с гипогонадотропным гипогонадизмом (15 — с синдромом Кальмана, 4 — с нормосмическим гипогонадотропным гипогонадизмом). Всем пациентам проводилась МРТ головного мозга с оценкой размеров ОЛ, ольфактометрический тест (Sniffin’ Sticks Test) и молекулярно-генетические исследования. Контрольную группу составили 15 детей, у которых при проведении МРТ орбит дополнительно оценивали размеры ОЛ. РЕЗУЛЬТАТЫ РЕЗУЛЬТАТЫ. Из 19 пациентов с ВИГГ нормальные размеры ОЛ имелись только у 1 пациента. У детей с гипогонадизмом высота и ширина ОЛ оказались достоверно меньше (p<0,01) в сравнении с контролем. Медиана высоты правой луковицы (ПЛ) у пациентов с ВИГГ составила 1,0 мм [0,2; 1,8] против 3,0 [2,5; 3,2] в контрольной группе, медиана ширины ПЛ — 1,0 мм [0,2; 1,9] против 2,5 [2,0; 3,0], медиана высоты левой луковицы (ЛЛ) у пациентов с ВИГГ — 0,8 мм [0,0; 1,2] против 3,0 [2,7; 3,2], медиана ширины ЛЛ — 0,8 мм [0,0; 1,2] против 2,5 [2,0; 3,0]. Выявлена корреляция между высотой (r=0,59) и шириной (r=0,67) левой ОЛ и результатами ольфактометрического теста (p<0,05). У 4 пациентов субъективная оценка обонятельной функции не совпала с данными ольфактометрического исследования. ЗАКЛЮЧЕНИЕ ЗАКЛЮЧЕНИЕ. Ольфактометрия позволила выявить нарушения обоняния у 78,5% пациентов с изолированным гипогонадотропным гипогонадизмом (15 из 19 пациентов), при этом субъективно на нарушения обоняния жаловались только 11 из 19 пациентов. Впервые в РФ представлены размеры ОЛ у пациентов с изолированным гипогонадотропным гипогонадизмом. У 94,7% пациентов вне зависимости от нарушения обонятельной функции отмечалась гипоплазия и/или аплазия одной или обеих ОЛ. Чаще всего встречалась гипоплазия обеих луковиц (36,8%), изменения ольфакторных луковиц (гипоплазия или аплазия) с одной стороны имелись у 31,6% пациентов.

BACKGROUND: Adipomyokines are synthesized and secreted into the bloodstream by cells of both muscle and adipose tissue. They can have both a negative metabolic effect, acting as pro-inflammatory adipokines in obesity, and a positive one, increasing in response to physical exertion in the form of myokines.AIM: To study the features of adipocytokine secretion in children with constitutionally exogenous obesity.MATERIALS AND METHODS: The study included 80 patients: 60 adolescents aged 15 [13; 16] years with constitutionally exogenous obesity SDS BMI: 3.0 [2.6; 3.3] and 20 control group children aged 16 [15; 17] years without excess weight SDS BMI: -0.3 [-1.25; 0.33]. Commercial enzyme immunoassay kits were used to determine the level of adipomyokines. The compositional composition of the body was evaluated by bioimpedance analysis (InBody 770 analyzer, South Korea) in the morning, on an empty stomach. Statistical processing was carried out using STATISTICA v.12.0 (StatSoft Inc., USA). The results are presented in the form of median (Me) and quartiles (Q1; Q3) corresponding to 25 and 75 percentiles. The critical significance level (p) was assumed to be <0.05.RESULTS: Levels of IL-6 and irisin are statistically significantly higher in obese adolescents compared to the control group: 0.55 [0.226; 1.35] pg/ml vs 0.202 [0.128; 0.652] pg/ml (p=0.041) and 11.16 [6.6; 22.76] mcg/ml vs 7.36 [6.48; 9.68] mcg/ml (p=0.043), respectively. Concentrations of IL-6, myostatin and decorin increase with an increase in the degree of obesity: grade I vs III: 0.226 [0.224; 0.398] vs 0.80 [0.36; 1.81] pg/ml (p=0,0197), 25,85 [21,53; 28,23] vs 31.41 [24.36; 35.06] ng/ml (p=0.03), 4065.3 [3244.9; 5245.5] vs 5322.5 [4199.8; 7702.4] pg/ml (p=0.0376), respectively. In obese children, IL-6 levels positively correlate with BMI, SDS BMI and the amount of adipose tissue, and myostatin — with BMI and SDS BMI. The concentration of irisin in the blood serum is significantly higher in obese girls than in obese boys and healthy girls. Obese patients, compared with lean peers, are characterized by a statistically significantly higher content of both fat and lean mass. With the progression of obesity, there is a statistically significant increase in the ratio of fat to lean mass (I degree — 0.66 [0.56; 0.7], III — 0.78 [0.68; 0.98] (p=0.0073).CONCLUSION: Patients with obesity and normal body weight have different levels of adipomyokines. An increase in the level of IL-6 with the progression of obesity is directly related to an increase in the content of adipose tissue. Further study of the features of adipocytokine secretion, their relationship with the features of the body composition and metabolic complications in obesity is required.