6 курс / Эндокринология / Ожирение_у_детей_и_подростков_Коваренко_М_А_,_Денисов_М_Ю_
.pdfQ 13
) A$#$) . $ $% % " "$ $%$ TA, " ):' # . %$" +
"$ $% |
|
TA |
|
|
||
|
|
|
|
|
|
|
1 |
|
|
2 |
|
|
|
|
/, |
|||||
|
, (]phedra L.), , |
|||||
|
. |
|
|
|
||
|
., - |
|||||
|
a- b- . - - |
|||||
|
, |
|
! |
|||
?$'# |
, . 7 |
|||||
-% + |
, !, - |
|||||
|
! !, . . |
|
||||
|
' (25 40 % ,- |
|||||
|
,) |
(60 75 % |
||||
|
,,). |
|
|
|
|
|
|
5 / ! - |
|||||
|
.b/ |
|||||
'$ |
2 |
|
|
|||
, , |
: |
|||||
)+ ' ), |
||||||
25 50 2 3 |
|
|
||||
" ):'$- |
$ 12 - |
|||||
"$%- |
. |
.' |
12 |
2 3 / |
||
|
(100 / 2) , 4 6 |
|
||||
|
• 6 . |
|||||
|
• < . |
|
|
|||
% "$- |
• /. |
|
|
|
|
|
• / . |
|
|
||||
'$+ |
• /. |
|
|
|
||
|
• 4 . |
|
||||
|
• 6 |
|
|
|
41
1 |
2 |
|
$%- |
Q ,, , , - |
|
/4, ,, - |
||
, '$#-- |
. M- |
w- ! |
% + |
,,. |
. |
|
! . |
|
S # %: |
- |
|
)$%$+ |
|
|
|
5 . $ |
|
%- |
' |
|
. . |
! ! |
|
+ |
, , |
|
|
||
|
, ' |
# %$( ) . #$
! , ( . 14). 6 !.
Q 14
) A$#$) . $ $% % " "$ $%$ A (? %A #), " ):' # . %$"
# %$( ) . #$
"$ $% |
|
A (? %A #) |
|
|
|
1 |
|
2 |
|
- . |
|
|
• -' - |
|
|
, |
. |
|
• 5 ! , |
|
|
. |
|
?$'# |
• -' , ! ! !. |
|
-% + |
• . |
! '. |
|
• . |
!. |
|
• 6 . |
|
|
• / , . |
|
|
• 4 / ! - |
|
|
.b/ |
42
1 |
|
2 |
|
|
|
|
0 #$ |
4 500 850 ,- |
|||||
,"$ |
|
|
|
|
||
|
Q ! - |
|||||
'$ |
. 5 ! |
|||||
500 1000 . - ! |
||||||
)+ ' ), |
1500 3000 . 1- |
|||||
|
' 3000 ' - |
|||||
|
! ,, |
|
|
|||
" ):'$- |
+ |
|
' |
|||
"$%- |
||||||
10 500 2 |
|
|||||
|
|
|||||
|
|
|
|
|
||
|
• + , |
|||||
|
|
|
||||
|
2- . |
|
|
|||
|
• - . |
|||||
% "$- |
• Q ' , . |
|||||
'$+ |
• . . |
|||||
|
• Q ,. |
|
|
|
||
|
• * . |
|
|
|||
|
• 4 , , . |
|
||||
|
• 6 , |
|
||||
|
• 7 |
|
,, - |
|||
|
- |
|||||
$%- |
,, , |
|||||
, '$#-- |
|
|
- |
|||
% + |
, ( ). |
|||||
|
• 4 ,, . |
|||||
|
• + ,, |
|
|
|||
S # %: |
- |
|
|
|
||
)$%$+ |
|
|
|
|
|
|
|
• . |
|
|
|||
|
• Q ', |
, |
|
, |
|
|
( , |
( 5 20 % ). - - |
|||||
|
||||||
;AA %, |
||||||
|
||||||
|
||||||
|
,, P*Q. |
|
||||
|
• * ( ) |
|
43
1 |
|
2 |
|
|
|
• - , |
|
6 |
|
|
, . |
|||
|
• - - |
|||
|
, - |
|||
|
|
! 2 |
||
|
! 2 . |
|
||
|
• 5 '- |
|||
|
2 - |
|||
%- |
. |
|
|
|
+ |
• 5 |
|||
|
, - |
|||
|
,- . |
|||
|
• 2 |
|
|
' |
|
2,4 1 . |
|
||
|
• - - |
|||
|
. |
|
|
|
|
• 5 - |
|||
|
! |
|
|
Q ,
. 4 -
.
44
3
"#$/+5&*$& 1. % ) $ #$, % )$ (BMI)#$): 2 20 ) %
45
"#$/+5&*$& 2. % ) $ #$, % )$ (BMI)
2 20 ) %
46
"#$/+5&*$& 3. 95 " % ): $%$): . $) +
)+ %- " " ), '$% %
|
|
|
|
?$): |
|
|
|
|
|
|
|
|
|
|
|
|
||||||
,. , |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
% ) |
$% ) |
% ) |
$% ) |
|||||||||||||||||||
' $ % |
||||||||||||||||||||||
|
|
1 |
|
|
|
|
1 |
|
|
|
|
1 |
|
|
|
|
1 |
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
5 |
25 |
50 |
75 |
95 |
5 |
25 |
50 |
75 |
95 |
5 |
25 |
|
50 |
75 |
95 |
5 |
25 |
50 |
75 |
95 |
||
|
|
|||||||||||||||||||||
|
2 |
2 |
2 |
|
2 |
|||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 |
98 |
101 |
102 |
104 |
106 |
55 |
56 |
57 |
58 |
59 |
101 |
103 |
104 |
105 |
107 |
57 |
57 |
58 |
59 |
60 |
||
|
||||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
3 |
104 |
107 |
109 |
111 |
113 |
63 |
64 |
65 |
66 |
67 |
104 |
105 |
107 |
108 |
110 |
65 |
65 |
66 |
67 |
68 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
5 |
108 |
110 |
112 |
114 |
116 |
69 |
70 |
71 |
72 |
74 |
107 |
108 |
110 |
111 |
113 |
69 |
70 |
71 |
72 |
73 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
7 |
110 |
113 |
115 |
116 |
119 |
74 |
75 |
76 |
77 |
78 |
110 |
112 |
113 |
114 |
116 |
73 |
73 |
74 |
75 |
76 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
9 |
113 |
116 |
117 |
119 |
121 |
76 |
78 |
79 |
80 |
81 |
114 |
115 |
117 |
118 |
120 |
75 |
76 |
77 |
78 |
79 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
11 |
116 |
119 |
121 |
123 |
125 |
78 |
79 |
80 |
81 |
83 |
118 |
119 |
121 |
122 |
124 |
78 |
79 |
79 |
80 |
81 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
13 |
121 |
124 |
126 |
128 |
130 |
79 |
81 |
82 |
83 |
84 |
121 |
123 |
125 |
126 |
128 |
80 |
81 |
82 |
82 |
84 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
15 |
127 |
129 |
131 |
133 |
135 |
81 |
83 |
83 |
84 |
86 |
124 |
126 |
128 |
129 |
131 |
82 |
83 |
83 |
84 |
86 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
17 |
132 |
135 |
136 |
138 |
140 |
85 |
86 |
87 |
88 |
89 |
126 |
127 |
129 |
130 |
132 |
83 |
83 |
84 |
85 |
86 |
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
"#$%&H(*$&. 2 — !
.
47
S S 8 10 R
8/$+#$* .. ^. 4 . 3.: , 1989. 256 .
G5$#&*$& / 0. +. . , 3. -. e, 3. /. e, /. 0. C. .- .: h3C+-.- , 2003. 216 .
W&99%&* _5., W&99%&* `. L
: $ . : - . . .: , 2000. 656 .
AvRuskin T. W., Pillai S., Kasi K., Juan C., Kleinberg D. L. Decreased prolactin secretion in childhood obesity // J. Pediatr. 1985. Vol. 106, € 3. 2. 373 378.
Bonora E., Targher G., Alberiche M. et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity // Diabetes Care. 2000. Vol. 23. 2. 57—63.
Caprio S., Bronson M., Sherwin R. S., Rife F., Tamborlane W. V.
Co-existence of severe insulin resistance and hyperinsulinaemia in preadolescent obese children // Diabetologia. 1996. Vol. 39. 2. 1489—1497.
Clarke W. R., Lauer R. M. Does childhood obesity track into adulthood? // Crit. Rev. Food Sci. Nutr. 1993. Vol. 33, € 4 5. 2. 423 430.
Dietz W. H. Critical periods in childhood for the development of obesity // Am. J. Clin. Nutr. 1994. Vol. 59, € 5. 2. 955 999.
Himes J. H., Dietz W. H. Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services // Am. J. Clin. Nutr. 1994. Vol. 59, € 2. 2. 307 316.
Johnston F. E. Health implications of childhood obesity // Ann. Intern. Med. 1985. Vol. 103, € 6 (Pt 2). 2. 1068 1072.
Nieto F. J., Szklo M., Comstock G. W. Childhood weight and growth rate as predictors of adult mortality // Am. J. Epidemiol. 1992. Vol. 136, € 2. 2. 201—213.
48
Sari R., Balci M. K., Altunbas H., Karayalcin U. The effect of body weight and weight loss on thyroid volume and function in obese women // Clin. Endocrinol. (Oxf). 2003. Vol. 59, € 2. 2. 258 262.
Sinha R., Fisch G., Teague -. et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. // N. Engl. J. Med. 2002. Vol. 346. 2. 802—810.
Troiano R. P., Flegal K. M., Kuczmarski R. J., Campbell S. M., Johnson C. L. Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991 // Arch. Pediatr. Adolesc. Med. 1995. Vol. 149, € 10. 2. 1085 1091.
Tuzcu A., Bahceci M., Dursun M. et al. Insulin sensitivity and hyperprolactinemia // J. Endocrinol. Invest. 2003. Vol. 26, € 4. 2. 341 346.
49
8 1 |
|
|
- ............................................................................................ |
|
3 |
L, ! ...................................... |
|
4 |
2 ....................................................................... |
|
6 |
1 (,)......................................................... |
|
9 |
* , .................................................................... |
|
13 |
- ........................ |
16 |
|
3 , ! ........................ |
16 |
|
6 ............................................ |
|
17 |
- ...................... |
18 |
|
/ , ........................................... |
|
18 |
1 : .......................... |
19 |
|
3 : .......................................................... |
|
19 |
4 ......................................................................... |
|
19 |
3 ................................................................................ |
|
23 |
a .................................................................................... |
|
23 |
6 .................................................................... |
|
23 |
4 ......................................................... |
|
24 |
$ ! |
.................... |
24 |
1...................................................................................................... |
|
24 |
4 ................................ |
24 |
|
2 ......................... |
25 |
|
Q ....................................... |
|
25 |
* ................................................................................... |
|
26 |
2 ............................................................................. |
|
29 |
-' ............................................... |
|
30 |
................................................................... |
|
33 |
- ( ) ................................................................... |
|
33 |
* , |
...................... |
34 |
3 .............................................. |
|
42 |
- .......................................................................................... |
|
45 |
C , ................................................................. |
|
48 |
50