Что нужно знать педиатру о метаболическом синдроме. Подходы к коррекции

1. Мищенкова Т.В., Звенигородская Л.А., Ткаченко Е.В. Роль эндоканнабиноидной системы в патогенезе морбидного ожирения. РМЖ. 2009; 11 (1): 12–7.
2. Звенигородская Л.А., Кучеренко Т.В., Ткаченко Е.В. и др. Типы пищевого поведения и гормоны пищевого поведения у больных с метаболическим синдромом. Эксперим. и клин. гастроэнтерология. 2007; 1: 24–7.
3. Захарова И.Н., Звенигородская Л.А., Яблочкова С.В. Метаболический синдром: взгляд педиатра. Эксперим. и клин. гастроэнтерология. 2010; 7: 84–91.
4. Troiano RP, Briefel RR, Carroll MD, Bialostosky K. Energy and fat intakes of children and adolescents in the United States: data from the National Health and Nutrition Examination Surveys. Am J Clin Nutr 2000; 72 Suppl.: 1343–53.
5. Dwyer JT, Evans M, Stone EJ et al. Adolescents' eating patterns influence their nutrient intakes. J Am Diet Assoc 2001; 101: 798–802.
6. American Dietetic Association. Evidence analysis library. Accessed July 12, 2007. Available at: www.adaevidencelibrary.com
7. Малявская С.И., Дворяшина И.В., Терновская В.А. Метаболический инсулинрезистентный синдром: диагностика, клиническое значение, педиатрические аспекты. Архангельск: Северный государственный медицинский университет, 2004.
8. Bonnie A. Spear, Sarah E. Barlow, Chris Ervin et al. Recommendations for Treatment of Child and Adolescent Overweight and Obesity. Pediatrics 2007; 120: 254–88.
9. Гинзбург М.М., Козупица Г.С., Крюков Н.Н. Ожирение и метаболический синдром. Влияние на состояние здоровья, профилактика и лечение. Самара: Парус, 2000.
10. Food and nutrition board, institute of medicine of the national academies Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). National Academies Press 2005; p. 504.
11. Uauy R, Aro A, Clarke R et al. WHO Scientific Update on trans fatty acids: summary and conclusions. Eur J Clin Nutr 2009; 63: 68–75.
12. Acheson KJ, Schutz Y, Bessard T et al. Glycogen storage capacity and de novo lipogenesis during massive carbohydrate overfeeding in man. Am J Clin Nutr 1988; 48: 240–7.
13. Касаткина Э.П., Одуд Е.А. Гликемические индексы продуктов и блюд в планировании питания больного инсулинзависимым сахарным диабетом. Проблемы эндокринологии. 1993; 39 (6): 39.
14. Jenkins DJ, Wolever TM, Taylor RH et al. Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 1981; 34 (3): 362–6.
15. Spieth LE, Harnish JD, Lenders CM et al. A low-glycemic index diet in the treatment of pediatric obesity. Arch Pediatr Adolesc Med 2000; 154: 947–51.
16. Черникова Н.А. Практические аспекты рационального питания при сахарном диабете. РМЖ 2009; 17 (10): 702–6.
17. Leonard H. Epstein, Rocco A. Paluch, James N. Roemmich. Increasing Healthy Eating vs. Reducing High Energy-dense Foods to Treat Pediatric Obesity. Obesity (Silver Spring), 2008; 16 (2): 318–26.
18. Ref. Australian Guide to Healthy Eating and Dietary Guidelines for children and adolescents in Australia; http://koala.imb.uq. edu.au/files/YourTrafficLightGuidetoEating WeightMan.pdf
19. American Academy of Pediatrics, Committee on Nutrition. The use and misuse of fruit juice in pediatrics. Pediatrics 2001; 107: 1210–3.
20. Striegel-Moore RH, Thompson D, Affenito SG et al. Correlates of beverage intake in adolescent girls: the National Heart, Lung and Blood Institute Growth and Health Study. J Pediatr 2006; 148: 183–7.
21. Carruth BR, Skinner JD. The role of dietary calcium and other nutrients in moderating body fat in preschool children. Int J Obes Relat Metab Disord 2001; 25: 559–66.
22. Skinner JD, Bounds W, Carruth BR, Ziegler P. Longitudinal calcium intake is negatively related to children's body fat indexes. J Am Diet Assoc 2003; 103: 1626–31.
23. Williams CL, Bollella M, Wynder EL. A new recommendation for dietary fiber in childhood. Pediatrics 1995; 96: 985–8.
24. Backhed F, Manchester JK, Semenkovich CF et al. Mechanisms underlying the resistance to diet-induced obesity in germ-free mice. Proc Natl Acad Sci USA 2007; 104: 979–84.
25. Martinez I, Wallace G, Zhang C et al. Diet-Induced Metabolic Improvements in a Hamster Model of Hypercholesterolemia Are Strongly Linked to Alterations of the Gut Microbiota. Appl Environ Microbiol 2009; 75: 4175–84.
26. Метаболический синдром. Под ред. Г.Е.Ройтберга. М.: Медпресс, 2007.
27. Шляхто Е.В., Красильникова Е.И., Сергеева Е.Г. Полиненасыщенные w-3 жирные кислоты и их роль в первичной и вторичной профилактике атеросклероза. РМЖ. 2006; 14 (4): 234–40.
28. Аронов Д.М. Сердечно-сосудистая система и Омега-3 полиненасыщенные жирные кислоты. РМЖ. 2006; 14 (4): 192–6.
29. Перова Н.В. Профилактика сердечно-сосудистых заболеваний: источники повышения потребления человеком омега-3-полиненасыщенных жирных кислот. Справ. поликлин. врача. 2007; 4 (6): 17–20.
30. Tudor-Locke C, Ainsworth BE, Popkin BM. Active commuting to school: an overlooked source of childrens' physical activity? Sports Med 2001; 31: 309–13.
31. Andersen RE, Crespo CJ, Bartlett SJ et al. Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey. JAMA 1998; 280: 1231–2.
32. Abbott RA, Davies PS. Habitual physical activity and physical activity intensity: their relation to body composition in 5,0–10,5-y-old children. Eur J Clin Nutr 2004; 58: 285–91.
33. Trost SG, Sirard JR, Dowda M et al. Physical activity in overweight and nonoverweight preschool children. Int J Obes Relat Metab Disord 2003; 27: 834–9.
34. Berkey CS, Rockett HR, Gillman MW, Colditz GA. One-year changes in activity and in inactivity among 10- to 15-year-old boys and girls: relationship to change in body mass index. Pediatrics 2003; 111: 836–43.
35. Чазова И.Е., Мычка В.Б. Метаболический синдром. М.: Медиа Медика, 2008.
36. Диагностика, лечение и профилактика артериальной гипертензии у детей и подростков. Российские рекомендации (второй пересмотр). Кардиоваск. терапия и профилактика. (Прил. 1). 2009; 8 (4).
37. Гиляревский С. Роль физических нагрузок в профилактике сердечно-сосудистых заболеваний. Диабет. Образ жизни. 2000; 2: 4–7.
38. Чазова И.Е., Мычка В.Б., Кисляк О.А. и др. Проект Рекомендаций экспертов ВНОК по диагностике и лечению метаболического синдрома (второй пересмотр). 2009.
39. Petersen KF, Dufour S, Befroy D et al. Reversal of nonalcoholic hepatic steatosis, hepatic insulin resistance, and hyperglycemia by moderate weight reduction in patients with type 2 diabetes. Diabetes 2005; 54: 603–8.
40. Nobili V, Manco M, Raponi M, Marcellini M. Case management in children affected by non-alcoholic fatty liver disease. J Paediatr Child Health 2007; 43: 414.
41. Ebbeling CB, Leidig MM, Feldman HA et al. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA 2007; 297: 2092–102.
42. Barlow SE, Dietz WH. Management of child and adolescent obesity: summary and recommendations based on reports from pediatricians, pediatric nurse practitioners, and registered dietitians. Pediatrics 2002; 110: 236–8.
43. Loomba R, Lutchman G, Kleiner DE et al. Clinical trial: Pilot study of metformin for the treatment of nonalcoholic steatohepatitis. Aliment Pharmacol Ther 2008; 29: 172–82.
44. Schwimmer JB, Middleton MS, Deutsch R, Lavine JE. A phase 
2 clinical trial of metformin as a treatment for non-diabetic paediatric non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2005; 21: 871–9.
45. Lavine JE. Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J Pediatr 2000; 136: 734–8.
46. Маев И.В., Дичева Д.Т., Андреев Д.Н. Роль тиоктовой (a-липоевой) кислоты в терапии неалкогольной жировой болезни печени. Cons. Med. Гастроэнтерология. (Прил.). 2011; 2: 82–4.
47. Лазебник Л.Б., Звенигородская Л.А. Метаболический синдром и органы пищеварения. М.: Анахарсис, 2009.
48. Dufour JF, Oneta CM, Gonvers JJ et al. Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin Е in nonalcoholic steatohepatitis. Clin Gastroenterol Hepatol 2006; 4: 1537–43.
49. David H. Geller, Danièle Pacaud, Catherine M. Gordon, Madhusmita Misra. State of the Art Review: Emerging Therapies: The Use of Insulin Sensitizers in the Treatment of Adolescents with Polycystic Ovary Syndrome (PCOS). Int J Pediatr Endocrinol 2011 (1): 9.
50. Wabitsch M, Hauner H, Heinze E et al. Body fat distribution and steroid hormone concentrations in obese adolescent girls before and after weight reduction. J Clin Endocrinol Metab 1995; 80 (12): 3469–75.
51. Reinehr T, de Sousa G, Roth CL et al. Androgens before and after weight loss in obese children. J Clin Endocrinol Metab 2005; 90 (10): 5588–95.
52. Hoeger K, Davidson K, Kochman L et al. The impact of metformin, oral contraceptives, and lifestyle modification on polycystic ovary syndrome in obese adolescent women in two randomized, placebo-controlled clinical trials. J Clin Endocrinol Metab 2008; 93 (11): 4299–06.
53. Martin KA, Chang RJ, Ehrmann DA et al. Evaluation and treatment of hirsutism in premenopausal women: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2008; 93 (4): 1105–20.
54. Nader S, Diamanti-Kandarakis E. Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis. Hum Reprod 2007; 22 (2): 317–22.
55. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med 2005; 352 (12): 1223–36.
56. Schindler AE. Differential effects of progestins on hemostasis. Maturitas 2003; 46 (Suppl. 1): 31–7.
57. Cassidenti DL, Paulson RJ, Serafini P et al. Effects of sex steroids on skin 5 alpha-reductase activity in vitro. Obstet Gynecol 1991; 78 (1): 103–7.
58. Hammond GL, Rabe T, Wagner JD. Preclinical profiles of progestins used in formulations of oral contraceptives and hormone replacement therapy. Am J Obstet Gynecol 2001; 185 (Suppl. 2): 24–31.
59. Franks S, Layton A, Glasier A. Cyproterone acetate/ethinyl estradiol for acne and hirsutism: time to revise prescribing policy. Hum Reprod 2008; 23 (2): 231–2.
60. Givens JR, Andersen RN, Wiser WL et al. Dynamics of suppression and recovery of plasma FSH, LH, androstenedione and testosterone in polycystic ovarian disease using an oral contraceptive. J Clin Endocrinol Metab 1974; 38 (5): 727–35.
61. Arslanian SA, Lewy V, Danadian K et al. Metformin therapy in obese adolescents with polycystic ovary syndrome and impaired glucose tolerance: amelioration of exaggerated adrenal response to adrenocorticotropin with reduction of insulinemia/insulin resistance. J Clin Endocrinol Metab 2002; 87 (4): 1555–9.
62. Glueck CJ, Wang P, Fontaine R et al. Metformin to restore normal menses in oligo-amenorrheic teenage girls with polycystic ovary syndrome (PCOS). J Adolesc Health 2001; 29 (3): 160–9.
63. De Leo V, Musacchio MC, Morgante G et al. Metformin treatment is effective in obese teenage girls with PCOS. Hum Reprod 2006; 21 (9): 2252–6.
64. Bridger T, MacDonald S, Baltzer F et al. Randomized placebo-controlled trial of metformin for adolescents with polycystic ovary syndrome. Arch Pediatr Adolesc Med 2006; 160 (3): 241–6.
65. Glueck CJ, Aregawi D, Winiarska M et al. Metformin-diet ameliorates coronary heart disease risk factors and facilitates resumption of regular menses in adolescents with polycystic ovary syndrome.
 J Pediatr Endocrinol Metab 2006; 19 (6): 831–42.
66. Ibanez L, Valls C, Potau N et al. Sensitization to insulin in adolescent girls to normalize hirsutism, hyperandrogenism, oligomenorrhea, dyslipidemia, and hyperinsulinism after precocious pubarche. J Clin Endocrinol Metab 2000; 85 (10): 3526–30.

И.Н.Захарова1, Л.А.Звенигородская2, С.И.Малявская3, Т.М.Творогова1, С.В.Яблочкова1

1 ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России;
2 ГБУЗ Центральный научно-исследовательский институт гастроэнтерологии Департамента здравоохранения Москвы;
3 ГБОУ ВПО Северный государственный медицинский университет Минздрава России, Архангельск