Adolescents’ hypothalamic syndrome of puberty age is a neuroendocrine syndrome of body restructuring with dysfunction of the hypothalamus, pituitary gland and other endocrine glands. In recent years the prevalence of hypothalamic syndrome among adolescents has increased to 3-4%. The purpose of the study was to examine the dynamics of cardiovascular system functioning in adolescents with hypothalamic syndrome of puberty age. Materials and methods. We examined 52 children with hypothalamic syndrome: 21 girls (40.4%) and 31 boys (59.6%)), who were in-patients at the endocrinology department of the RCCH during the period from August to November 2015. The average age of patients was 13.6 ± 0.45 years old (11-18 years old). Results. The patients with hypothalamic syndrome complained most frequently of excess body weight (79.6%), increased appetite (82.6%), and headache (78.5%) of varying intensity, increased blood pressure (38.5%), cardiac arrhythmia (31.8%), and irritability (22.7%). The objective study found obesity of different degrees (overweight – 36.1%, Ist degree – 27.8%, IInd degree – 22.2%), and 13.9% of children had normal body weight. 58.2% of the children had stretch marks on their hips, 25.1% on the arms, 15.8% on the chest, and 0.9% of the children had them on the back. The stretch marks were from pale pink to red. The thyroid gland was enlarged in 59.6% of adolescents (IA degree in 37.4% and IB – 22.2%). The arterial pressure rate in 17.3% of patients was labile (episodic elevations were observed), and 9.1% of the patients had a persistent I degree arterial hypertension. In the laboratory studies we obtained the following results: in the biochemical study, the level of cholesterol in the 26.9% of cases was within the normal range (3.63-5.2 mmol /l) in 38.5% of the patients its level corresponded to the upper limit of the norm (5.1-5.3 mmol/L), and 34.6% had hypercholesterolemia (5.6-6.0 mmol/L). An increase in high density в-lipoprotein was found in 34.6% of adolescents. Microalbuminuria occurred in 23 children (44.2%). Glucose tolerance test was performed in all cases. In 30.8% of them there could be observed a flat glycemic curve. The electrocardiogram showed an increase in the bioelectric potentials in the left ventricle in 17.3% of cases. In 13.5% there was a left, and in 5.8% of them – a right bundle branch block. Respiratory arrhythmia was identified in 51.9% of children. They had a reduced (26.4%) index of peripheral vascular resistance (V/A) at rheoencephalography and the venous drainage was hampered. 30,6% of patients were diagnosed with angiospastic type of cerebral hemodynamics, in which an increased tone of small cerebral vessels (79.5%) and a hampered venous drainage (38.3%) were observed with a normal blood supply to the brain. Conclusions. Most adolescents with hypothalamic syndrome in the puberty period are obese in different degrees. 30,77% have hyperinsulinism, 44,23% of the children suffer from microalbuminuria and in 26.4% of cases there is a tendency to the development of arterial hypertension, which is a predictor of the development of metabolic syndrome.
Full text: PDF (Ukr) 186K