[Overweight, obesity and metabolic syndrome in children with type 1 diabetes melllitus]. / Nadwaga, otylosc i cechy zespolu metabolicznego u dzieci z cukrzyca typu 1.

INTRODUCTION: Obesity can be an additional risk factor for developing cardiovascular diseases in patients with diabetes. Aim of the study was the assessment of overweight, obesity and other elements of the metabolic syndrome in children with type 1 diabetes mellitus. MATERIAL AND METHODS: 300 children treated with insulin at least one year were enrolled in the study. In the examined group anthropometric data, data concerned with diabetes and additional laboratory tests including risk factors for cardiovascular diseases were assessed. RESULTS: The median age of the examined group was 13.7 years. The body mass deficiency was noted in 0.66%, normal body mass in 71.6%, overweight in 15.3% and obesity in 12.3%. The abdominal obesity was noted in 16.0% of children. The rise in the body weight between 3-6 months from the beginning of the insulin therapy and the present assessment was statistically significant. Children with normal weight had a better metabolic control in comparison to children with overweight/obesity. Girls had a higher rise in body mass index values between the time of diagnosis and the present investigation compared to boys. Higher values of blood pressure or hypertension were noted in 16.6% of children. Altogether in 25.3% of children some dyslipidemia was observed. The metabolic syndrome criteria were noted in: 28.0% - one criterion, 13.0% - two criteria, and 0.3% - three criteria. CONCLUSIONS: The population of children with type 1 diabetes is characterized by high frequency of overweight/obesity, abdominal obesity, dyslipidemia and hypertension. The features of metabolic syndrome are less frequent. It is worthwhile to monitor the risk for development of cardiovascular diseases in this group of children.

[The role of FTO gene polymorphism in the pathogenesis of obesity]. / Rola polimorfizmu genu FTO w patogenezie otylosci.

Both environmental and genetic factors play a role in the pathogenesis of obesity. At present, researchers are examining the genetic background of overweight. Over 100 genes are suspected to influence the obesity. One of those genes is FTO (fat mass and obesity-associated gene). In the manuscript, the relationship between FTO gene polymorphism (AA allele) and overweight, obesity and their consequences are discussed. It was proved, in studies on large number of people, that FTO gene polymorphism is related to higher body mass index, weight and abdominal circumference. Some authors showed that FTO gene polymorphism influences the food intake, energy expanditure and insulin resistance. The expression of FTO gene product was noticed in both, the peripheral as well as central nervous system (hypothalamus). It is possible that FTO gene product is involved in the DNA and RNA reparation and other metabolic processes, however, its function is not yet clear. The assessment of FTO gene polymorphism can allow us to separate patients with the tendency for higher weight. The elucidation of the role of FTO in the pathogenesis of obesity can result in the development of new therapeutic options for this epidemic of XXI century.

[The assessment of T regulatory cells in the peripheral blood of children with metabolic syndrome]. / Ocena limfocytów T regulatorowych we krwi obwodowej dzieci z zespolem metabolicznym.

UNLABELLED: The metabolic syndrome is defined as the co-existence of risk factors for the development of cardio-vascular disease: obesity, hypertension, insulin resistance and dyslipidemia. For a few years there has been a growing interest in immune-inflammatory aspects of obesity and metabolic syndrome. According to many authors the disturbances in the number and(or) function of T regulatory cells are responsible for autoimmune diseases. It is possible that they play a role in a pathogenesis of chronic inflammation accompanying obesity. THE AIM OF THE STUDY was to determine the percentages of T regulatory cells in children with metabolic syndrome. MATERIAL AND METHODS: Fourty seven children with metabolic syndrome were prospectively enrolled into the study according to the IDF criteria (central obesity and two of: hypertension, hypertriglycerydemia, low HDL, hyperglycemia/glucose intolerance/diabetes). With the use of five-colour flow cytometry the following percentages of T cells in the peripheral blood were assessed: CD4(+), CD4(+)CD25(high), CD4(+)CD25(high)FoxP3(+), CD4(+)CD25(high)CD127(low), CD4(+)CD25(high)FoxP3(+)CD127(low). RESULTS: In the group of children with metabolic syndrome we noted lower percentages of CD4(+)CD25(high) cells compared to control children: 1.7 vs. 3.7% (p = 0.01). The differences in CD4(+)CD127(low) cells were not statistically significant: 15.7 vs. 17.6% (p = 0.1). We did not observe the differences between examined and control group in the percentages of CD4(+)CD25(high)CD127(low) and CD4(+)CD25(high)FoxP3(+) cells (respectively: 0.54% vs. 0.58%, 0.49 vs. 0.59%, p > 0.05). CONCLUSIONS: Results of our investigation suggest the lower percentages of CD4(+)CD25(high) but not other Tregs subpopulation cells in children with metabolic syndrome. The further research concerning the role of Tregs in the pathogenesis of immunologic disturbances accompanying metabolic syndrome will continue.