Differences in Gut Microbiota Composition and Predicted Metabolic Functions: a Pilot Study of Adolescents with Normal Weight and Obesity.

Understanding the principles underlying the stability and sustainability of the gut microbiome of adolescents with normal weight and obesity will make it possible to implement a personalized approach to the correction of metabolic disorders. The article presents the results of a pilot study of the diversity and metabolic potential of the gut microbiome in adolescents with normal body weight and obesity. Biological material was studied using metagenomic sequencing of the V3-V4 variable regions of the 16S rRNA gene. In all adolescents with normal weight, similar degree of the phylogenetic relationship between the bacterial taxa of the community was demonstrated. In contrast, obese adolescents were characterized by the presence of phylogenetically distinct taxa in the gut microbiota. However, even with differences in taxonomic composition, the gut microbial community can compensate for the absence of certain taxonomic groups by implementing the necessary metabolic functions using other phylogenetically close taxa.

Diversity and Metabolic Potential of the Gut Microbiome in Adolescents with Functional Bowel Disorder.

The article presents the results of a pilot study of the diversity and metabolic potential of the gut microbiome in adolescents with various forms of functional bowel disorder. The participants were the patients of the Clinic of Research Center for Family Health and Human Reproduction Problems. Biological material was studied using metagenomic sequencing of V3-V4 variable regions of the 16S rRNA gene. We showed that the composition of the minor component of the intestinal microbiome in adolescents with functional bowel disorder differs from that in the healthy subjects (control). Different types of transit disturbances in functional bowel disorder also differ from each other. According to the metabolic potential, adolescents can be divided into two groups irrespective of the pathophysiological manifestations: for one group, a more intensive metabolism in amino acid and lipid biosynthesis pathways was predicted than for the other.

The relationship between the composition of the microbiota and functional intestinal disorders in obese adolescents.

Functional gastrointestinal disorders (FGIDs) in children and adolescents are one of the most common pathologies of the digestive tract. The aim of the study was to study the structure of the colon microbiota in obese adolescents and to establish its relationship with the clinical manifestations of the disease FGIDs. The study included 20 adolescents aged 11-17 years. The main group included 13 adolescents with a clinically confirmed diagnosis of obesity (the standard deviation of the body mass index (SDS BMI) is more than 2,0) in combination with FGIDs. The control group consisted of 7 adolescents with normal body weight and no abdominal complaints (SDS BMI=0,66). Clinical symptoms from the bowel re diagnosed on the basis of the Rome IV. The consistency of feces was evaluated using the Bristol Stool Form Scale. The study of biological material was carried out by standard bacteriological methods. It is shown that in adolescents with obesity and FGIDs, there is a decrease in the concentration of representatives of bifidoflora, an increase in the microbial density of Escherichia coli with altered properties and an excessive growth of potentially pathogenic enterobacteria. It is established that the presence of conditionally pathogenic bacteria is sem. Enterobacteriaceae is associated with abdominal pain during defecation. In obese adolescents in the group with unformed stools, Clostridium spp was recorded as part of the intestinal microbiota.

Metasequencing of V3-V4 Variable Regions of 16S rRNA Gene in Opportunistic Microbiota and Gut Biocenosis in Obese Adolescents.

Opportunistic microorganisms in the gut biocenosis were studied in adolescents with normal body weight and obesity (patients consulted at the Clinical Department of Research Center of Family Health and Human Reproduction Problems). The biological material was studied by standard bacteriological methods, representatives of Enterobacteriaceae family were also characterized using metagenomic sequencing of V3-V4 variable regions of 16S gene rRNA. Gut microbiota of obese adolescents was unbalanced and was characterized by low levels of bifido- and lactoflora representatives, a spectrum of E. coli associations, and high prevalence of opportunistic microorganisms and their associations. Representatives of Enterobacteriaceae family were most often found in the gut microbiota of obese adolescents.

[Arterial hypertension and oral disease in adolescents]. / Arterial'naya gipertenziya i bolezni polosti rta u podrostkov.

AIM: To establish significant associations between hypertension and the presence and severity of common oral diseases in adolescents. MATERIAL AND METHODS: A cross-sectional study was conductedWith participation of 130 adolescents, from which 2 groups were formed, matched by sex and age (n=65; 38 boys and 28 girls in each group). Inclusion criteria: age 10-17 years; hypertension for inclusion in the group of «cases¼ and a normal level of blood pressure for inclusion in the control group; informed voluntary consent to participate in the study. A diagnosis of hypertension was confirmed by daily monitoring of blood pressure. The frequency and severity of the clinical manifestations of the main oral diseases: caries, gingivitis, periodontitis were evaluated in the groups. Regression models have been adjusted for the index of oral hygiene and body weight. RESULTS: Hypertensive adolescents were significantly likely to have dental caries (50 (77% vs 32 (49%), p=0.001), periodontitis (26 (40%) vs 6 (9%), p=0.001) and moderate to severe gingivitis (12 (18%) vs 2 (3%), p=0.009), than in the control group. In the adjusted regression models, significant associations of hypertension with periodontitis (OR 3.9, 95% CI 1.4-10.5) and dental caries (OR 3, 95% CI 1.3-7.1) were established. It is also shown that hypertension is associated with more pronounced signs of periodontal inflammation (OR 3, CI 1.6-5.6). CONCLUSION: Results suggest that hypertension in adolescents is associated with poorer oral health. It is advisable to take this into account when developing a synergistic approach to the medical support of these patients, aimed at reducing cardiovascular risk in the long term.

[The relationship of hemodynamic parameters of periodontal microvascular bed and lipid peroxidation products in adolescents with arterial hypertension]. / Vzaimosvyaz' pokazatelei gemodinamiki mikrososudistogo rusla parodonta i produktov lipoperoksidatsii u podrostkov s arterial'noi gipertenziei.

THE AIM: Of the study was to establish the relationship of hemodynamic parameters of periodontal tissues and lipid peroxidation products in adolescents with arterial hypertension (AH). METHODS: The study included 132 adolescents (average age 14.51±1.91 years), from which 2 clinical groups (1 - the group with AH without periodontal disease (n=19, average age - 15±1.53 years) and 2 - the group with AH with periodontal diseases (n=57, average age - 14.7±1.89 years)) and 2 comparison groups (3 - the comparison group without AH and periodontal diseases (n=19, average age - 13.82±1.89 years) and 4 - comparison group without AH and with periodontal diseases (n=37, mean age - 14.57±2.01 years)) were formed. Hemodynamic analysis of the periodontal microcirculatory bed using the Doppler ultrasound method and the level of lipid peroxidation products using spectrophotometric and fluorometric methods was performed. RESULTS: In adolescents with hypertension without and with inflammatory periodontal diseases as a whole, unidirectional changes in the hemodynamics of the vascular bed of the periodontium were observed in the form of increased values of the maximum blood flow velocity in systole and an increase in the peripheral resistance index. At the same time, the group with hypertension and periodontal disease was distinguished by lower values of these indicators. In the system of lipid peroxidation, increased values of ketodienes and conjugated trienes occurred in patients with hypertension without periodontal disease and end products that actively reacting with thiobarbituric acid in patients with hypertension and periodontal disease. Correlation analysis showed the presence of intersystem relationships between the hemodynamic parameters of the vascular bed of periodontal adolescents with hypertension without periodontal disease. In the group of adolescents with arterial hypertension and periodontal disease, there was a decrease in the correlation coefficients between intersystem parameters by almost two times, as well as the appearance of pathological dependencies between toxic metabolites of the lipid peroxidation process - products that actively reacting with thiobarbituric acid and vascular blood flow indicators. CONCLUSION: It has been noted that in adolescent patients with hypertension and periodontal diseases on the background of lower vascular blood flow and accumulation of end toxic metabolites, pathological dependencies occur between them, which may contribute to more intense damage to the tissues of the periodontal complex in the presence of hypertension.

Composition and Structure of Gut Microbiome in Adolescents with Obesity and Different Breastfeeding Duration.

Gut microbiome of adolescents with obesity and different duration of breastfeeding was analyzed by metagenomic analysis of V3-V4 variable domains of the 16S rRNA gene. In subgroup with breastfeeding duration <3 months, intrapopulation structure of gut microbiome by alpha diversity indices was similar in adolescents with obesity and normal body weight. The decrease in phylotype abundance in the structure of communities was associated only with obesity, while dysbiotic state persisted in both lean and overweight adolescents, which confirmed the effect of breastfeeding duration on stability of gut microbiome.

[The modern methods for the rehabilitation of adolescents suffering obesity]. / Sovremennye tekhnologii reabilitatsii podrostkov s ozhireniem.

BACKGROUND: To-day, obesity spreads dramatically fast all over the world not only among the adults but also among the children. According to the data available from the scientific literature, the number of adolescents suffering from obesity in Russia increased more than 1.5 times during the period from 2006 till 2015. The combination of non-drug therapeutic measures (including diet therapy, therapeutic physical exercises, and psychophysiological technologies) constitutes the basis for the treatment of obesity. Russia has gained a vast experience with the management of this condition with the use of natural and preformed therapeutic agents. AIM: The main objective of the present study was the comparative assessment of the effectiveness of the rehabilitation programs for the obese subjects with based on the application of alternative and complementary therapeutic modalities for the treatment of the adolescent girls with obesity. MATERIAL AND METHODS: The study included 86 girls with obesity at the age of 13-17 years who were randomly divided into 3 groups matched for the age and anthropometric characteristics. All the patients were prescribed a treatment course, including motivational training and aerobic exercise, in addition to the routine recommendations for the short-term modification of eating habits. The vacuum therapy was additionally included in the combined treatment protocol for the patients of the first group (n=28) while the patients of the second group (n=29) received the treatment in the spa capsule (SC) and the girls of the third group (n=29) underwent transcranial magnetic stimulation therapy. RESULTS: The analysis of the results obtained in this study has demonstrated a significant reduction of the body weight, waist and hip circumferences in the patients of all study groups (p<0.05). The comparison of these results with the baseline characteristics showed that the use of combined physiotherapy including the treatment in the spa capsule had significant advantages over local vacuum therapy in terms of weight dynamics (p=0.009), body mass index (p=0.009), hip circumference (p=0.019) and the chest skinfold thickness (p=0.02). CONCLUSION: The use of alternative and complementary therapeutic modalities in the combination with motivational training and aerobic exercises effectively contributes to the weight loss in the obese adolescent girls, with the combined pysiotherapeutic treatment having advantages over local therapy methods.

[The experience with the application of the selective electro-stimulation impacts in the children presenting with the disturbances of the locomotor function].

AIM: The objective of the present study was the improvement of the effectiveness of medical rehabilitation of the children presenting with the disturbances of the locomotor function using a «LymphaVision¼ apparatus for the selective electrical stimulation. MATERIALS AND METHODS: The study included 42 patients with movement disorders divided into two groups depending on the method of non-drug therapy. The main group was comprised of the patients receiving the treatment by electrical stimulation with the use of the «LymphaVision¼ apparatus while the remaining patients made up the group of comparison (they were treated with by means of Vermel electrophoresis with the use of a 1% sodium bromide solution). The increase of the muscular strength evaluated based on the scoring system and the number of motor skills were used as the criteria of the effectiveness of the treatment. The applied Statistica for Windows package, version 6.0 («StatSoft¼, USA). Was employed for the statistical analysis of the data obtained. The significance and number of differences between two independent samples of the quantitative features were assessed using the Mann-Whitney U test. The Wilcoxon matched pairs test was used to compare the two matched groups. RESULTS: The children comprising the group treated by means of selective exposure to electrical stimulation with the use of the «LymphaVision¼ apparatus in the course of the rehabilitation process exhibited a significant increase in the strength of the muscles of the lower extremities and the trunk over the baseline values (p=0.003 and p=0.04 respectively) and acquired a significantly greater number of the new motor skills (p=0.02). CONCLUSION: The application of the proposed method is characterized by the highly pronounced clinical efficiency. This approach is pathogenetically well-substantiated for the treatment of the children presenting with the locomotor disorders developing as the consequences of perinatal lesions in the central nervous system and promotes the restoration of the capabilities of the child's body, such as normalization of the muscle tone, increase of the motor activity and muscle strength.

[Multicentric carpotarsal osteolysis in a rheumatologist's practice].

Multicentric carpotarsal osteolysis (MCTO) syndrome is a rare skeletal dysplasia associated with missense mutation in the MAFB gene, usually manifesting in young childhood, and showing variative phenotypic signs and course. The clinical manifestations of the syndrome include aggressive osteolysis predominantly of carpal and tarsal bones, progressive nephropathy, and mild craniofacial anomalies. The similarity between the initial clinical manifestations of MCTO and the symptoms of childhood inflammatory joint diseases makes a diagnosis very difficult, in the early stages of the disease in particular, and frequently leads to the ungrounded use of long-term immunosuppressive therapy. The paper describes a familial case of MCTO without affecting the kidneys in the mother and daughter.

[Uric acid and factors of cardiometabolic risk in adolescents with arterial hypertension].

AIM: To elucidate links of blood serum uric acid level (SUAL) with cardiometabolic risk factors (CMR) in adolescent boys with arterial hypertension (AH). MATERIAL AND METHODS: We examined 261 adolescent boys (mean age 15.8+/-1.3 years) with primary AH. Examination included 24-hour blood pressure (BP) monitoring, and measurement of office BP, BMI Z-score, levels of serum glucose, uric acid, total cholesterol (TC), high density lipoprotein cholesterol (HDL) and triglycerides (TG). Low density lipoprotein cholesterol (LDL) was calculated using Friedwald equation. RESULTS: SUAL was significantly and independently of patient age related to BMI Z-score (=0.0000001) and TG level (=0.01). There were no correlation between SUAL and glucose level. According to logistic regression analysis highest tertile of SUAL was regardless of age significantly associated with excess body mass and obesity (odds ratio [OR] 3.5 [95% confidence interval [CI] 1.9-6.7; =0.0001]), and dyslipidemia (OR 3.05, 95%CI 1.3-6.9; =0,007]). Significant relationship was also found between elevated SUAL and clasterization of 2-3 CMR (OR 3.2, CI 1.3-7.7; =0.01]). CONCLUSION: Hyperuricemia in adolescent boys with AH is a marker of high cardiometabolic risk. This justifies screening for high SUA levels among boys with elevated BP with subsequent estimation of individual risk and timely initiation of preventive measures.