Browsing by Author "Dzīvīte-Krišāne, Iveta"

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    Children's rights in healthcare : The influence of age on involvement
    (EDP Sciences, 2024) Popeiko, Poļina; Puķīte, Ieva; Dāvidsone, Zane; Dzīvīte-Krišāne, Iveta; Visnevska, Inta; Gardovska, Dace; Vilka, L.; Krūmiņa, J.; Rīga Stradiņš University
    The aim of this article is to highlight the significance of actively involving young children in their own healthcare and paediatric healthcare planning. Based on a study conducted in a hospital setting, which revealed a lack of personalized care and inadequate understanding among younger children, this article discusses the potential benefits of empowering young patients. The theoretical framework explores various dimensions, including child-centred care, communication strategies, child development, and the impact of involving children in decision-making processes. By fostering children’s participation and creating a safe environment, healthcare professionals can enhance the overall quality of care and promote positive health outcomes for young patients.
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    Evaluation of Prenatal and Postnatal Risk Factors of Obesity in Obese and Normal Weight Children and Adolescents
    (2023-08-01) Gailīte, Jurgita; Siliņa, Ieva; Petrošina, Eva; Dzīvīte-Krišāne, Iveta; Gardovska, Dace; Department of Paediatrics; Statistics Unit
    Obesity is considered a global epidemic worldwide. During the COVID lockdown, many daily habits changed not only for adults, but also for children. These changes are likely to further increase the prevalence and severity of obesity, which could lead to early health problems and chronic diseases. Therefore, it is important to identify preventable and non-preventable risk factors of obesity, which would be useful in planning long-term obesity prevention programmes in the country. The aim of the study was to investigate the prenatal and postnatal obesity risk factors in obese and normal weight children and adolescents. The prospective study from 2013 to 2018 included 198 children and adolescents — 181 children with obesity and 17 children with normal body weight who attended a paediatric endocrinologist. No statistically significant differences in prenatal risk factors of obesity were found between normal weight and obese children in the study: birth weight (p = 0.530), excessive weight gain during pregnancy in mothers (p = 0.787), type 2 diabetes mellitus in the family (p > 0.999). No statistically significant difference was found for the postnatal risk factor of obesity — duration of exclusive breastfeeding (p = 0.120), a statistically significant difference was only observed in parental obesity prevalence between children with normal weight and obesity (p = 0.004). Therefore, it is important to involve all family members to change children’s daily habits.
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    Long-term prognosis of patients with pediatric pheochromocytoma
    (2014-02) Bausch, Birke; Wellner, Ulrich; Bausch, Dirk; Schiavi, Francesca; Barontini, Marta; Sanso, Gabriela; Walz, Martin K.; Peczkowska, Mariola; Weryha, Georges; Dall'Igna, Patrizia; Cecchetto, Giovanni; Bisogno, Gianni; Moeller, Lars C.; Bockenhauer, Detlef; Patocs, Attila; Rácz, Karoly; Zabolotnyi, Dmitry; Yaremchuk, Svetlana; Dzīvīte-Krišāne, Iveta; Castinetti, Frederic; Taieb, David; Malinoc, Angelica; Von Dobschuetz, Ernst; Roessler, Jochen; Schmid, Kurt W.; Opocher, Giuseppe; Eng, Charis; Neumann, Hartmut P.H.
    A third of patients with paraganglial tumors, pheochromocytoma, and paraganglioma, carry germline mutations in one of the susceptibility genes, RET, VHL, NF1, SDHAF2, SDHA, SDHB, SDHC, SDHD, TMEM127, and MAX. Despite increasing importance, data for long-term prognosis are scarce in pediatric presentations. The European-American-Pheochromocytoma-Paraganglioma-Registry, with a total of 2001 patients with confirmed paraganglial tumors, was the platform for this study. Molecular genetic and phenotypic classification and assessment of gene-specific long-term outcome with second and/or malignant paraganglial tumors and life expectancy were performed in patients diagnosed at <18 years. Of 177 eligible registrants, 80% had mutations, 49% VHL, 15% SDHB, 10% SDHD, 4%NF1, and one patient each in RET, SDHA, and SDHC. A second primary paraganglial tumor developed in 38% with increasing frequency over time, reaching 50% at 30 years after initial diagnosis. Their prevalence was associated with hereditary disease (P=0.001), particularly in VHL and SDHD mutation carriers (VHL vs others, P=0.001 and SDHD vs others, P=0.042). A total of 16 (9%) patients with hereditary disease had malignant tumors, ten at initial diagnosis and another six during follow-up. The highest prevalence was associated with SDHB (SDHB vs others, P<0.001). Eight patients died (5%), all of whom had germline mutations. Mean life expectancy was 62 years with hereditary disease. Hereditary disease and the underlying germline mutation define the long-term prognosis of pediatric patients in terms of prevalence and time of second primaries, malignant transformation, and survival. Based on these data, gene-adjusted, specific surveillance guidelines can help effective preventive medicine.
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    Metaboliskā sindroma riska faktori, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Promocijas darba kopsavilkums
    (Rīgas Stradiņa universitāte, 2022) Gailite, Jurgita; Gardovska, Dace; Dzīvīte-Krišāne, Iveta
    Ievads. Sabiedrības veselības pētījumi norāda uz strauju aptaukošanās izplatību ne tikai pieaugušajiem, bet īpaši strauja izplatība tiek novērota arī pusaudžiem un pirmsskolas vecuma bērniem. Latvijā augstāka liekā svara izplatība ir septiņgadīgiem zēniem, salīdzinot ar meitenēm, attiecīgi 23,7 % un 21,8 %. Taču meitenēm šis īpatsvars kopš 2008. gada ir pakāpeniski palielinājies no 18,3 % līdz 21,8 %. Bērniem un pusaudžiem ar aptaukošanos agrīni draud attīstīties sirds un asinsvadu sistēmas slimības, arteriāla hipertensija, dislipidēmija, metaboliskais sindroms, insulīna rezistence, 2. tipa cukura diabēts, dažādu veidu audzēji, ortopēdiskas, nopietnas psiholoģiskas un neiroloģiskas problēmas, kā arī citi hroniski traucējumi. Metaboliskā sindroma īpašā nozīme pieaugušo vecumā ir saistīta ar iespēju identificēt personas, kurām ir liels gan 2. tipa cukura diabēta, gan sirds un asinsvadu sistēmas slimību risks. Attiecībā uz bērnu metabolisko sindromu autoru viedoklis atšķiras.Mērķis. Pētīt metaboliskā sindroma riska faktorus, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Materiāls un metodes. Pētījumā atbilstoši iekļaušanas un izslēgšanas kritērijiem iekļauti 198 bērni, no tiem 181 bērns ar aptaukošanos un 17 bērni ar normālu ķermeņa svaru. Pirmajā pētījuma etapā bērni iedalīti grupās attiecīgi pēc svara un vecuma: I pētījuma grupa –10 gadu veci un vecāki bērni ar aptaukošanos, II pētījuma grupa – bērni līdz 10 gadu vecumam ar aptaukošanos, kontroles grupa – bērni ar normālu ķermeņa svaru. Šajā etapā pētījuma bērniem veikts aptaukošanās prenatālo un postnatālo riska faktoru novērtējums un aptaukošanās komplikāciju skrīnings. Otrajā pētījuma etapā pēc Starptautiskās diabēta federācijas izstrādātajiem kritērijiem izvērtēts metaboliskais sindroms bērniem no 10 gadu vecuma, t. i., tikai I pētījuma grupas (n = 143) bērniem. Visi iegūtie dati apkopoti Excel datubāzē un analizēti, izmantojot RStudio V.1.4.1103. Atšķirības uzskatītas par statistiski nozīmīgām, ja nozīmības līmenis p bija < 0,05. Rezultāti. Aptaukošanās prenatālie riska faktori, kā dzimšanas svars (p = 0,530), pārmērīgs svara pieaugums grūtniecības laikā mātei (p = 0,787), pozitīva 2. tipa cukura diabēta anamnēze ģimenē (p > 0,999), statistiski nozīmīgi neatšķīrās bērniem ar aptaukošanos un normālu ķermeņa svaru. Arī aptaukošanās postanatālam riska faktoram, ekskluzīvas zīdīšanas ilgumam (p = 0,120) netika atrasta statistiski nozīmīga atšķirība starp bērniem ar aptaukošanos un normālu svaru. Statistiski nozīmīga atšķirība pētījuma grupās tika novērota tikai postnatālam aptaukošanās riska faktoram – vecāku aptaukošanās faktam (p = 0,004). Bērniem ar aptaukošanos gan I grupā, gan arī II grupā bija augsta vecāku aptaukošanās izplatība, attiecīgi 79,8 % un 63,0 %, salīdzinot ar normāla svara bērniem. Bērniem ar normālu svaru vecāku aptaukošanās konstatēta tikai 33,3 % gadījumu. Veicot aptaukošanās komplikāciju skrīningu, bērniem ar lieko svaru novērotas statistiski nozīmīgas sirds un asinsvadu sistēmas slimību, insulīna rezistences un citu bioķīmisko rādītāju izmaiņas, salīdzinot ar normāla svara bērniem. I pētījumā grupā gan sistoliskā asinsspiediena mediāna 123,0 (IQR 116,0; 132,0), gan arī diastoliskā asinsspiediena mediāna 78,0 (IQR 71,5; 83,0) bija nozīmīgi augstāka, salīdzinot ar kontroles grupu, kurā sistoliskā asinsspiediena mediāna bija 115,0 (IQR 110,0; 120,0), bet diastoliskā asinsspiediena mediāna 70,0 (IQR 65,0; 76,0) (p = 0,012). Kontroles grupā nevienam bērnam nebija konstatēts paaugstināts kopējā holesterīna līmenis virs 5,2 mmol/l, bet I pētījuma grupā tāds bija 8,8 % bērnu. Bērniem ar aptaukošanos gan I, gan arī II pētījuma grupā statistiski nozīmīgi augstāka bija insulīna rezistences koeficienta HOMA-IR mediāna, attiecīgi 3,9 (IQR 2,6; 5,6) un 2,3 (IQR 1,5; 3,4), salīdzinot ar normāla svara bērniem – 1,1 (IQR 0,8; 2,1) (p < 0,001). I grupas bērniem metaboliskais sindroms, izvērtējot to atbilstoši Starptautiskās diabēta federācijas izstrādātajiem kritērijiem, tika diagnosticēts 21 % (n = 30) gadījumu. Metaboliskā sindroma incidence pētāmajā populācijā pieauga līdz ar bērnu vecumu: vecumā no 10 līdz 16 gadiem metaboliskais sindroms tika diagnosticēts 17,1 %, bet 16 gadu un vecāku bērnu grupā – 38,5 % bērnu. Bērniem ar metabolisko sindromu bija nozīmīgi lielāka svara mediāna (p < 0,001) un zemāka jutība pret insulīnu (p = 0,039), salīdzinot ar bērniem bez metaboliskā sindroma. Pētījuma laikā netika apstiprināta aptaukošanās prenatālu riska faktoru – tādu kā dzimšanas svars (p = 0,145), pārmērīgs svara pieaugums grūtniecības laikā mātei (p = 0,625), pozitīva 2. tipa cukura diabēta anamnēze ģimenē (p = 0,519) – ietekme uz metaboliskā sindroma attīstību. Aptaukošanās postnatālais riska faktors, ekskluzīvas zīdīšanas ilgums, arī neietekmēja metaboliskā sindroma attīstību (p > 0,999). Metaboliskā sindroma varbūtība bērniem pieauga, palielinoties ķermeņa masas indeksam, un 11,13 reizes varbūtību palielināja tēva aptaukošanās.Secinājumi. Bērniem ar aptaukošanos jau agrīni tika novēroti sirds un asinsvadu sistēmas slimību un 2. tipa cukura diabēta riska faktori. Desmitgadīgiem un vecākiem bērniem ar aptaukošanos bija augstāks asinsspiediens, paaugstināts kopējā holesterīna daudzums un augstāks insulīna rezistences koeficients HOMA-IR. Metaboliskā sindroma diagnoze tika apstiprināta gandrīz ceturtdaļai bērnu pētāmajā populācijā. Metaboliskā sindroma varbūtību nozīmīgi palielināja gan aptaukošanās pakāpe, gan arī vecāku aptaukošanās.
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    Metaboliskā sindroma riska faktori, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Promocijas darbs
    (Rīgas Stradiņa universitāte, 2022) Gailite, Jurgita; Gardovska, Dace; Dzīvīte-Krišāne, Iveta
    Ievads. Sabiedrības veselības pētījumi norāda uz strauju aptaukošanās izplatību ne tikai pieaugušajiem, bet īpaši strauja izplatība tiek novērota arī pusaudžiem un pirmsskolas vecuma bērniem. Latvijā augstāka liekā svara izplatība ir septiņgadīgiem zēniem, salīdzinot ar meitenēm, attiecīgi 23,7 % un 21,8 %. Taču meitenēm šis īpatsvars kopš 2008. gada ir pakāpeniski palielinājies no 18,3 % līdz 21,8 %. Bērniem un pusaudžiem ar aptaukošanos agrīni draud attīstīties sirds un asinsvadu sistēmas slimības, arteriāla hipertensija, dislipidēmija, metaboliskais sindroms, insulīna rezistence, 2. tipa cukura diabēts, dažādu veidu audzēji, ortopēdiskas, nopietnas psiholoģiskas un neiroloģiskas problēmas, kā arī citi hroniski traucējumi. Metaboliskā sindroma īpašā nozīme pieaugušo vecumā ir saistīta ar iespēju identificēt personas, kurām ir liels gan 2. tipa cukura diabēta, gan sirds un asinsvadu sistēmas slimību risks. Attiecībā uz bērnu metabolisko sindromu autoru viedoklis atšķiras.Mērķis. Pētīt metaboliskā sindroma riska faktorus, komplikācijas un īpatnības bērniem un pusaudžiem ar aptaukošanos. Materiāls un metodes. Pētījumā atbilstoši iekļaušanas un izslēgšanas kritērijiem iekļauti 198 bērni, no tiem 181 bērns ar aptaukošanos un 17 bērni ar normālu ķermeņa svaru. Pirmajā pētījuma etapā bērni iedalīti grupās attiecīgi pēc svara un vecuma: I pētījuma grupa –10 gadu veci un vecāki bērni ar aptaukošanos, II pētījuma grupa – bērni līdz 10 gadu vecumam ar aptaukošanos, kontroles grupa – bērni ar normālu ķermeņa svaru. Šajā etapā pētījuma bērniem veikts aptaukošanās prenatālo un postnatālo riska faktoru novērtējums un aptaukošanās komplikāciju skrīnings. Otrajā pētījuma etapā pēc Starptautiskās diabēta federācijas izstrādātajiem kritērijiem izvērtēts metaboliskais sindroms bērniem no 10 gadu vecuma, t. i., tikai I pētījuma grupas (n = 143) bērniem. Visi iegūtie dati apkopoti Excel datubāzē un analizēti, izmantojot RStudio V.1.4.1103. Atšķirības uzskatītas par statistiski nozīmīgām, ja nozīmības līmenis p bija < 0,05. Rezultāti. Aptaukošanās prenatālie riska faktori, kā dzimšanas svars (p = 0,530), pārmērīgs svara pieaugums grūtniecības laikā mātei (p = 0,787), pozitīva 2. tipa cukura diabēta anamnēze ģimenē (p > 0,999), statistiski nozīmīgi neatšķīrās bērniem ar aptaukošanos un normālu ķermeņa svaru. Arī aptaukošanās postanatālam riska faktoram, ekskluzīvas zīdīšanas ilgumam (p = 0,120) netika atrasta statistiski nozīmīga atšķirība starp bērniem ar aptaukošanos un normālu svaru. Statistiski nozīmīga atšķirība pētījuma grupās tika novērota tikai postnatālam aptaukošanās riska faktoram – vecāku aptaukošanās faktam (p = 0,004). Bērniem ar aptaukošanos gan I grupā, gan arī II grupā bija augsta vecāku aptaukošanās izplatība, attiecīgi 79,8 % un 63,0 %, salīdzinot ar normāla svara bērniem. Bērniem ar normālu svaru vecāku aptaukošanās konstatēta tikai 33,3 % gadījumu. Veicot aptaukošanās komplikāciju skrīningu, bērniem ar lieko svaru novērotas statistiski nozīmīgas sirds un asinsvadu sistēmas slimību, insulīna rezistences un citu bioķīmisko rādītāju izmaiņas, salīdzinot ar normāla svara bērniem. I pētījumā grupā gan sistoliskā asinsspiediena mediāna 123,0 (IQR 116,0; 132,0), gan arī diastoliskā asinsspiediena mediāna 78,0 (IQR 71,5; 83,0) bija nozīmīgi augstāka, salīdzinot ar kontroles grupu, kurā sistoliskā asinsspiediena mediāna bija 115,0 (IQR 110,0; 120,0), bet diastoliskā asinsspiediena mediāna 70,0 (IQR 65,0; 76,0) (p = 0,012). Kontroles grupā nevienam bērnam nebija konstatēts paaugstināts kopējā holesterīna līmenis virs 5,2 mmol/l, bet I pētījuma grupā tāds bija 8,8 % bērnu. Bērniem ar aptaukošanos gan I, gan arī II pētījuma grupā statistiski nozīmīgi augstāka bija insulīna rezistences koeficienta HOMA-IR mediāna, attiecīgi 3,9 (IQR 2,6; 5,6) un 2,3 (IQR 1,5; 3,4), salīdzinot ar normāla svara bērniem – 1,1 (IQR 0,8; 2,1) (p < 0,001). I grupas bērniem metaboliskais sindroms, izvērtējot to atbilstoši Starptautiskās diabēta federācijas izstrādātajiem kritērijiem, tika diagnosticēts 21 % (n = 30) gadījumu. Metaboliskā sindroma incidence pētāmajā populācijā pieauga līdz ar bērnu vecumu: vecumā no 10 līdz 16 gadiem metaboliskais sindroms tika diagnosticēts 17,1 %, bet 16 gadu un vecāku bērnu grupā – 38,5 % bērnu. Bērniem ar metabolisko sindromu bija nozīmīgi lielāka svara mediāna (p < 0,001) un zemāka jutība pret insulīnu (p = 0,039), salīdzinot ar bērniem bez metaboliskā sindroma. Pētījuma laikā netika apstiprināta aptaukošanās prenatālu riska faktoru – tādu kā dzimšanas svars (p = 0,145), pārmērīgs svara pieaugums grūtniecības laikā mātei (p = 0,625), pozitīva 2. tipa cukura diabēta anamnēze ģimenē (p = 0,519) – ietekme uz metaboliskā sindroma attīstību. Aptaukošanās postnatālais riska faktors, ekskluzīvas zīdīšanas ilgums, arī neietekmēja metaboliskā sindroma attīstību (p > 0,999). Metaboliskā sindroma varbūtība bērniem pieauga, palielinoties ķermeņa masas indeksam, un 11,13 reizes varbūtību palielināja tēva aptaukošanās.Secinājumi. Bērniem ar aptaukošanos jau agrīni tika novēroti sirds un asinsvadu sistēmas slimību un 2. tipa cukura diabēta riska faktori. Desmitgadīgiem un vecākiem bērniem ar aptaukošanos bija augstāks asinsspiediens, paaugstināts kopējā holesterīna daudzums un augstāks insulīna rezistences koeficients HOMA-IR. Metaboliskā sindroma diagnoze tika apstiprināta gandrīz ceturtdaļai bērnu pētāmajā populācijā. Metaboliskā sindroma varbūtību nozīmīgi palielināja gan aptaukošanās pakāpe, gan arī vecāku aptaukošanās.
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    Risk Factors, Complications and Characteristics of Metabolic Syndrome in Obese Children and Adolescents. Summary of the Doctoral Thesis
    (Rīga Stradiņš University, 2022) Gailite, Jurgita; Gardovska, Dace; Dzīvīte-Krišāne, Iveta
    Introduction. Public health research indicates that the prevalence of obesity is rapidly increasing not only among adults, but especially is rapidly increasing among adolescents, slightly less among young children. In Latvia, the prevalence of overweight and obesity is higher in seven-year-old boys compared to girls, 23.7 % and 21.8 %, respectively. However, for girls, this proportion has gradually increased since 2008 from 18.3 % to 21.8 %. Children and adolescents with obesity are at risk of early cardiovascular disease, arterial hypertension, dyslipidemia, metabolic syndrome, insulin resistance, type 2 diabetes mellitus, various types of tumors, orthopedic problems, serious psychological and neurological problems, and other health problems. Metabolic syndrome has a special role in adulthood and is associated with a higer risk for type 2 diabetes mellitus and cardiovascular disease. However, the definition, diagnostic criteria, risk factors, prevention, and treatment of metabolic syndrome in children and adolescents have not yet been standardized.Aim. To study the risk factors, complications and features of metabolic syndrome in children and adolescents with obesity.Materials and methods. The study included 198 children according to inclusion and exclusion criteria, including 181 children with obesity and 17 children with normal body weight. In the first phase of the study, the children were divided into groups according to weight and age, study group I – children 10 years and older with obesity, study group II – children under ten years with obesity, control group – children with normal body weight. In this study phase, prenatal and postnatal obesity risk factors were evaluated, and obesity complications were screened. The second phase of the study evaluated metabolic syndrome as defined by the International Federation of Diabetes at 10 years of age, only in children in study group I (n = 143). All research data were summarized in an Excel database and analyzed using RStudio V.1.4.1103. Differences were considered statistically significant if the significance level was p < 0.05.Results. There were no statistically significant differences regarding prenatal obesity risk factors, large birth weight (p = 0.530), maternal weight gain during pregnancy (p = 0.787), and a positive family history of type 2 diabetes mellitus (p > 0.999) between obese and normal weight children. No statistically significant differences were found in the duration of breast feeding (p = 0.120) between obese and normal weight children. A statistically significant difference was observed in the study groups only for the postnatal obesity risk factor – parental obesity (p = 0.004). Children with obesity had a high prevalence of parental obesity in study group I and group II, 79.8 % and 63.0 %, respectively, compared to children of normal weight. In children of normal weight, parental obesity was detected in only 33.3 % of the cases. Screening for obesity complications has shown statistically significant changes in cardiovascular disease, insulin resistance, and other biochemical parameters in obese children compared to normal weight children. In study group I, the median systolic blood pressure 123.0 (IQR 116.0; 132.0) and the median diastolic blood pressure 78.0 (IQR 71.5; 83.0) were significantly higher compared to controls, with the median systolic blood pressure 115.0 (IQR 110.0; 120.0) and the median diastolic blood pressure 70.0 (IQR 65.0; 76.0) (p = 0.012). No child had an elevated total cholesterol above 5.2 mmol/l in the control group, compared to 8.8 % in study group I. Children with obesity had a statistically significant higher median HOMA-IR in both study group I and group II, 3.9 (IQR 2.6; 5.6) and 2.3 (IQR 1.5; 3.4) in control group, respectively. The median HOMA-IR for children of normal weight was 1.1 (IQR 0.8; 2.1) (p < 0.001).In children in study group I, metabolic syndrome was diagnosed in 21 % (n = 30) according to the criteria developed by the International Federation of Diabetes. The incidence of metabolic syndrome in the study population increased with age, with 17.1 % of children diagnosed with metabolic syndrome between aged 10 to 16 years and 38.5 % of children over 16 years of age diagnosed with MS. Children with metabolic syndrome had significantly higher median weight (p < 0.001) and lower insulin sensitivity (p = 0.039) compared to children without metabolic syndrome. There was no evidence of prenatal risk factors for obesity such as large birth weight (p = 0.145), excessive weight gain during maternal pregnancy (p = 0.625), a positive family history of type 2 diabetes mellitus (p = 0.519) had an effect on the development of metabolic syndrome. The postnatal risk factor for obesity – the duration of exclusive breastfeeding also did not affect the development of metabolic syndrome (p > 0.999). The risk of metabolic syndrome in children increased with increasing body mass index, and the risk of metabolic syndrome was 11.13 times higher in the case of paternal obesity. Conclusions. Risk factors for cardiovascular disease and type 2 diabetes mellitus have been observed early in obese children. Children with obesity over 10 years of age had higher blood pressure, elevated total cholesterol and increased insulin resistance and HOMA-IR ratio. The diagnosis of metabolic syndrome was confirmed in almost a quarter of the pediatric study population. The risk of metabolic syndrome increased significantly with both the degree of obesity and the level of parental obesity.
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    Role of Single Nucleotide Variants in FSHR, GNRHR, ESR2 and LHCGR Genes in Adolescents with Polycystic Ovary Syndrome
    (2021-12-11) Lidaka, Lasma; Beķere, Laine; Rota, Adele; Isakova, Jekaterina; Lazdāne, Gunta; Ķīvīte-Urtāne, Anda; Dzīvīte-Krišāne, Iveta; Kempa, Inga; Dobele, Zane; Gailīte, Linda; Department of Obstetrics and Gynaecology; Scientific Laboratory of Molecular Genetics; Institute of Public Health
    Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women, affecting up to 16.6% of reproductive-age women. PCOS symptoms in adolescents comprise oligomenorrhoea/amenorrhoea and biochemical and/or clinical hyperandrogenism. Long-term health risks of PCOS patients include infertility, metabolic syndrome, type 2 diabetes and cardiovascular disease. Genetic factors have been proven to play a role in development of the syndrome and its symptoms. Objective: To investigate single nucleotide variants (SNVs) in the GNRHR, ESR2, LHCGR and FSHR genes in adolescent patients with PCOS and their association with PCOS symptoms. Methods: We conducted a cross-sectional study comprising of 152 adolescents: 63 patients with PCOS, 22 patients at risk of developing PCOS and 67 healthy controls. Participants were recruited from out-patients attending a gynaecologist at the Children’s Clinical University Hospital, Riga, Latvia, between January 2017 and December 2020. Genomic DNA was extracted from whole blood, and SNVs in the GNRHR, ESR2, LHCGR and FSHR genes were genotyped. The distributions of SNV genotypes were compared among the three groups and genotype-phenotype associations within the PCOS group were evaluated. Results: No statistically significant differences were found in the distributions of genotypes for GNRHR (rs104893837), ESR2 (rs4986938), LHCGR (rs2293275) and FSHR (rs6166, rs6165, rs2349415) among PCOS patients, risk patients and healthy controls. Within the PCOS group, ESR2 rs4986938 minor allele homozygous patients had a significantly higher level of total testosterone than major allele homozygous patients and heterozygous patients. A significantly higher total testosterone level was also observed in PCOS patients carrying the LHCGR rs2293275 minor allele compared with major allele homozygous patients. Conclusions: The SNVs ESR2 rs4986938 and LHCGR rs2293275 play a role in the phenotypic characteristics of PCOS. To fully uncover their influence on the development of PCOS and its symptoms, further studies of larger cohorts and a follow up of this study sample through to adulthood are required. Furthermore, studies of adolescent PCOS patients conducted prior to the latest European Society of Human Reproduction and Embryology (ESHRE) criteria (2018) should be re-evaluated as the study groups might include risk patients according to these updated criteria, thereby potentially significantly impacting the published results.
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    Short-term predictors for weight correction success of the first paediatricweight correction programme in children’s clinical university hospital in Riga
    (2019-03) Gailite, Jurgita; Apela, Dana; Dzīvīte-Krišāne, Iveta; Gardovska, Dace; Department of Paediatrics
    Background and objectives: The efficacy of a weight correction programme can be affected by such predictors as the number of contact hours, gender, age, baseline weight, parental weight status, psycho-emotional status, insulin resistance, and socioeconomic status. The aim of this current study was to evaluate the overall efficacy of the Weight Correction Programme at Children’s Clinical University Hospital, and explore the impact of the probable predictors. We evaluated the efficacy depending on gender, age, parental weight status, signs of depression, baseline body mass index z-score (z-BMI), and baseline waist circumference. Materials and Methods: The data were gathered from medical records. The inclusion criteria were as follows: Entered the programme by 13 June 2017, at least five years old, follow-up data available. All the respondents were divided into two age groups: <10 years old and ≥10 years old. Results: The study included 181 respondents. They were 5 to 17 years old on the first day of participation in theWeight Correction Programme. Results indicated that 117 (65%) patients managed to reduce z-BMI and 69 (38%) patients achieved clinically significant reduction of z-BMI. Boys had four times higher odds (odds ratio (OR) = 4,22; CI 1.37-13.05; p = 0.012) to reduce their z-BMI by at least 0.20 units than girls. The respondents of the older age group (≥10 years) had a better chance to reduce z-BMI than the younger ones (OR = 11,51; CI 2.04-64.83; p = 0.006). The odds to reduce z-BMI were lower by 7% for every extra cm of waist circumference (OR = 0.93; CI 0.88-0.99; p = 0.014) for reducing z-BMI. The follow-up time was also a positive predictor, and with every month the odds for clinically significant z-BMI reduction increased by 7% (OR = 1.07; CI 1.00-1.15; p = 0.047). The parental weight status, signs of depression, and baseline z-BMI were not significant predictors. Conclusions: More than half of the patients of the respondents managed to reduce their z-BMI. Female gender, younger age, and larger waist circumference were negative predictors.
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    Type 2 diabetes mellitus, impaired glucose tolerance and associated comorbidities in children during 2002-2013 in children's clinical university hospital, Latvia
    (2018) Gailite, Jurgita; Mikilpa-Mikgelba, Agnese; Siliņa, Ieva; Kirillova, Inara; Lauga-Tuņina, Una; Dzīvīte-Krišāne, Iveta; Gardovska, Dace; Department of Paediatrics
    The world has seen a rise of type 2 diabetes mellitus in children during the last 20 years. It is proposed that this increase is due to unhealthy eating habits, increasing obesity, especially among teenagers, and better diagnostics. The main risks associated with diabetes are microvascular and macrovascular complications, which can lead to early disability and premature death. The aim of our study was to identify children with type 2 diabetes mellitus or impaired glucose tolerance and investigate associated comorbidities at the time of diagnosis in the Children's Clinical University Hospital in Latvia. A retrospective analysis was performed of all children with type 2 diabetes mellitus or glucose tolerance impairment from 2002 till 2013, who were treated in Children's Endocrinology Centre. According to inclusion criteria, 57 patients were selected of whom 24 (42%) had type 2 diabetes mellitus and 33 (58%) had impaired glucose tolerance. Body mass index was analysed according to percentile and all patients were found to have excess weight. In children with type 2 diabetes mellitus, all patients had body mass index over the 99th percentile. Arterial hypertension was found in 66.7% and dyslipidemia in 54.2% type 2 diabetes mellitus patients. From all type 2 diabetes mellitus patients, 71% (n = 17) were girls and they had statistically significantly higher total cholesterol (p = 0.02) and low-density lipoprotein (p = 0.003) levels. Considering, that girls with type 2 diabetes mellitus have high cardiovascular risk in adulthood, it is very important not only to achieve normal glucose levels early, but also to treat comorbidities, to reduce further microvascular and macrovascular complication risk.