Резюме. В последние десятилетия избыточная масса тела и ожирение стали одной из важнейших проблем для жителей боль-шинства стран мира. По данным Всемирной организации здравоохранения (ВОЗ), более миллиарда человек на планете имеют лишний вес, зарегистрировано более 300 млн больных ожирением. Данные клинических и экспериментальных исследований показывают отчетливую взаимосвязь между ожирением и рядом хронических заболеваний, таких как сахарный диабет 2 типа (СД2), атеросклероз, ИБС, высоким риском развития онкологической патологии, нарушениями в репродуктивной сфере, патологией опорно-двигательного аппарата, а также отклонениями в психическом статусе и процессах социальной адапта-ции. Поэтому значительные усилия современной эндокринологии направлены на изучение этиопатогенетических аспектов, лежащих в основе этих заболеваний и идентификацию возможных маркеров. Ключевые слова: ожирение, адипоцитокины, адипонектин, RBP4, резистин, висфатин, интерлейкин Resume. In recent decades, overweight and obesity have become a major problem for most countries. According to the World Health Organization (WHO), more than a billion people worldwide are overweight and more than 300 million are obese. These clinical and experimental studies highlight a clear relationship between obesity and several chronic diseases such as type 2 diabetes mellitus (T2DM), atherosclerosis, coronary heart disease, high risk of oncological diseases, disorders of the reproductive sphere, pathology of the musculoskeletal system, as well as deviations in mental status and processes of social adaptation. Therefore, considerable efforts of modern endocrinology focused on the study of etiopathogenetic aspects that underlie these diseases and identification of possible markers.

The primary objective of the present work was to study specific features of adiponectin gene (ADIPOQ) expression in the subcutaneous and visceral fatty tissues along with the serum adiponectin level in children. The secondary objective was to elucidate the relationship between these variables and the basic anthropometric characteristics. The study included a total of 62 patients (31 boys and 31 girls at the age from 2.5 to 18 (median 13.6 (8.5-15.1) years] after they underwent planned surgical interventions. The expression of the adiponectin gene ADIPOQ was determined in paired samples of adipose tissue using the polymerase chain reaction in the real time; in addition, the serum adiponectin levels were measured. The expression of the adiponectin gene ADIPOQ was shown to be unrelated either to the age or to the sex of the children. Nor was there any significant difference between its expression in the subcutaneous and visceral tissues. The highest expression of mRNA encoding for adiponectin was recorded in the children at the Tanner stages 2-3 of sexual development. The ADIPOQ gene expression in the subcutaneous and visceral tissues of overweight children was 22% and 22.6% higher respectively than in the same tissues of normal weight children. Gene expression in the subcutaneous adipose tissue negatively correlated with the serum adiponectin level ( R = –0.38, p = 0.002), BMI SD (R = –0.35, p = 0.004 ), and the waist circumference (R = –0.36, p = 0.004). The results of the study suggest the necessity of further studies to clarify the pathophysiological role of adiponectin in the development of obesity and the related metabolic disturbances.

In recent years, the independent role of adipose tissue in the pathogenesis of obesity and related complications has been actively discussed. Adipose tissue is also a key factor in the development and progression of insulin resistance. Among adipokines secreted by adipose tissue and influencing the development of insulin resistance and metabolic disorders, the most studied are leptin, adiponectin, resistin, visfatin. These adipokines are dedicated to this review.

The objective of this work was to study the relationship between the serum adiponectin level on the one hand, and the age, stage of sexual development and main anthropometric characteristics of children and adolescents depending on the degree of obesity, the presence or absence of metabolic disorders on the other hand. A total of 111 children and adolescents at the age from 2.5 to 17.9 years were available for the examination including 56 presenting with "simple" constitutional exogenous obesity, 12 overweight patients, and 43 with normal body weight. The concentration of adiponectin in the serum of obese children and adolescents was lower than in those with normal body weight (p=0.009). The highest adiponectin level was documented in prepubertal children; it decreased progressively in the course of sexual development and negatively correlated with BMI, waist circumference---???---(WC), and BMI SDS. The children presenting with obesity complicated by insulin resistance, the serum adiponectin level was lower than in those having normal and stimulated immunoreactive insulin concentrations, HOMA-IR and Matsuda's ISI indices. The study revealed the relationship between serum adiponectin levels, concentrations of high density lipoprotein cholesterol and triglycerides. The data obtained give reason to conjecture that the reduction of serum adiponectin level may be a link connecting obesity, insulin resistance, and atherogenic changed in the serum developing as early as the childhood that can be used as an additional biomarker for the identification of a group of children and adolescents at high risk of complications associated with obesity.