Clinical course and prevalence of obesity associated with sphincter of Oddi dysfunction by pancreatic type in adolescents

I.S. Lembryk, O.O. Tsitsyura, R.Yu. Pryimak


Background. Gastroenterological manifestations of obesity is a topical problem of medicine in terms of mutually burdened nature. The purpose was to study the prevalence and clinical features of disease in adolescents with alimentary-constitutional obesity and concomitant sphincter of Oddi dysfunction by pancreatic type, or without such combination. Materials and methods. One hundred twenty adolescents with alimentary-constitutional obesity alone or in combination with sphincter of Oddi dysfunction by pancreatic type were exa­mined. They were treated according to modern protocols of diagnosis and treatment in the Ivano-Frankivsk Regional Children’s Clinical Hospital for the period from 2016 through 2019. Results. The prevalence of obesity in Ukraine, according to statistics, was 13.4 % per 1,000 children, which confirms the optimization of the diagnosis of this pathological condition compared to European data (10–15 % per 1,000 children population). We have found that among the examined children, males prevailed (70.0 and 30.0 %, p < 0.05). In majority of children with combined pathology, the duration of illness before admission to the hospital was 6.0 ± 2.1 years, with isolated course of the disease — 4.5 ± 3.1 years. The main risk factors for the pancreatic involvement are: genetic predisposition, low physical activity and diet violations, less frequently — insufficient fluid intake. Among the clinical manifestations of combined pathology, spastic pain with localization in the left subcostal region, which persisted for several hours and was poorly controlled by pain killers (75.0 and 25.0 %, c2 = 17.69, p < 0.05), prevailed. The total dyspeptic index (abdominal distension and diarrhea) in children with combined pathology was higher than in the others (5.01 ± 0.06 points and 3.02 ± 0.04 points, p < 0.05). The intoxication index due to general weakness was higher in the cohort of children with alimentary-constitutional obesity and functional pancreatic disorder (7.02 ± 0.06 points and 3.50 ± 0.02 points, p < 0.05). Conclusions. Obesity is often combined with functional pancreatic pathology, and individual clinical and laboratory markers and risk factors for pancreatic involvement in the pathological process should be based on updated diagnostic and treatment protocols.


adolescents; alimentary-constitutional obesity; sphincter of Oddi dysfunction by pancreatic type; clinical course


Belousov YuV. Pancreatitis and pancreatopatics: classification characteristics, principles of diagnostics and treatment in children. Zdorov`e rebenka. 2012;(43):129-133.

Babinets LS, Kytsai KYu. Clinical and Pathogenetic Aspects of Chronic Pancreatitis of Biliary Genesis and Obesity. Gastroenterologia. 2016;(59):86-92. doi: 10.22141/2308-2097.1.59.2016.74538.

Styne DM, Arslanian SA, Connor EL, et al. Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Mar 1;102(3):709-757. doi: 10.1210/jc.2016-2573.

World Health Organization. Growth reference 5-19 years: BMI-for-age (5-19 years). Available from:

Uc A, Zimmerman MB, Wilschanski M, et al. Impact of Obesity on Pediatric Acute Recurrent and Chronic Pancreatitis. Pancreas. 2018 Sep;47(8):967-973. doi: 10.1097/MPA.0000000000001120.

Kumar S, Ooi CY, Werlin S, et al. Risk Factors Associated With Pediatric Acute Recurrent and Chronic Pancreatitis: Lessons From INSPPIRE. JAMA Pediatr. 2016 Jun 1;170(6):562-9. doi: 10.1001/jamapediatrics.2015.4955.

Guyatt GH, Schünemann HJ, Djulbegovic B, Akl EA. Guidelane panels shold not GRADE good practice statements. J Clin Epidemiol. 2015 May;68(5):597-600. doi: 10.1016/j.jclinepi.2014.12.011.   

Skinner AC, Perrin EM, Moss LA, Skelton JA. Cardiometabolic risks and severety of obesity in children and young adults. N Engl J Med. 2015 Oct;373(14):1307-17. doi: 10.1056/NEJMoa1502821. 

Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics. 2007 Dec;120 Suppl 4:S193-228. doi: 10.1542/peds.2007-2329D.

Eriksson JG, Kajantie E, Lampl M, Osmond C. Trajectories of body mass index amongs children who develop type 2 diabetes as adults. J Intern Med. 2015 Aug;278(2):219-26. doi: 10.1111/joim.12354.

Daniels SR, Hassink SG; Committee on Nutrition. The role of the pediatrician in primary prevention obesity. Pediatrics. 2015 Jul;136(1):e275-92. doi: 10.1542/peds.2015-1558.

Rajjo T, Amasri J, Al Notal A, et al. The assotiation of weight loss and cardiometabolic outcomes in obese children. Systemic review and meta-regression. J Clin Endocrinol Metab. 2017 Mar 1;102(3):758-762. doi: 10.1210/jc.2016-2575.

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