POLYORGANIC PATHOLOGY OF ELDERLY PATIENTS WHO WERE BORN LARGE FOR GESTATIONAL AGE 
Garmash O.V., Pytetska N.I., Ryaboкon E.N.
Kharkov national medical university, Kharkov, Kharkov. Ukraine

Introduction. According to results of WHO researches, 12.7 of 15 million cases of cerebral stroke, which takes the 2nd place among diseases with a fatal outcome and is the most widespread cause of a persistent disability, are caused by hypertension (HTN). HTN is often combined with obesity – the independent risk factor of cardiovascular complications. Today we know that there’s a correlation between a fetal macrosomia (birth weights greater than the 90th percentile) and development of cardiovascular and metabolic diseases during the adulthood.
The purpose of this work is to reveal the interconnection between hemodynamic, metabolic disorders and a dental status of patients born with fetal macrosomia. 
Materials and methods. Eight patients (aged 63-83 years) with hypertension and body weight at birth over 4 kg were examined. Medical documentation which contains the information about weight and growth at birth in elderly patients was not available (we used data obtained from own words of participants of the study), which explains small number of participants of the study. General clinical examination and anthropometric examination were carried out. Obesity class was defined by body mass index (BMI). Dental examination was made using standard algorithms: analysis of complaints and a collection of past history data, examination of mucosa of oral cavity, periodontium, and hard tooth tissues. Caries intensity was defined by DMF index (the total number of teeth that are decayed (D), missing (M), or filled (F) in an individual), hygienic condition of an oral cavity – by Green-Vermillion (OHI-S) index. Periodontal state was defined by Ramfjord index. Statistical data processing was performed with an analysis package in «Microsoft Excel» system.
Results of the study. Average age of examined patients was 70.2±2.6 years. One patient (12.5%) turned out to have diabetes mellitus type 2. One patient (12.5%) had a myocardial infarction. Two patients (25%) had ischemic stroke. According to anthropometric examination data 12.5% (1 person) of patients had normal body weight, 62.5% (5 persons) had excessive weight, 25% (2 persons) suffered from obesity.
Dental pathology was revealed in 100% of cases. Due to past history data we know that 2 patients (25%) used complete removable dentures more than 20 years. Another two of them (25%) used partial removable dentures. The rest of patients had unremovable orthopedic constructions. The value of mathematical expectation of DMF index showed a very high intensity of carious processes – (20.63±3.55) points (P < 0.05). According to past history of examined patients most teeth were removed as a result of inflammatory and degenerative periodontal diseases. Values of hygiene and periodontal indexes were studied for 5 patients with preserved teeth (in case of index teeth absence adjacent teeth were examined). OHI-S index revealed a bad hygiene condition of oral cavities – (3.36±0.72) points (P < 0.05). Ramfjord index showed pronounced pathological processes in periodontium – (4.56±0.23) points (P < 0.05). The recession of gums and periodontal pockets was determined in 5 patients and indicated inflammatory and degenerative diseases of periodontal tissues with different severity grades. It is remarkable that 5 patients had a “thick” biotype of periodontal tissues.
Therefore, our study confirms that people with the body weight over 4-4.5 kg have a high risk of developing of cardiovascular pathology and metabolic disorders in future life. Obviously, pathological changes of central hemodynamics which occur in this case affect the microcirculatory section of maxillofacial system as well favouring the development of inflammatory and degenerative diseases of periodontal tissues. 
It’s necessary to continue research in this field to increase the statistical reliability of the results we obtained.