ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet2015223-29ometendo-6826Research ArticleНаучные исследованияOriginal studiesГормональный статус и орексиновая система у больных ожирением, осложненным синдромом обструктивного апноэ снаHormonal status and the orexin system in obese patients with obstructive sleep apnea syndromeСтруеваНаталья ВикторовнаStruevaNatalya Viktorovna

аспирант

Ph.D student

nstr84@mail.ruМельниченкоГалина АфанасьевнаMelnichenkoGalina Afanas'evnamelnich@endocrincentr.ruПолуэктовМихаил ГурьевичPoluektovMikhail Gur'evichpolouekt@mail.ruСавельеваЛариса ВикторовнаSavel'evaLarisa Viktorovna

  к.м.н., зав. отделением терапии эндокринопатий 

larisa.savelieva@inbox.ruКацияГулинара ВикторовнаKatsyaGulinara Viktorovna

д.м.н., главный научный сотрудник лаборатории биохимической эндокринологии и гормонального анализа 

dmeno@rambler.ruГончаровНиколай ПетровичGoncharovNikolay Petrovich

д.м.н., проф., руководитель лаборатории биохимической эндокринологии и гормонального анализа 

goncharovN@endocrincentr.ruФГБУ "Эндокринологический научный центр" Минздрава России, МоскваРоссияEndocrinology Research CentreRussian FederationФГБУ «Эндокринологический научный центр» Минздрава России, МоскваРоссияEndocrinology Research CentreRussian FederationГБОУ ВПО «Первый московский государственный медицинский университет имени И.М. Сеченова» Минздрава России, МоскваРоссияI. M. Sechenov First Moscow State Medical UniversityRussian Federation2015040520151222430Copyright © Струева Н.В., Мельниченко Г.А., Полуэктов М.Г., Савельева Л.В., Кация Г.В., Гончаров Н.П., 20152015Струева Н.В., Мельниченко Г.А., Полуэктов М.Г., Савельева Л.В., Кация Г.В., Гончаров Н.П.Strueva N.V., Melnichenko G.A., Poluektov M.G., Savel'eva L.V., Katsya G.V., Goncharov N.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/6826

Целью настоящего исследования явилось изучение связи между гормональной секрецией и расстройствами дыхания во сне обструктивного характера. В исследование было включено 76 больных первичным ожирением (37 мужчины и 39 женщины). Согласно поставленным целям и задачам данные пациенты были разделены на две сопоставимые по возрасту, полу и ИМТ группы: первая – больные с СОАС (n = 41), вторая – без нарушений дыхания во сне (n = 35). СОАС сопровождается увеличением экскреции свободного кортизола в ночное моче, высоким уровнем базального инсулина, нарушением продукции ИФР-1 печенью, дисфункцией гипофизарно-гонадной оси. Таким образом, расстройства дыхания во сне негативно влияют на гормональную секрецию у больных ожирением. Так как достоверных отличий уровня орексина А у больных ожирением с СОАС и без него обнаружено не было (42,0 [14; 99,5] против 18,0 [14,5; 124,5] пг/мл; р = 0,9), мы не можем утверждать, что наличие синдрома обструктивного апноэ сна у этой когорты пациентов сопровождается какими-либо особыми изменениями активности орексиновой системы.

The aim of research was to estimate the influence of hormone metabolism and sleep apnea on patients with obesity. 76 patients (37 males and 39 females) with obesity were included in this study. After night polysomnography all patients were divided in two groups comparableby age, sex ratio and BMI. The first group consisted of 41 patients with obstructive sleep apnea syndrome (OSAS), the second (controls) – 35 patients without breath disorders during sleep. OSAS is accompanied by the increase in urinary cortisol during the night, high levels ofbasal insulin, disturbances of hepatic production of IGF-1, dysfunction of the pituitary-gonadal axis. Our results show that sleep-related breathing disorders render markedly and negatively affect on hormonal parameters of patients with obesity. As a reliable difference of basalsecretion of orexin A in obese patients with and without OSAS was not revealed (42,0 [14; 99,5] vs. 18,0 [14,5; 124,5] pg/ml; р=0,9), we were not able to show the existence that the existence of OSAS is followed by any special changes of activity of the orexin system.

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The authors declare that there are no conflicts of interest present.