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Коморбідний ендокринологічний пацієнт
Коморбідний ендокринологічний пацієнт

Международный эндокринологический журнал Том 20, №2, 2024

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Метаболічний синдром, дисомнії та мелатонін

Метаболічний синдром, дисомнії та мелатонін

Авторы: Сергієнко В.О., Сегін В.Б., Гоцко М.Є., Сергієнко Л.М., Сергієнко О.О.
Львівський національний медичний університет імені Данила Галицького, м. Львів, Україна

Рубрики: Эндокринология

Разделы: Справочник специалиста

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Резюме

Останніми роками спостерігається зацікавленість вивченням особливостей взаємозв’язків між метаболічним синдромом (МС), порушеннями сну і мелатоніном (МЕЛ). Дисомнії та інсомнії є важливими факторами ризику інсулінової резистентності, ожиріння, МС, цукрового діабету 2-го типу зі ступенем впливу, подібним до традиційних чинників. Отже, лікування дисомній є одним із ключових завдань профілактики й лікування МС. Регулювання процесів сну і циркадних ритмів за допомогою екзогенного втручання (зокрема, використання мелатонінергічних лікарських засобів), імовірно, може відігравати головну роль у профілактиці й лікуванні дисомній при МС. МЕЛ діє як потужний антиоксидант, здатний долати гематоенцефалічний бар’єр, пригнічувати оксидантний стрес, хронічне запалення і взаємодіяти з мікробіомом кишечника. Із клінічної точки зору дисбаланс МЕЛ може вказувати на «дефіцит темряви». Доведено, що нейрогормон має системні ефекти завдяки своїм механізмам дії, що має потенціал для впливу на перебіг багатьох хронічних захворювань. На сьогодні мелатонінергічні препарати отримали схвалення виключно для лікування інсомнії, корекції наслідків зміни часових поясів і депресії, що супроводжується розладами сну. Однак МЕЛ потенційно має терапевтичні властивості в лікуванні нейродегенеративних захворювань, посттравматичного стресового розладу, нервово-психічних розладів, деменції, автоімунних, алергічних захворювань. Збільшення потреби у використанні препаратів МЕЛ спонукало до пошуку безпечних, але екологічно чистих лікарських засобів. Повідомляється, що фітомелатонін може мати переваги, пов’язані з поліпшеною біодоступністю й ефективністю. Метою цього огляду є аналіз особливостей взаємозв’язків між МС, дисомніями і МЕЛ. Пошук проводився в Scopus, Science Direct (від Elsevier) і PubMed, включно з базами даних MEDLINE. Використані ключові слова «метаболічний синдром», «дисомнії», «інсомнії», «синдром обструктивного апное», «мелатонін». Для виявлення результатів дослідження, які не вдалося знайти під час онлайн-пошуку, використовувався ручний пошук бібліографії публікацій.

In recent years, there has been an interest in studying the specifics of the relationships between metabolic syndrome (MetS), sleep disorders and melatonin (MEL). Dyssomnia and insomnia are important risk factors for insulin resistance, obesity, MetS, and type 2 diabetes mellitus with a degree of influence similar to traditional factors. Thus, the treatment of dyssomnia is one of the key tasks in the prevention and treatment of MetS. The regulation of sleep and circadian rhythms by exogenous intervention (in particular, the use of melatonergic drugs) is likely to play a central role in the prevention and treatment of dyssomnia in MetS. MEL acts as a powerful antioxidant that can cross the blood-brain barrier, suppress oxidative stress, chronic inflammation, and interact with the gut microbiome. From a clinical point of view, an imbalance of MEL may indicate a “darkness deficit”. It has been proven that the neurohormone has systemic effects due to its mechanisms of action, the potential to influence the course of many chronic diseases. Currently, melatonergic drugs are approved exclusively for the treatment of insomnia, jetlag, and depression accompanied by sleep disorders. However, MEL potentially has therapeutic properties in the treatment of neurodegenerative diseases, post-traumatic stress disorder, neuropsychiatric disorders, dementia, autoimmune and allergic diseases. The increasing need for the use of MEL products has prompted the search for safe but environmentally friendly medicines. It is reported that phytomelatonin may have advantages related to improved bioavailability and efficacy. The purpose of this review is to analyze the specifics of the relationship between MetS, dyssomnia, and MEL. The search was conducted in Scopus, Science Direct (from Else­vier), and PubMed, including MEDLINE databases. The keywords used were “metabolic syndrome”, “dyssomnia”, “insomnia”, “obstructive sleep apnea”, and “melatonin”. We conducted a manual search of the bibliography of publications to identify research results that were eluded during the online search.


Ключевые слова

метаболічний синдром; соціальний джетлаг; дисомнії; інсомнії; синдром обструктивного апное; мелатонін; огляд літератури

metabolic syndrome; social jetlag; dyssomnia; insomnia; obstructive sleep apnea; melatonin; literature review

doi: http://dx.doi.org/10.22141/2224-0721.20.2.2024.1375

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