fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2023-8-3-124-130fcmedicine-751Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESНарушение циркадной ритмики в патофизиологии сахарного диабетаReview article circadian disruption in pathophysiology of diabetes mellitushttps://orcid.org/0000-0003-4705-3823БыковЮ. В.BykovYu. V.

Быков Юрий Витальевич - кандидат медицинских наук, ассистент кафедры анестезиологии и реаниматологии с курсом ДПО ФГБОУ ВО «СтГМУ» МЗ РФ.

355017, Ставрополь, ул. Мира, д. 310

Yuri V. Bykov - MD, PhD, Assistant Professor, Department of Anesthesiology, Resuscitation and Emergency Medicine, Stavropol State Medical University.

310, Mira Street, Stavropol, 355017

yubykov@gmail.comФГБОУ ВО «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской Федерации; ГБУЗ «Детская городская клиническая больница им. Г.К. Филиппского»РоссияStavropol State Medical University; City Clinical Children's HospitalRussian Federation20232909202383124130Copyright © Быков Ю.В., 20232023Быков Ю.В.Bykov Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/751

Сахарный диабет (СД) - ведущая эндокринопатия с неуклонным ростом заболеваемости, имеющая большое количество диабетических осложнений и высокие затраты со стороны здравоохранения. Патофизиологические механизмы развития СД до конца не выяснены. Нарушение циркадных ритмов (ЦР) рассматривается как возможное звено в патогенезе данного заболевания. ЦР - автономная система нейроэндокринных сигналов и факторов клеточной транскрипции, которые координируют основные физиологические процессы с суточным циклом. Циркадные часы (ЦЧ) подразделяются на центральные (расположенные в супрахиазматических ядрах гипоталамуса) и периферические (расположенные в органах и клетках). ЦЧ обеспечивают ежедневные циркадные колебания клеток, в том числе и β-клетках поджелудочной железы. Поломка в работе ЦЧ лежит в основе циркадного десинхроноза (ЦД). Метаболизм глюкозы и выработка инсулина имеют чёткий ЦР, нарушение которого может быть одним из триггеров развития СД. Выработка гормона мелатонина (МТ) как важного регулятора ЦР может быть нарушена при СД, что является ещё одним доказательством вовлечённости ЦД в патофизиологию данной эндокринопатии. Для СД характерен низкий уровень МТ. МТ обладает антиоксидантной активностью, что может играть важную роль в предотвращении диабетических осложнений при СД. ЦД - самостоятельный патологический синдром, причинами которого могут быть: смена часовых поясов, нарушение режима дня и питания. На данный момент ЦД рассматривается как важная причина, приводящая к СД. Патофизиологические механизмы, приводящие к СД на фоне ЦД, до конца не выяснены. В первую очередь рассматривается генетическая гипотеза поломки биологических часов в β-клетках поджелудочной железы. Важную роль в развитии СД на фоне ЦД может играть окислительный стресс. Своевременная диагностика и специфическое лечение ЦД на фоне СД могут предотвратить развитие и тяжесть диабетических осложнений.

Diabetes mellitus is a leading endocrine disease with a steadily increasing incidence, and its complications impose a heavy burden on the healthcare. Although pathophysiology of diabetes mellitus has been extensively investigated through the recent decades, the role of circadian rhythms in this regard was vaguely described. Circadian rhythms comprise an autonomous system of neuroendocrine signals and transcription factors that enfold key physiological processes into a daily cycle. Circadian clocks are subdivided into central (located in the suprachiasmatic nuclei of the hypothalamus) and peripheral oscillators (located in organs and cells) which produce circadian variations in the activity of virtually all cells within the human body, including the β cells of the pancreas. Circadian rhythm disruption causes circadian desynchronization which is associated with impaired glucose metabolism and insulin secretion, thereby being considered as one of the triggers of diabetes mellitus. Production of melatonin, a master regulator of circadian rhythms and a potent antioxidant, is significantly reduced in patients with diabetes mellitus. Circadian desynchronization may be triggered by a jetlag or an eating disorder. At present, circadian disruption is viewed as an important cause for the development of diabetes mellitus, although the mechanisms of such link have not been fully elucidated hitherto and might include genetic predisposition and increased oxidative stress. Timely diagnosis and appropriate treatment of circadian disruption in patients with diabetes mellitus may ameliorate the severity or prevent diabetes complications.

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