cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1024Research ArticleМЕТАБОЛИЧЕСКИЙ СИНДРОМMETABOLIC SYNDROMEВлияние терапии постоянным положительным давлением на показатели углеводного и липидного обменов у больных с синдромом ZContinuous positive airway pressure therapy and carbohydrate and lipid metabolism in patients with Z syndromeГалявиР. А.GalyaviR. A.galyavi@mail.ruЛитвинА. Ю.LitvinA. Yu.galyavi@mail.ruЧазоваИ. Е.ChazovaI. E.galyavi@mail.ruНИИ клинической кардиологии им. А.Л. Мясникова ФГУ РК НПК Росздрава, МоскваA.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex, Russian Federal Agency of Health and Social Development, Moscow20052012200546, ч.I6775Copyright © Галяви Р.А., Литвин А.Ю., Чазова И.Е., 20052005Галяви Р.А., Литвин А.Ю., Чазова И.Е.Galyavi R.A., Litvin A.Y., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1024

Цель. Оценить влияние терапии постоянным положительным давлением (СРАР-терапии) на показатели углеводного и липидного обменов у больных с метаболическим синдромом (МС) в сочетании с синдромом обструктивного апноэ сна (СОАС). Материал и методы. В исследование были включены 62 пациента c МС, 20 женщин и 42 мужчины в возрасте 39-66 лет (средний возраст – 52,4±7,6). 15 пациентов без СОАС составили контрольную группу, у 47 (основная группа) был диагностирован СОАС различной степени тяжести. 11 пациентов основной группы в течение 12 недель находились на СРАР-терапии. До начала исследования и через 12 недель использования СРАР-терапии у пациентов проводили антропометрическое обследование: рост, массы тела (МТ), объема талии (ОТ) и бедер (ОБ), определение индекса МТ (ИМТ); биохимическое исследование крови: общий холестерин (ОХС), ХС липопротеидов высокой плотности (ХС ЛВП), триглицериды (ТГ), глюкоза, пероральный тест толерантности к глюкозе; определяли уровень лептина, резистина и адипонектина; использовали суточное мониторирование артериального давления. Результаты. Показатели МТ, ИМТ, ОТ, ОТ/ОБ, ОХС снизились, но недостоверно. Уровень ХС ЛВП повысился с 0,99±0,2 ммоль/л до 1,12±0,1 ммоль/л (р<0,05). Концентрация ТГ уменьшилась с 4,18±3,3 ммоль/л до 2,31±1,2 ммоль/л (р<0,05). Содержание глюкозы натощак снизилось с 5,8±0,8 ммоль/л до 5,3±0,3 ммоль/л (р<0,05) и после нагрузки с 8,3±1,8 ммоль/л до 6,5±1,9 ммоль/л (р<0,05). Уровни адипоцитокинов достоверно улучшались: концентрация лептина снизилась с 15,14±4,6 до 11,17±5,2 нг/мл (р<0,05); резистин уменьшился с 3,02±0,87 до 2,5±0,51 нг/мл (p<0,05); уровень адипонектина повысился с 2,44±0,6 до 3,34±0,9 нг/мл (p<0,05). Заключение. Эффективная СРАР-терапия достоверно улучшает метаболические показатели у больных МС с СОАС.

Aim. To examine continuous positive airway pressure (CPAP) therapy effects on carbohydrate and lipid metabolism in patients with metabolic syndrome (MS) and obstructive sleep apnea syndrome (OSAS). Material and methods. The study involved 62 MS patients: 20 females and 42 males, aged 39-66 years (mean age 52.4±7.6 years). Control group included 15 patients without OSAS, another 47 had OSAS of varying severity (main group). CPAP therapy was administered to 11 OSAS patients for 12 weeks. At baseline and 12 weeks later, height, body weight (BW), waist and hips circumference (WC, HC) were measured, with body mass index calculation (BMI); levels of total cholesterol (TCH), high-density lipoprotein (HDL) CH, triglycerides (TG), glucose, leptin, resistin, adiponectin were assessed; glucose tolerance test and 24-hour blood pressure (BP) monitoring were performed. Results. BW, BMI, WC, WC/HC, TCH decrease wasn’t statistically significant. HDL CH level increased from 0.99±0.2 to 1.12±0.1 mmol/l (р<0.05). TG concentration decreased from 4.18±3.3 to 2.31±1.2 mmol/l (р<0.05). Fasting glucose level fell from 5.8±0.8 to 5.3±0.3 mmol/l (р<0.05), and after glucose load test – from 8.3±1.8 to 6.5±1.9 mmol/l (р<0.05). Adipocytokine levels significantly improved: leptin level decreased from 15.14±4.6 to 11.17±5.2 ng/ml (р<0.05); resistin concentration – from 3.02±0.87 to 2.5±0.51 ng/ml (p<0.05), and adiponectin level increased form 2.44±0.6 to 3.34±0.9 ng/ml (p<0.05). Conclusion. Effective CPAP therapy significantly improved metabolic parameters in patients with MS and OSAS.

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