Нарушение дофаминергической системы в патофизиологии сахарного диабета
https://doi.org/10.52420/2071-5943-2023-22-4-119-127
Аннотация
Введение. Сахарный диабет (СД) – наиболее распространенная эндокринопатия с высоким ростом заболеваемости и большим количеством осложнений.
Цель работы – провести аналитический обзор литературы с оценкой состояния проблемы нарушения дофаминергической системы при СД с патофизиологических позиций.
Материалы и методы. Поиск проведен в базах данных и электронных библиотеках Cochrane Library, PubMed, eLibrary, Medscape по поисковым словам: сахарный диабет (diabetes mellitus), дофамин (dopamine), инсулин (insulin), дофаминергическая система (dopaminergic system), диабетическая энцефалопатия (diabetic encephalopathy). Для обзора отобрано 66 источников.
Результаты и обсуждение. Дисфункция дофаминергической системы может рассматриваться в качестве важного компонента патофизиологии СД. Гиперактивация выработки дофамина (ДА) на фоне СД ингибирует синтез инсулина, что приводит к гипергликемии. С другой стороны, гипоинсулинемия запускает активацию дофаминергической системы, формируя порочный круг. Увеличение выработки ДА при СД играет важную роль в формировании вторичной дисфункции центральной нервной системы, в первую очередь за счет развития церебральной недостаточности. Многочисленные доклинические исследования подтверждают дисфункцию дофаминергической системы (ее активацию) при СД. Клинические исследования по данной проблематике малочисленны и требуют дальнейшего изучения.
Заключение. Дисфункция дофаминергической системы при СД является актуальным направлением изучения патофизиологии симптомов неврологических нарушений данного заболевания. СД 1 и 2 типа − патогенетически разные заболевания, и поэтому нарушения выработки ДА могут быть обусловлены недостаточностью инсулина у больных с СД 1 типа, разными сроками манифестации, с гиперинсулинемией и инсулинорезистентностью при СД 2 типов. Поиск достоверных методов диагностики дисфункции дофаминергической системы может улучшить понимание происходящих патологических процессов в нейроэндокринной системе при СД, что важно в решении вопросов их коррекции в дополнение к патогенетической терапии.
Ключевые слова
Об авторах
Ю. В. Быков
Ставропольский государственный медицинский университет
Россия
Россия
Юрий Витальевич Быков, кандидат медицинских наук,
Ставрополь
В. А. Батурин
Ставропольский государственный медицинский университет
Россия
Россия
Владимир Александрович Батурин, доктор медицинских наук, профессор,
Ставрополь
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Рецензия
Для цитирования:
Быков Ю.В., Батурин В.А. Нарушение дофаминергической системы в патофизиологии сахарного диабета. Уральский медицинский журнал. 2023;22(4):119-127. https://doi.org/10.52420/2071-5943-2023-22-4-119-127
For citation:
Bykov Yu.V., Baturin V.A. Disruption of the dopaminergic system in the pathophysiology of diabetes mellitus. Ural Medical Journal. 2023;22(4):119-127. (In Russ.) https://doi.org/10.52420/2071-5943-2023-22-4-119-127
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