diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13021diaendo-13021Research ArticleОбзорыReviewАнализ вклада синдрома обструктивного апноэ/гипопноэ сна и вариабельности уровня гликемии в развитие и прогрессирование нарушений ритма сердца у пациентов с сахарным диабетом 2 типаAnalysis of the contribution of obstructive sleep apnea/hypopnea syndrome and glycemic level variability to the development and progression of cardiac arrhythmias in patients with type 2 diabetes mellitushttps://orcid.org/0000-0002-7879-9321ЭнертА. В.EnertA. V.

Энерт Анастасия Витальевна - к.м.н., ассистент.

634050, Томск, Московский тракт, 2

Anastasiya V. Enert - MD, PhD, Assistant.

2 Moscovski Traсt, 634050 Tomsk

anastasiya_enert@mail.ruhttps://orcid.org/0009-0008-8482-0239АпальковД. Г.ApalkovD. G.

Апальков Добрыня Геннадьевич - ординатор.

Томск

Dobrynya G. Apalkov - clinical resident.

Tomsk

dobrynja7024@gmail.comhttps://orcid.org/0009-0006-3222-0755ПерелетоваС. Р.PereletovaS. R.

Перелетова Светлана Ростиславовна – ординатор.

Томск

Svetlana R. Pereletova - clinical resident.

Tomsk

sveta_pereletova@mail.ruhttps://orcid.org/0009-0003-4542-5109ТрубченкоК. В.TrubchenkoK. V.

Трубченко Ксения Владимировна

Томск

Ksenia V. Trubchenko - MD.

Tomsk

kseniyad1981@mail.ruhttps://orcid.org/0000-0001-9011-8720СапринаТ. В.SaprinaT. V.

Саприна Татьяна Владимировна - д.м.н., профессор; Scopus Author ID: 55554548800.

Томск

Tatyana V. Saprina - MD, PhD, Professor; Scopus Author ID: 55554548800.

Tomsk

tanja.v.saprina@mail.ruСибирский государственный медицинский университетРоссияSiberian State Medical University (SSMU)Russian Federation202406052024272158167Copyright © Энерт А.В., Апальков Д.Г., Перелетова С.Р., Трубченко К.В., Саприна Т.В., 20242024Энерт А.В., Апальков Д.Г., Перелетова С.Р., Трубченко К.В., Саприна Т.В.Enert A.V., Apalkov D.G., Pereletova S.R., Trubchenko K.V., Saprina T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13021

В данном обзоре информация представлена в рамках триады: синдром обструктивного апноэ/гипопноэ сна (СОАГС), вариабельность уровня гликемии и сердечно-сосудистые заболевания у пациентов с сахарным диабетом 2 типа (СД2). Проанализированы эпидемиологические аспекты, патогенетические взаимосвязи, возможные инструментальные и лабораторные методы диагностики, а также подходы к персонализированной терапии. Активно проводятся исследования в отдельных направлениях обозначенной триады, однако исследований, включающих одновременный мониторинг показателей, отражающих данные нарушения у пациентов с СД, не найдено. До сих пор остаются спорными многие вопросы. Нарушения дыхания во сне у пациентов с СД2 изучаются активно, но чаще для диагностики используются опросники, а не инструментальные методы. Недостаточно данных, посвященных изучению влияния гипоксии на прогрессирование осложнений у пациентов с СД2. Активно проводятся исследования нарушений ритма у пациентов с СД2 в сочетании с различными кардиологическими проблемами. Наибольший интерес представляет изучение нарушений ритма у пациентов с СД2 без сопутствующих коморбидных состояний со стороны сердечно-сосудистой системы, с целью выявления ранних признаков диабетической кардиоваскулярной автономной нейропатии и кардиомиопатии, а также дополнительных ранних факторов риска развития и прогрессирования сердечно-сосудистых заболеваний. Большинство исследований посвящено изучению ассоциации СОАГС и различных нарушений ритма у кардиологических пациентов. Однако нет данных о сочетанном влиянии вариабельности гликемии и СОАГС на развитие нарушений ритма сердца у пациентов с СД2. Необходимы дополнительные исследования для выявления особенностей влияния СОАГС на нарушения ритма сердца у пациентов с СД2.

In this review, information is presented within the triad: obstructive sleep apnea/hypopnea syndrome (OSA), glycemic variability, and cardiac arrhythmias in patients with type 2 diabetes mellitus (DM2). Epidemiological aspects, pathogenetic relationships, possible instrumental and laboratory diagnostic methods, as well as approaches to personalized therapy are analyzed. Research is being actively conducted in certain areas of the designated triad, however, no studies have been found that include simultaneous monitoring of indicators reflecting these disorders in patients with DM2. Many issues are still controversial. Sleep disturbances in patients with DM2 are actively studied, but more often questionnaires are used for diagnosis, rather than instrumental methods. There is insufficient data examining the effect of hypoxia on the progression of complications in patients with DM2. Rhythm disturbances are being actively studied in patients with DM2 in combination with various cardiological problems. Of greatest interest is the study of rhythm disturbances in patients with DM2 without concomitant comorbid conditions of the cardiovascular system, in order to identify early signs of diabetic cardiovascular autonomic neuropathy and cardiomyopathy, as well as additional early risk factors for the development and progression of cardiovascular diseases. Most of the studies are devoted to the study of the association of OSA and various arrhythmias in cardiac patients. However, there is no data on the combined effect of glycemic variability and OSA on the development of cardiac arrhythmias in patients with DM2. Additional studies are needed to identify the features of the effect of OSA on cardiac arrhythmias in patients with DM2.

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