diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/8156diaendo-8232Research ArticleОсложненияComplicationsПредикторы и методы диагностики нарушений автономной иннервации миокарда у больных сахарным диабетом 1 и 2 типаPredictors and diagnosis of cardiac autonomic nervous dysfunction in patients with type 1 and type 2 diabetes mellitushttps://orcid.org/0000-0002-5673-2652ПоповКирилл АндреевичPopovKirill A.

Клинический ординатор

clinical resident

mbinfakare@mail.ruТокмаковаАлла ЮрьевнаTokmakovaAlla Y.

д.м.н., гл.н.с.

MD, PhD, chief research associate

alla-tokmakova@yandex.ruБондаренкоИрина ЗиятовнаBondarenkoIrina Z.

д.м.н., гл.н.с.

MD, PhD, chief research associate

iz_bondarenko@mail.ru<p>ФГБУ &laquo;Эндокринологический научный центр&raquo; Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation201710082017203185193Copyright &#x00A9; Попов К.А., Токмакова А.Ю., Бондаренко И.З., 20172017Попов К.А., Токмакова А.Ю., Бондаренко И.З.Popov K.A., Tokmakova A.Y., Bondarenko I.Z.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/8232

Диабетическая кардиоваскулярная автономная нейропатия (ДКАН) – осложнение сахарного диабета (СД) с характерной ранней и диссеминированной нейрональной дегенерацией малых нервных волокон как симпатического, так и парасимпатического отделов. ДКАН является опасным и коварным осложнением СД, что во многом определяет течение болезни и структуру смертности, однако часто недооценивается и не распознается практикующими врачами. Сбор анамнеза и проведение физикального обследования не являются достаточными для постановки диагноза. Лабораторная диагностика и инструментальные методы оценки ДКАН трудоемки и не всегда доступны. Раннее выявление ДКАН у больных СД – первостепенно значимая задача, так как позволяет своевременно начать терапию. На сегодняшний день не существует единого алгоритма диагностики ДКАН у пациентов с различными нарушениями углеводного обмена. Это связано с недостаточным количеством клинических исследований, несовершенными протоколами их проведения.

Обзор представляет анализ клинических и экспериментальных исследований, посвященных проблеме ДКАН. Рассмотрены распространенность, факторы риска, возможные пути патогенеза, клинические проявления. Обсуждаются общепринятые и новые методы диагностики, преимущества и недостатки того или иного исследования.

Diabetic cardiovascular autonomic neuropathy (DCAN) is a diabetic complication characterised by early dissemination of sympathetic and parasympathetic, small-fibre neuronal degeneration. DCAN is the most dangerous and insidious complication that influences the clinical course and mortality rate of diabetes; however, it is often underestimated and not recognised by practitioners. Medical history and a physical examination are not sufficient for diagnosing DCAN. Laboratory diagnosis and the instrumental methods used to evaluate DCAN are time-consuming and not always available. Early detection of DCAN in diabetic patients is important for the early implementation of therapy. Today, there is no uniform diagnostic algorithm for DCAN in patients with various disorders of carbohydrate metabolism. This is due to the insufficient number of clinical trials and limitations of current protocols.

This review presents an overview of the clinical and experimental studies of DCAN. The epidemiology, clinical manifestations, risk factors and underlying pathogenesis of DCAN are considered. The advantages and disadvantages of conventional and new diagnostic methods are discussed.

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