Медицинский совет (Mar 2018)
Development of carbohydrate metabolism disorder from the perspective of chronobiology
Abstract
In recent decades, the biorhythms of the endocrine system sparked a new generation of research and debates among researchers on the changes of biorhythms in the development of carbohydrate metabolism disorder (CMD). The hormone melatonin produced by the pineal gland is of particular interest from the perspective of chronobiology. Melatonin circulating in blood can act as a typical hormone, reaching far-located target cells, and play a key role as a paracrine signal molecule for regional coordination of cellular functions [1]. This hormone synchronizes hormonal stimuli and metabolic processes subject to the changing time of day [2]. Melatonin is involved in the regulation of insulin secretion and contributes to the pathophysiology of carbohydrate metabolism disorders. Therefore, there is an active discussion among researchers about the prospects of using melatonin for the treatment of diabetes mellitus (DM). Such conditions as impaired fasting glycemia (IFG), impaired glucose tolerance (IGT), obesity, dyslipidemia have been recognized as independent pathological processes that require attention of doctors. Our work was aimed at studying circadian rhythms of physiological functions (body temperature, fasting glycaemia, heart rate) and the role of leptin in the development of carbohydrate metabolism disorders (IFG, IGT, type 2 DM). The study showed that the predominance of adipose tissue over the muscular plays an important role in the development of CMD, which forms abdominal obesity against the background of environmental external factors and human behavioural features, as well as the development of leptin and insulin resistance, which, as glucose metabolism disorder progresses, leads to insulin and leptin deficiency. This work reflects the changes in biological rhythms that occur prior to the manifestation of type 2 DM. Changes in diurnal fluctuations of basal temperature (BT), fasting glycemia, and heart rate occur against the background of obesity and during the development of early carbohydrate metabolism disorder (ECMD) and type 2 DM, the aggravation of metabolic disturbances leads to a change in the circadian rhythms pattern, which in turn can be both a consequence and a cause of CMD. The thermoregulation disorder is closely related to the leptin level and indicates an involvement of melatonin hormone in the process, which, after additional studies, may be used as a drug of therapy and prevention of carbohydrate metabolism disorders.
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