Свободнорадикальное окисление при нарушениях сна в андро- и менопаузе (обзор литературы)

В данном обзоре представлены данные об изменениях физиологии сна при репродуктивном старении. Отмечено, что основными нарушениями сна являются инсомнические расстройства и синдром обструктивного апноэ сна (СОАС). Представлены результаты зарубежных и отечественных исследований в области свободнорадикального окисления при депривации сна на животных моделях, свидетельствующие о зависимости процессов от длительности депривации сна. Наибольшее количество исследований свободнорадикальных процессов на человеке с сомнологической патологией проведено при изучении СОАС. Биоматериалом для определения параметров свободнорадикального окисления могут быть кровь, моча, слюна, конденсат выдыхаемого воздуха. Показано, что интенсивность окислительного стресса зависит от степени тяжести СОАС, о чём свидетельствуют положительные корреляции уровня активных продуктов тиобарбитуровой кислоты, продуктов окисления белков и карбонильных групп с индексом апноэ/ гипопноэ, определяя развитие не только окислительного, но и карбонильного стресса у пациентов с тяжёлой степенью СОАС. Такие биомаркеры, как тиоредоксин, малоновый диальдегид, супероксиддисмутаза и восстановленное железо показали более устойчивую связь между повышенным окислительным стрессом и СОАС. Несмотря на полученные результаты, вопрос об ассоциации окислительного стресса и гипоксии при СОАС остаётся дискутабельным, что связано с полученными противоположными результатами некоторых исследований. Инсомния, встречающаяся в основном у лиц женского пола, сопровождается высоким содержанием уровня конечных продуктов перекисного окисления липидов со снижением активности таких антиоксидантов, как параоксоназа, ферментативное звено глутатионовой системы. Наравне с этим у менопаузальных женщин отмечается низкий уровень мочевой кислоты, коррелирующий с высокими баллами Питтсбургского опросника индекса качества сна. Последними исследованиями выявлена ассоциация активности системы «липопероксидация – антиоксиданты» и полиморфизма 3111Т/С гена Clock у менопаузальных женщин европеоидной расы, свидетельствующая о защитной роли минорного аллеля.

окислительный стресс, карбонильный стресс, нарушения сна, андропауза, менопауза

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