Особенности экскреции мелатонина при полиморбидной сердечно-сосудистой патологии с тревожно-депрессивными расстройствами у мужчин молодого и среднего возраста

Abstract

Objective. To evaluate melatonin (MT) excretion patterns in patients with polymorbid cardiovascular diseases (coronary artery disease, hypertension, metabolic syndrome), anxiety and depressive disorders, and to determine the targets for therapeutic intervention in this group of patients. Design and methods . The study included 40 men (mean age — 37,11 ± 6,93 years) with polymorbid cardiovascular diseases and 10 healthy men (mean age — 37,5 ± 4,95 years). We used complex psychological test methods, laboratory tests and instrumental evaluation of the cardiovascular system. The 6‑sulfatoxymelatonin (6‑SMT) was assessed by ELISA using kits «BÜHLMANNEKM6S». Results. The circadian blood pressure profile was abnormal in most of the patients with the change from «dipper» pattern to «non-dipper» or «night-peaker». Nocturnal excretion of 6‑SMT was significantly lower in the second group compared to the first, third and fourth groups, but there were no significant changes in its daily excretion (p < 0,001). The rate «mild depression» and «subclinical anxiety» symptoms was 86,6 % in the studied groups with polymorbid cardiovascular diseases (p < 0,001). The signs of «severe depression» were found in 92,3 % of patients in group 2 (p < 0,001), while «clinical anxiety» was present in 91,6 % of patients in group 3 (p < 0,001). Conclusions. Patients with polymorbid cardiovascular diseases show abnormal MT levels, characterized by the decrease of night and increased daytime excretion of 6‑SMT. It is more prominent in depressive patients compared to healthy ones and to individuals with anxiety syndrome (p < 0,001). In patients with polymorbid cardiovascular diseases cardiotropic and antihypertensive therapy might be in particular required during the followed time periods: during second part of nocturnal sleep (03:00–06:00) and during the first hours after morning awakening (06:00–08:00).