Особенности изменений стресс-регулирующих систем у подростков с сердечно-сосудистой патологией при эндотелиальной дисфункции

Abstract

Relevance. Endothelial dysfunction serves as a starting mechanism for any vascular pathology and its progression. The state of endothelial function is greatly influenced by stress, however, the study of the features of the functioning of stress-regulating systems in adolescents with cardiovascular disorders has practically not been studied. Objective: to investigate stress-regulating system changes in adolescents with cardiovascular disease at endothelial dysfunction. Materials and methods. A total of 73 adolescents (49 boys and 24 girls) with cardiovascular disease (CVD) aged 12–18 were surveyed. The adolescents were divided into 3 groups: those with normal endothelial function, those with endothelial dysfunction and those with paradoxical vascular endothelial response. Stress regulation is dominated by stress- realizing and stress-limiting systems. The state of stress-realizing systems was assessed by the level of cortisol, malondialdehyde, carbonylated proteins (CP) in blood serum and catecholamines (CA) in urine; stress-limiting systems — by the level of glutathione peroxidase (GPO), superoxide dismutase (SOD), serotonin in the blood and melatonin in urine. Results. In adolescents with endothelial dysfunction and paradoxical vascular endothelial response, there was a regulatory imbalance of key antioxidant enzymes (SOD and GPO) and a decrease in serotonin levels. In endothelial vascular dysfunction, changes in stress-regulatory systems are more pronounced in girls. The revealed correlation relations of the studied indicators in adolescents with normal function and vascular endothelium dysfunction emphasize strong links between monoamines (CA and melatonin), enzymatic (GPO) tension and activation of non-enzymatic (melatonin) links of antioxidant system. Conclusion. In adolescents with a non-inflammatory pathology of CVD, endothelial function depends on the activation and interaction of stress-regulating systems. With vascular endothelial dysfunction, changes in the content of monoamines and indicators of the pro- and antioxidant systems have gender differences, indicating stress-limiting stress and activation of stress-realizing systems in girls. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: adolescents, cardiovascular system, endothelial function, stresslimiting indicators, stressrealizing indicators.