Abstract
The aim. Assessment of the relationship between the occurrence of endotoxemia and impaired resorption function of the small intestine, arrhythmia of the motility of the stomach and intestines, and excessive bacterial growth in the metabolic syndrome (MS).Materials and methods. 62 patients with MS were examined. The average age was 48.62+3.75 years. The motor function of the gastrointestinal tract was studied using peripheral electrogastroenterocolography. To assess the absorption processes in the small intestine, stress tests with glucose and d-xylose were used. Blood endotoxin level, quantitative and& qualitative composition of parietal microbiota of small intestine were determined using an Agilent gas chromatograph with mass-selective and flame-ionization detectors (Agilent Technologies, USA).Results. 82.9% of the examined patients with MS showed clinical signs of intestinal damage. The electrical activity of& the& small intestine departments in the postprandial period was low in 70% of patients. The electrical activity of& the& colon on an empty stomach was not changed, and after a food load was reduced. Discoordination of motility is observed between small intestine and the colon, aggravated after food stimulation. A significant decrease in the rhythm of contractions is observed at the frequencies of the jejunum, ileum, and colon both on an empty stomach and in the postprandial period, which indicates a weakening of propulsive bowel contractions in patients with MS. In patients with MS, an increase in& the& absorption of glucose and d-xylose was revealed in comparison with the group of healthy individuals. In patients with MS, excessive bacterial growth in small intestine is observed mainly due to conditionally pathogenic microbiota strains. According to the results of the study of blood endotoxin level in patients with MS, a significant increase was revealed in comparison with the control group. Correlation analysis showed a moderate negative relationship between the level of endotoxin and electrical activity of small intestine, between the level of endotoxin and the ratio of the ratio of& the& colon to the ileum. A moderate positive relationship was established between the degree of endotoxemia increase and glucose absorption in small intestine.Conclusion. A study of the level of endotoxin and indicators of excessive bacterial growth, motor evacuation and resorption functions of small intestine revealed important pathogenetic patterns regarding the contributing role of the latter in& the development of endotoxemia in patients with MS.
Highlights
82.9% of the examined patients with metabolic syndrome (MS) showed clinical signs of intestinal damage
Как следует из таблицы 1, у большинства больных с Метаболический синдром (МС) (70%) электрическая активность желудка в I фазу исследования не нарушена, но во II фазу у 60% больных в ответ на пищевую стимуляцию она была снижена
В пищевую фазу электрическая активность тощей и подвздошной кишки сопоставима с контролем
Summary
Ляпина Мария Витальевна, к.м.н., доцент кафедры пропедевтической и факультетской терапии Лукашевич Анна Павловна, к.м.н., ассистент кафедры пропедевтики внутренних болезней с курсом сестринского дела Вахрушев Яков Максимович, д.м.н., профессор, заведующий кафедрой пропедевтики внутренних болезней с курсом сестринского дела. Candidate of Medical Sciences, Associate Professor of the Department of Propaedeutic and Faculty Therapy; ORCID: 0000–0002–9608–2746 Anna P. Lukashevich, Candidate of Medical Sciences, assistent of the Department of Propaedeutics of Internal Medicine with a nursing course; ORCID: 0000–0001–9424–6316 Yakov M. Vakhrushev, Doctor of Medical Sciences, professor, Head of the Department of Propaedeutics of Internal Medicine with a nursing course; ORCID: 0000–0003–4634–2658. Значительное снижение ритмичности сокращений наблюдается на частотах тощей, подвздошной и толстой кишки как натощак, так и в постпрандиальном периоде, что указывает на ослабление пропульсивных сокращений кишечника у больных с МС. Ключевые слова: метаболический синдром, эндотоксемия, избыточный бактериальный рост, моторно-эвакуаторная и резорбционная функции тонкой кишки
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