urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2023-22-4-119-127urmj-1299Research ArticleЛитературные обзоры | Literature reviewsLiterature reviewsНарушение дофаминергической системы в патофизиологии сахарного диабетаDisruption of the dopaminergic system in the pathophysiology of diabetes mellitushttps://orcid.org/0000-0003-4705-3823БыковЮ. В.BykovYu. V.

Юрий Витальевич Быков, кандидат медицинских наук, 

Ставрополь

Yuri V. Bykov, Ph.D. in medicine, 

Stavropol

yubykov@gmail.comhttps://orcid.org/0000-0002-6892-3552БатуринВ. А.BaturinV. A.

Владимир Александрович Батурин, доктор медицинских наук, профессор, 

Ставрополь

Vladimir A. Baturin, Doctor of Science (Medicine), Professor, 

Stavropol

baturin@gmail.comСтавропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian Federation202313082023224119127Copyright © Быков Ю.В., Батурин В.А., 20232023Быков Ю.В., Батурин В.А.Bykov Y.V., Baturin V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1299Введение

Введение. Сахарный диабет (СД) – наиболее распространенная эндокринопатия с высоким ростом заболеваемости и большим количеством осложнений.

Цель работы – провести аналитический обзор литературы с оценкой состояния проблемы нарушения дофаминергической системы при СД с патофизиологических позиций.

Материалы и методы

Материалы и методы. Поиск проведен в базах данных и электронных библиотеках Cochrane Library, PubMed, eLibrary, Medscape по поисковым словам: сахарный диабет (diabetes mellitus), дофамин (dopamine), инсулин (insulin), дофаминергическая система (dopaminergic system), диабетическая энцефалопатия (diabetic encephalopathy). Для обзора отобрано 66 источников.

Результаты и обсуждение

Результаты и обсуждение. Дисфункция дофаминергической системы может рассматриваться в качестве важного компонента патофизиологии СД. Гиперактивация выработки дофамина (ДА) на фоне СД ингибирует синтез инсулина, что приводит к гипергликемии. С другой стороны, гипоинсулинемия запускает активацию дофаминергической системы, формируя порочный круг. Увеличение выработки ДА при СД играет важную роль в формировании вторичной дисфункции центральной нервной системы, в первую очередь за счет развития церебральной недостаточности. Многочисленные доклинические исследования подтверждают дисфункцию дофаминергической системы (ее активацию) при СД. Клинические исследования по данной проблематике малочисленны и требуют дальнейшего изучения.

Заключение

Заключение. Дисфункция дофаминергической системы при СД является актуальным направлением изучения патофизиологии симптомов неврологических нарушений данного заболевания. СД 1 и 2 типа − патогенетически разные заболевания, и поэтому нарушения выработки ДА могут быть обусловлены недостаточностью инсулина у больных с СД 1 типа, разными сроками манифестации, с гиперинсулинемией и инсулинорезистентностью при СД 2 типов. Поиск достоверных методов диагностики дисфункции дофаминергической системы может улучшить понимание происходящих патологических процессов в нейроэндокринной системе при СД, что важно в решении вопросов их коррекции в дополнение к патогенетической терапии.

Introduction

Introduction. Diabetes mellitus (DM) is the most common endocrinopathy with a high incidence and a high number of complications.

The aim of this work was to conduct an analytical literature review assessing the state of the problem of dopaminergic dysfunction in diabetes from a pathophysiological perspective.

Materials and methods

Materials and methods. Searching Cochrane Library, PubMed, eLibrary, Medscape databases and digital libraries using the search words: diabetes mellitus, dopamine, insulin, dopaminergic system, diabetic encephalopathy. A total of 66 sources were selected for the review.

Results and discussion

Results and discussion. Dopaminergic system dysfunction can be considered an important component of the pathophysiology of diabetes. Hyperactivation of dopamine (DA) production in the setting of diabetes inhibits insulin synthesis, resulting in hyperglycemia. On the other hand, hypoinsulinemia triggers activation of the dopaminergic system, forming a vicious circle. Increased DA production in diabetes plays an important role in the development of secondary central nervous system dysfunction, primarily through the development of cerebral insufficiency. Numerous preclinical studies confirm the dysfunction of the dopaminergic system (its activation) in diabetes. Clinical studies on this issue are scarce and require further investigation.

Conclusion

Conclusion. Dysfunction of the dopaminergic system in diabetes is an important area of research into the pathophysiology of symptomatic neurological disorders in this disease. Type 1 and type 2 diabetes are pathogenetically different diseases, and therefore impaired DA production may be due to insulin deficiency in patients with type 1 diabetes, different timing of manifestation, with hyperinsulinemia and insulin resistance in type 2 diabetes. Finding reliable methods to diagnose dysfunction of the dopaminergic system may improve understanding of the ongoing pathological processes in the neuroendocrine system in diabetes, which is important in addressing their correction in addition to pathogenetic therapy.

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The authors declare that there are no conflicts of interest present.