RUDN University, Russia
Irina Kurnikova is a Professor of Medicine, RUDN University (Peoples Friendship University of Russia), Russia. She has done her PhD in 2010. She has dealt with the problems of endocrinology for more than 20 years. She had led a course of Endocrinology at the Medical Academy (Izhevsk, Russia), Endocrinology department of Russian Scientific Center of Medical Rehabilitation and Health Resort, Russia. Currently, she teaches at Peoples' Friendship University of Russia, Curator of the Scientific Direction of Endocrinology. She has published more than 20 articles in well-known journals, and is the author of 25 books and manuals in Russian.
Statement of the Problem: Three systems provide the physiological functioning and interaction with the environment: Autonomic nervous regulation, endocrine-metabolic system and immune system. The most operational system of autonomic regulation, the level of functioning of which varies with age and systemic disorders inside the body. The purpose of this study is to assess the impact of diabetes mellitus on mechanisms of autonomic regulatory in different age groups.
Methodology & Theoretical Orientation: 101 people were divided in four age groups: 20-30 years, 31-40 years, 41-50 years and 51-60 years of age. All patients were evaluated based on autonomic regulation by the method of spectral analysis of daily variability of the heart rhythm power spectrum of oscillation in three frequency bands: 0.004-0.08 Hz (very low frequency – VLF), 0.09-0.16 Hz (low frequency – LF) and 0.17-0.5 Hz (high frequency – HF). The selection of three frequency ranges is due to differences in their formation. The low frequency range reflects the activity of the sympathetic system on the segmental level, the high-frequency range, the activity of parasympathetic nervous system at the segmental level.
Findings: Patients with diabetes at the age of 30-40 years we have seen a decrease in parasympathetic activity, which is more typical for patients the next decade of life. Since the age of 41, there was considerable centralization on mechanism of regulation (increase VLF), which usually starts 10-15 years later. The decrease in the total power spectrum on the background of inadequate compensator of diabetes showed decrease of reserve opportunities of the organism.
Conclusion & Significance: An important cause of early atherosclerosis in patients with diabetes is, in addition to endothelial dysfunction, syndrome of “early aging of regulatory system” (the reason - autonomic neuropathy). The status autonomic regulation in the current decade corresponds next age decade of the patient, which leads to increased comorbidities and increased cardiovascular risk.