gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2023-33-2-34-44gastro-j-778Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESПищевые привычки, уровень тревоги и депрессии у пациентов с синдромом раздраженного кишечника: клинико-лабораторные сопоставленияEating Habits, Anxiety and Depression in Patients with Irritable Bowel Syndrome: Clinical and Laboratory Comparisonshttps://orcid.org/0000-0001-9370-4768ГаусО. В.GausO. V.

Гаус Ольга Владимировна — кандидат медицинских наук, доцент, доцент кафедры факультетской терапии и гастроэнтерологии.

644099, Омск, ул. Ленина, 12

Olga V. Gaus — Cand. Sci. (Med.), Associate Professor of the Department of Faculty Therapy and Gastroenterology, Omsk State Medical University.

644099, Omsk, Lenina str., 12

gaus_olga@bk.ruhttps://orcid.org/0000-0002-6581-7017ЛивзанМ. А.LivzanM. A.

Ливзан Мария Анатольевна — доктор медицинских наук, член-корреспондент РАН, профессор, заведующая кафедрой факультетской терапии и гастроэнтерологии, ректор.

644099, Омск, ул. Ленина, 12

Maria A. Livzan — Dr. Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Professor, Head of the Department of Faculty Therapy and Gastroenterology, Rector of the Omsk State Medical University.

644099, Omsk, Lenina str., 12

mlivzan@yandex.ruФГБОУ ВО «Омский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияOmsk State Medical UniversityRussian Federation2023280420233323444Copyright © Гаус О.В., Ливзан М.А., 20232023Гаус О.В., Ливзан М.А.Gaus O.V., Livzan M.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.gastro-j.ru/jour/article/view/778Цель исследования

Цель исследования: оценить уровень гормонов стресса (кортизол в слюне), нейромедиаторов (серотонин в сыворотке крови, дофамин в плазме крови) во взаимосвязи с пищевыми привычками, уровнем тревоги и депрессии у пациентов с СРК.

Материалы и методы

Материалы и методы. Проведено открытое когортное проспективное исследование с включением 263 пациентов с установленным диагнозом СРК, среди них 189 (71,9 %) женщин и 74 (28,1 %) мужчины. Средний возраст пациентов с СРК составил 29 [25; 35] лет. В контрольную группу вошли 40 здоровых добровольцев. Всем включенным в исследование лицам проводилась оценка рациона питания и пищевых привычек по опросникам WHO CINDI program questionnaire, «Информация о питании и пищевом поведении», выраженности тревоги и депрессии по опроснику HADS, в том числе уровня специфической тревоги в отношении гастроинтестинальных симптомов по опроснику VSI, качества жизни по опроснику IBS-QoL. Кроме того, методом иммуноферментного анализа проводилась оценка уровней кортизола в утренней и вечерней порциях слюны, серотонина в сыворотке крови и дофамина в плазме крови.

Результаты

Результаты. Среди пациентов с СРК, по сравнению с лицами группы контроля, отмечается статистически значимо более высокий уровень кортизола в утренней и вечерней порциях слюны (U = 19,5, p < 0,001 и U = 111,5, p < 0,001 соответственно), серотонина в сыворотке крови (U = 269,0, p = 0,042) и более низкий уровень дофамина в плазме крови (U = 93,5, p = 0,0002). Среднее значение уровня кортизола в слюне среди пациентов с СРК составило 45,39 [29,86; 70,10] нг/мл в утренние часы и 19,21 [13,98; 23,50] нг/мл в вечерние, тогда как в группе здоровых лиц — 19,00 [16,50; 21,70] и 9,70 [8,50; 10,50] нг/мл соответственно. Среднее значение уровня серотонина в сыворотке крови среди пациентов с СРК составило 188,78 [150,41; 230,32] нг/мл, дофамина в плазме — 28,83 [20,08; 41,54] нг/мл, среди здоровых лиц — 142,8 [130,52; 154,15] и 58,20 [48,15; 66,62] нг/мл соответственно.

Выводы

Выводы. У пациентов с СРК секреция гормона стресса (кортизол) и нейромедиаторов (серотонин, дофамин) находится в тесной взаимосвязи с характером питания, уровнем тревоги и депрессии, а также ассоциирована с клиническим вариантом и степенью тяжести течения заболевания.

Aim

Aim: to assess the level of stress hormones (cortisol in saliva), neurotransmitters (serotonin in blood serum, dopamine in blood plasma) in relation to eating habits, anxiety and depression levels in patients with IBS.

Materials and methods

Materials and methods. An open cohort prospective study was conducted with the inclusion of 263 patients with an established diagnosis of IBS, among them 189 (71.9 %) women and 74 (28.1 %) men. The average age of patients with IBS was 29 [25; 35] years. The control group included 40 healthy volunteers. All individuals included in the study were assessed for diet and eating habits using the WHO CINDI program questionnaire, “Information on Nutrition and Eating Behavior”, the severity of anxiety and depression according to the HADS questionnaire, the level of specific anxiety in relation to gastrointestinal symptoms according to the VSI questionnaire, quality of life according to the IBS-QoL questionnaire. In addition, the enzyme immunoassay method was used to assess the levels of cortisol in the morning and evening portions of saliva, serotonin in the blood serum and dopamine in the blood plasma.

Results

Results. Among patients with IBS there is a statistically significantly higher level of cortisol in the morning and evening portions of saliva (U = 19.5, p < 0.001 and U = 111.5, p < 0.001, respectively), serotonin in blood serum (U = 269.0, p = 0.042) and lower plasma dopamine levels (U = 93.5, p = 0.0002) compared with controls. The mean salivary cortisol level among patients with IBS was 45.39 [29.86; 70.10] ng/ml in the morning and 19.21 [13.98; 23.50] ng/ml in the evening, while in the group of healthy individuals it was 19.0 [16.5; 21.7] and 9.7 [8.5; 10.5] ng/ml, respectively. The average content of serotonin in blood serum in patients with IBS was 188.78 [150.41; 230.32] ng/ml, among healthy individuals — 142.80 [130.52; 154.15] ng/ml. The average content of dopamine in blood plasma in patients with IBS was 28.83 [20.08; 41.54] ng/ml, in healthy individuals — 58.20 [48.15; 66.62] ng/ml.

Conclusion

Conclusion. In patients with IBS the secretion of the stress hormone (cortisol) and neurotransmitters (serotonin, dopamine) is closely related to the nature of nutrition, the level of anxiety and depression, and is also associated with the clinical variant and severity of the course of the disease.

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