arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2019-25-6-630-638arthyper-1830Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL ARTICLEВзаимосвязь показателей кальциевого обмена и ренин-ангиотензин-альдостероновой системы при первичном гиперпаратиреозе в до- и раннем послеоперационном периодахCorrelations between parameters of calcium metabolism and renin-angiotensin-aldosterone system in patients with primary hyperparathyroidism in the pre- and early postoperative periodshttps://orcid.org/0000-0002-8916-7346ДобреваЕ. А.DobrevaE. A.

Добрева Екатерина Александровна — кандидат медицинских наук, старший научный сотрудник отделения патологии околощитовидных желез

Москва

Ekaterina A. Dobreva, MD, PhD, Senior Researcher; Parathyroid Pathology Department

Moscow

dobrevae@mail.ruhttps://orcid.org/0000-0001-5952-5846БибикЕ. Е.BibikE. E.

Бибик Екатерина Евгеньевна — научный сотрудник отделения патологии околощитовидных желез

ул. Дмитрия Ульянова, д. 11, Москва, 117036.Тел.: +7(495)600–00–63

Ekaterina E. Bibik, MD, Researcher, Parathyroid Pathology Department

11 Dmitry Ulyanov street, Moscow, 117036Phone: +7(495)600–00–63

bibikaterina@mail.ruhttps://orcid.org/0000-0001-6667-062XЕремкинаА. К.EremkinaA. K.

Еремкина Анна Константиновна — кандидат медицинских наук, ведущий научный сотрудник отделения патологии околощитовидных желез

Москва

Anna K. Eremkina, MD, PhD, Leading Researcher, Parathyroid Pathology Department

Moscow

a.lipatenkova@gmail.comhttps://orcid.org/0000-0002-6733-0958РеброваО. Ю.RebrovaO. Yu.

Реброва Ольга Юрьевна — доктор медицинских наук, профессор кафедры эндокринологии института высшего и дополнительного постдипломного образования

Москва

Olga Yu. Rebrova, MD, PhD, DSc, Professor, Higher and Postgraduate Education Institute

Moscow

o.yu.rebrova@gmail.comhttps://orcid.org/0000-0001-8303-3825НиканкинаЛ. В.NikankinaL. V.

Никанкина Лариса Вячеславовна — кандидат медицинских наук, заведующая клинико-диагностической лабораторией

Москва

Larisa V. Nikankina, MD, PhD, Head, Clinical Diagnostic Laboratory

Moscow

larisa.nikankina@yandex.ruhttps://orcid.org/0000-0002-4659-5439МалышеваН. М.MalyshevaN. M.

Малышева Наталья Михайловна — кандидат медицинских наук, ведущий научный сотрудник клинико-диагностической лаборатории

Москва

Natalya M. Malysheva, MD, PhD, Leading Researcher, Clinical Diagnostic Laboratory

Moscow

natalya.m@list.ruhttps://orcid.org/0000-0002-9717-9742МокрышеваН. Г.MokryshevaN. G.

Мокрышева Наталья Георгиевна — доктор медицинских наук, профессор РАН, исполняющая обязанности директора

Москва

Natalya G. Mokrysheva, MD, PhD, DSc, Professor of the RAS, the Acting Director

Moscow

nm70@mail.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр эндокринологии» Министерства здравоохранения Российской ФедерацииРоссияEndocrinology Research CentreRussian Federation201902122019256630638Copyright © Добрева Е.А., Бибик Е.Е., Еремкина А.К., Реброва О.Ю., Никанкина Л.В., Малышева Н.М., Мокрышева Н.Г., 20202020Добрева Е.А., Бибик Е.Е., Еремкина А.К., Реброва О.Ю., Никанкина Л.В., Малышева Н.М., Мокрышева Н.Г.Dobreva E.A., Bibik E.E., Eremkina A.K., Rebrova O.Y., Nikankina L.V., Malysheva N.M., Mokrysheva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1830

Все больше данных свидетельствует о наличии взаимосвязи между ренин-ангиотензин-альдостероновой системой (РААС) и параметрами кальциевого обмена. Вероятно, субклинические изменения активности отдельных компонентов РААС могут являться предикторами поражения сердечно-сосудистой системы у пациентов с первичным гиперпаратиреозом (ПГПТ). Цель исследования — изучить активность компонентов РААС и параметры кальциевого обмена у пациентов с манифестным ПГПТ и нормотонией в до- и раннем послеоперационном периодах. Материалы и методы. Проведено проспективное несравнительное исследование 35 пациентов с верифицированным диагнозом ПГПТ без сопутствующих кардиоваскулярных заболеваний и значимых факторов риска их развития, а также на фоне отсутствия приема препаратов, влияющих на кальциевый обмен и РААС. Всем пациентам на дооперационном этапе и на третьи сутки после паратиреоидэктомии были исследованы основные биохимические и гормональные показатели кальциевого обмена, а также параметры РААС. Результаты. У пациентов с ПГПТ и нормотонией корреляций уровней паратгормона и сывороточного кальция с показателями РААС как в до-, так и в послеоперационном периоде не выявлено, однако на 3-и сутки после успешной паратиреоидэктомии продемонстрировано снижение концентрации альдостерона сыворотки (p = 0,004). Заключение. Для уточнения взаимосвязей компонентов кальциевого обмена и РААС и выявления возможных предикторов развития сердечно-сосудистой патологии при ПГПТ необходимо проведение дальнейших крупных исследований с продолжительным периодом наблюдения пациентов.

первичный гиперпаратиреознарушение кальциевого обменаартериальная гипертензиянормотонияренин-ангиотензин-альдостероновая системаальдостеронprimary hyperparathyroidismcalcium metabolism disordershypertensionnormotensionrenin-angiotensin systemaldosteroneИсследование проведено при финансовой поддержке Министерства здравоохранения Российской Федерации в рамках выполнения государственного задания «Патогенетические основы формирования артериальной гипертензии и возможности ее коррекции при синдроме множественных эндокринных неоплазий и изолированных опухолевых заболеваниях надпочечников», регистрационный № НИОКТР АААА-А17-117012610106-2.The research was funded by the Ministry of Health of the Russian Federation within the framework of the Governmental task “Pathogenetic mechanisms of hypertension development and possibilities of its correction in multiple endocrine neoplasia and isolated adrenal tumor diseases”, No. R&D AAAAA-A17117012610106-2.ReferencesAndersson P, Rydberg E, Willenheimer R. 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The authors declare that there are no conflicts of interest present.