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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2018-4-42-47</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-2330</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>САХАРНЫЙ ДИАБЕТ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DIABETES MELLITUS</subject></subj-group></article-categories><title-group><article-title>Развитие нарушений углеводного обмена с позиций хронобиологии</article-title><trans-title-group xml:lang="en"><trans-title>Development of carbohydrate metabolism disorder from the perspective of chronobiology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Южакова</surname><given-names>А. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Yuzhakova</surname><given-names>A. E.</given-names></name></name-alternatives><bio xml:lang="ru"/><bio xml:lang="en"/><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Нелаева</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nelaeva</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор медицинских наук, профессор </p><p>Тюмень</p></bio><bio xml:lang="en"><p>MD, Prof.</p><p>Tyumen</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хасанова</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Khasanova</surname><given-names>Yu. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кандидат медицинских наук </p><p>Тюмень</p></bio><bio xml:lang="en"><p>PhD in medicine</p><p>Tyumen</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Тюменский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Tyumen State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Консультативно-диагностический центр «Эндос»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Endos Diagnostic Center</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>31</day><month>03</month><year>2018</year></pub-date><volume>0</volume><issue>4</issue><fpage>42</fpage><lpage>47</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Южакова А.Е., Нелаева А.А., Хасанова Ю.В., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Южакова А.Е., Нелаева А.А., Хасанова Ю.В.</copyright-holder><copyright-holder xml:lang="en">Yuzhakova A.E., Nelaeva A.A., Khasanova Y.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/2330">https://www.med-sovet.pro/jour/article/view/2330</self-uri><abstract><p>В течение последних десятилетий исследователи активно обсуждают тему о биоритмах эндокринной системы, а именно их изменения при развитии нарушений углеводного обмена (НУО). Особый интерес с позиций хронобиологии представляет гормон шишковидного тела мелатонин. Циркулирующий в крови мелатонин может действовать как типичный гормон, достигая далеко расположенных клеток-мишеней, и играть ключевую роль в качестве паракринной сигнальной молекулы для регионарной координации клеточных функций [<xref ref-type="bibr" rid="cit1">1</xref>]. Данный гормон синхронизирует гормональные стимулы и метаболические процессы с учетом меняющегося времени суток [<xref ref-type="bibr" rid="cit2">2</xref>]. Мелатонин участвует в регуляции секреции инсулина и вносит вклад в патофизиологию нарушений углеводного обмена. Поэтому среди ученых идет активное обсуждение о перспективах применения мелатонина для лечения СД. Такие состояния, как нарушение гликемии натощак (НГН), нарушение толерантности к глюкозе (НТГ), ожирение, дислипидемия, на сегодняшний день уже являются самостоятельными патологическими процессами, требующими внимания врачей. Целью нашей работы было изучение циркадианных ритмов физиологических функций (температура тела, гликемия натощак, частота сердечных сокращений) и роли лептина в формировании нарушений углеводного обмена (НГН, НТГ, СД2). В ходе исследования было подтверждено, что в формировании НУО играет важную роль преобладание жировой ткани над мышечной, которое формирует абдоминальное ожирение на фоне внешних факторов среды и поведенческих особенностей человека, а также развитие лептинои инсулинорезистентности, которое по мере прогрессирования нарушений метаболизма глюкозы приводит к инсулинои лептинодефициту. В данной работе отражены изменения биологических ритмов, происходящие до манифестации СД2. Так, на фоне ожирения происходит изменение суточных колебаний БТ, гликемии натощак, ЧСС, а при развитии РНУО и СД2 усугубление метаболических нарушений приводит к изменению структуры циркадианных ритмов в организме, что, в свою очередь, может быть как следствием, так и причиной НУО. Нарушение показателей терморегуляции тесно связано с уровнем лептина в организме и указывает на вовлеченность в данный процесс гормона мелатонина, который после дополнительных исследований, возможно, может быть использован в качестве препарата терапии и профилактики нарушений углеводного обмена.</p></abstract><trans-abstract xml:lang="en"><p>In recent decades, the biorhythms of the endocrine system sparked a new generation of research and debates among researchers on the changes of biorhythms in the development of carbohydrate metabolism disorder (CMD). The hormone melatonin produced by the pineal gland is of particular interest from the perspective of chronobiology. Melatonin circulating in blood can act as a typical hormone, reaching far-located target cells, and play a key role as a paracrine signal molecule for regional coordination of cellular functions [<xref ref-type="bibr" rid="cit1">1</xref>]. This hormone synchronizes hormonal stimuli and metabolic processes subject to the changing time of day [<xref ref-type="bibr" rid="cit2">2</xref>]. Melatonin is involved in the regulation of insulin secretion and contributes to the pathophysiology of carbohydrate metabolism disorders. Therefore, there is an active discussion among researchers about the prospects of using melatonin for the treatment of diabetes mellitus (DM). Such conditions as impaired fasting glycemia (IFG), impaired glucose tolerance (IGT), obesity, dyslipidemia have been recognized as independent pathological processes that require attention of doctors. Our work was aimed at studying circadian rhythms of physiological functions (body temperature, fasting glycaemia, heart rate) and the role of leptin in the development of carbohydrate metabolism disorders (IFG, IGT, type 2 DM). The study showed that the predominance of adipose tissue over the muscular plays an important role in the development of CMD, which forms abdominal obesity against the background of environmental external factors and human behavioural features, as well as the development of leptin and insulin resistance, which, as glucose metabolism disorder progresses, leads to insulin and leptin deficiency. This work reflects the changes in biological rhythms that occur prior to the manifestation of type 2 DM. Changes in diurnal fluctuations of basal temperature (BT), fasting glycemia, and heart rate occur against the background of obesity and during the development of early carbohydrate metabolism disorder (ECMD) and type 2 DM, the aggravation of metabolic disturbances leads to a change in the circadian rhythms pattern, which in turn can be both a consequence and a cause of CMD. The thermoregulation disorder is closely related to the leptin level and indicates an involvement of melatonin hormone in the process, which, after additional studies, may be used as a drug of therapy and prevention of carbohydrate metabolism disorders.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>сахарный диабет</kwd><kwd>ранние нарушения углеводного обмена</kwd><kwd>мелатонин</kwd><kwd>лептин</kwd><kwd>ожирение</kwd><kwd>циркадианные ритмы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>diabetes mellitus</kwd><kwd>early carbohydrate metabolism disorder</kwd><kwd>melatonin</kwd><kwd>leptin</kwd><kwd>obesity</kwd><kwd>circadian rhythms</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Мелатонин: перспективы применения в практике. Под ред. проф. С.И. Рапопорта. Монография. 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