СЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯ И ЖИЗНЕННОЕ ИСТОЩЕНИЕ: ПРОСПЕКТИВНОЕ ИССЛЕДОВАНИЕ В РОССИИ/СИБИРИ (ПРОГРАММА ВОЗ МОНИКА — ПСИХОСОЦИАЛЬНАЯ)

Цель. Исследовать распространенность жизненного истощения, его влияния на 14-летний риск развития сердечно-сосудистых заболеваний (ССЗ) (артериальной гипертонии (АГ), инфаркта миокарда (ИМ) и инсульта), а так же генетических особенностей жизненного истощения в открытой популяции среди мужчин 25-64 лет в России/Сибири (г.Новосибирск, мегаполис Западной Сибири).

Материал и методы. Была обследована случайная репрезентативная выборка мужчин 25-64 лет в рамках программы ВОЗ “МONICA-психосоциальная (MOPSY)” в 1994г. Маастрихтский опросник (ОМ) использовался для оценки жизненного истощения. Генотипирование было выполнено для переменного числа тандемных повторов (VNTR) полиморфизмов генов DRD4 и DAT. Все новые случаи АГ, ИМ и инсульта были зарегистрированы у лиц без ССЗ в течение 14 лет (с 1994 по 2008гг). Статистический анализ проводился с помощью пакета программ SPSS 11.5. Кокс-пропорциональная регрессионная модель была использована для оценки риска развития (Hazard ratio — HR) с учетом временного интервала. Тест Х2 был использован для оценки статистической значимости различий между группами.

Результаты. В исследованной популяции уровень жизненного истощения составил 66,8%. HR был значительно увеличен (АГ: HR=3,2; ИМ: HR=2,7; инсульт: HR=3,2) у мужчин с жизненным истощением, по сравнению с лицами без жизненного истощения в открытой популяции в течение первых пяти лет наблюдения. Многофакторное моделирование показало, что жизненное истощение вместе с сопутствующим социальным градиентом определяет развитие АГ, ИМ и инсульта в открытой популяции среди мужчин 25-64 лет. 7 аллель DRD4 и генотип 9/9 гена DAT были связаны с высоким уровнем жизненного истощения.

Заключение. В открытой популяции среди мужчин 25-64 лет (Россия/ Сибирь, г.Новосибирск) определен высокий уровень жизненного истощения, как предиктор риска развития ССЗ. Жизненное истощение существенно связано с определенными VNTRr-полиморфизмами генов DRD4 и DAT.

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