PECULIARITIES OF AUTONOMOUS AND THYROIDAL STATE IN SCHOOL CHILDREN UNDER DIFFERENT INTENSITY OF EDUCATIONAL PROCESS

Introduction. High loads, intensification of education, characterize the modern educational process and contribute to the negative dynamics of the health indices of modern schoolchildren. The aim of the study is to investigate the features of the autonomous and thyroid status of schoolchildren exposed to the different intensity of the educational process. Material and methods. The objects of the study were schoolchildren with the different intensity of the educational process, students of schools. Hygienic evaluation of the educational process was carried out taking into account the requirements of Sanitary Regulations and Norms 2.4.2.2821-10. The data analysis of the survey, laboratory studies, electrocardiography, cardiointervalography and ultrasound scanning of the thyroid gland was performed. Results. The reduction of the duration of small changes, the excess of the volume of daily and weekly academic load up to 20.0% with a comparative hygienic assessment of the educational process regimes, in schools with an in-depth study of the subjects of the physical and mathematical cycle. Characterized by a large expenditure of time on homework, shorter sleep, high involvement in the additional educational process for students of specialized schools. Arrhythmias were by 1.7 times more common in students of the physical and mathematical school. Relative risk increased by 4.6 times. The activity of the sympathetic part of the autonomic nervous system was found to be elevated in 50% of schoolchildren enrolled in an in-depth program. Violations of the volume and structure of the thyroid gland occurred up to 2.6 times more often. The relative risk of activating the synthesis of antibodies to thyroglobulin and thyroperoxidase was higher by 5.7 times. Relationships are established between the blood level of cortisol and the frequency of registration of arrhythmias, the degree of activation of antibody production, the parameters of the thyroid gland. Discussion. The obtained data are consistent with the results of domestic studies and can serve as the basis for expanding the list of studies during preventive medical examinations of minors. Conclusion. In educational institutions with in-depth study of the subjects of the physical and mathematical cycle, the educational process is more intensive, which leads to the activation of the sympathetic part of the autonomic nervous system, an increase in the risk of developing autonomic dysfunctions, arrhythmias, and thyroid status disorders.

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Features of autonomic nervous system homeostasis in patients with chronic atrophic gastritis combined with thyroid pathology

GASTROENTEROLOGY ◽

10.22141/2308-2097.55.3.2021.241585 ◽

2021 ◽

Vol 55 (3) ◽

pp. 159-165

Author(s):

E.V. Zigalo ◽

L.M. Mosiychuk ◽

O.M. Shevtsova ◽

O.P. Petishko ◽

L.V. Demeshkina

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Thyroid Gland ◽

Atrophic Gastritis ◽

Adaptive Capacity ◽

Chronic Atrophic Gastritis ◽

The Body ◽

Autonomic Nervous ◽

Thyroid Pathology ◽

Functional Reserves

Background. The indicators of heart rate variability reflect the vital processes of managing the physiological functions of the body — autonomic balance and functional reserves of its management mechanisms, the adaptive capacity of the body, and stress resistance. At the expressed disturbances of autonomic nervous system homeostasis, the risk of emergence and progression of diseases increases. This is especially true for the elderly, who are characterized by comorbidity. The purpose of the study was to assess the state of adaptive capacity and autonomic regulation of the body in patients with precancerous conditions of the stomach with the thyroid gland pathology. Materials and methods. Seventy-two patients with chronic atrophic gastritis were divided into groups: group I consisted of 34 patients with nodules in the thyroid gland; group II included 23 patients with pathological changes of the thyroid gland and 15 patients of group III had a normal thyroid gland. The heart rate variability was assessed based on the results of PRECISE-diagnostics. To diagnose the functional state of the small intestinal microbiota, a hydrogen breath test was performed. Results. In 81.9 % of patients with chronic atrophic gastritis and thyroid pathology, an imbalance of the sympathetic and parasympathetic parts of the autonomic nervous system with a prevalence of vagotonia including the patients with thyroid nodules (64.7 %) and pathological changes in the thyroid gland (56.5 %) (р < 0.05). A significant violation of the body’s adaptive capacity was found in 63.2 % of patients with chronic atrophic gastritis. The frequency of reduced adaptive capacity of the organism was twice higher in patients with comorbid pathology (p < 0.05). 56.1 % of patients with chronic atrophic gastritis associated with thyroid pathology experienced a decrease in functional reserves of the body. In the spectrum of detected disorders, 68.8 % of patients presented with depletion of functional reserves of the body with increased central control and 31.2 % of patients — hormonal imbalance with a predominance of the humoral link with the inclusion of autonomous control (p < 0.05). The analysis of the stress index showed in half of the examined patients insufficient stress resistance with a probable increase in mean figures to (136.8 ± 7.4) m/s (p < 0.05). Correlations were found between the frequency of detection of excessive bacterial growth syndrome and maladaptation (r = 0.64; p < 0.05), imbalance of the sympathetic and parasympathetic parts of the autonomic nervous system (r = 0.59; p < 0.05). Conclusions. The course of chronic atrophic gastritis associated with thyroid pathology is associated with an imbalance of sympathetic and parasympathetic parts of the autonomic nervous system, depletion of adaptive mechanisms, reduced functional reserves of the body, and stress resistance. At the same time, disorders of the body’s adaptive potential and changes in autonomic balance are associated with the disorders of the small intestinal microbiota, which requires a multidisciplinary approach to the management of patients with comorbid pathology of the stomach and thyroid gland.

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