The Role of Quality of Life in Melatonin Content as a Regulator of Defense and Aggression Factors in Gastroesophageal Reflux Disease Patients With Sleep Apnea Syndrome

Abstract

The aim of the study: to study the effect of the quality of life on the melatonin content, and at the same time to assess the state of the factors of aggression and protection of the esophageal mucosa in patients with GERD without comorbidities and with concomitant obstructive sleep apnea/hypopnea syndrome (OSAHS).
 Methods. 45 patients were taken for the study. 23 of them had GERD concomitant COPD, 22 were with isolated GERD with a non-erosive form.
 Melatonin levels were determined using the enzyme immunoassay method (ELIZA). Quality of life was assessed using the SF-36 questionnaire. Antioxidant protection of the mucous membrane (protection factor) – was assessed by the activity of superoxide dismutase (SOD). SOD activity in blood serum was determined by calorimetric method. Determination of the DC level was carried out in the blood by the spectrofluorimetric method.
 Results. The study showed that in patients with GERD with concomitant COPD, there is a significant decrease in the indicators of antioxidant activity and melatonin, both with indicators from the control group and with indicators of patients with GERD without comorbidity.
 At the same time, in patients with GERD without comorbidities, an increase in the level of DC was observed in comparison with the control group and patients with GERD with concomitant pathology and acidity of gastric juice.
 When analyzing the indicators of QOL in patients with GERD with concomitant pathology, there is a significantly more pronounced decrease in mental health, role emotional functioning and vitality.
 Conclusions. It has been established that in patients with GERD in the stage of exacerbation of the disease, there is a statistically significant decrease in QOL indicators with a high degree of reliability, manifesting itself in patients without combined pathology in the spectrum of indicators of the physical component of health, and in patients with GERD with concomitant obstructive sleep syndrome – in the spectrum of the psychological component quality of life.
 It has been shown that with a decrease in QOL in patients with GERD, the level of melatonin decreases, the decrease in which more clearly increases in patients with concomitant obstructive sleep apnea.
 Simultaneously with a drop in the level of melatonin in patients with GERD without associated pathology, the aggression factor increases with a high degree of certainty - that is, a decrease in the pH of gastric juice and an increase in the content of DC, while in patients with GERD with concomitant sleep apnea syndrome, the factor decreases with a high degree of certainty. Protection of the esophageal mucosa – (that is, a decrease in SOD activity), which must be taken into account when treating this category of patients.