epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333/epi.par.con.2024.207epilepsia-1145Research ArticleSCIENTIFIC SURVEYSНАУЧНЫЕ ОБЗОРЫRole of neuropeptide Y in development of valproate-induced eating behaviour disorderРоль нейропептида Y в развитии вальпроат-индуцированного расстройства пищевого поведенияhttps://orcid.org/0000-0002-2840-837XШнайдерН. А.ShnayderN. A.

Шнайдер Наталья Алексеевна - д.м.н., проф.

ул. Бехтерева, д. 3, Санкт-Петербург, 192019; ул. Партизана Железняка, д. 1, Красноярск, 660022

WoS ResearcherID M-7084-2014, Scopus Author ID 24503222300

Natalia A. Shnayder - Dr. Sci. Med., Prof.

3 Bekhterev Str., Saint Petersburg, 192019; 1 Partizan Zheleznyak Str., Krasnoyarsk, 660022

WoS ResearcherID M-7084-2014, Scopus Author ID 24503222300

naschnaider@yandex.ruhttps://orcid.org/0000-0001-8279-4198ГречкинаВ. В.GrechkinaV. V.

Гречкина Виолетта Владимировна.

ул. Бехтерева, д. 3, Санкт-Петербург, 192019; наб. Обводного канала, д. 9И, Санкт-Петербург, 191167

Scopus Author ID 58076147700

Violetta V. Grechkina.

3 Bekhterev Str., Saint Petersburg, 192019; 9I Obvodnoy Canal Emb., Saint Petersburg, 191167

Scopus Author ID 58076147700

https://orcid.org/0000-0002-4186-5911КиссинМ. Я.KissinM. Ya.

Киссин Михаил Яковлевич - д.м.н., проф.

наб. Обводного канала, д. 9И, Санкт-Петербург, 191167; ул. Льва Толстого, д. 6-8, Санкт-Петербург, 197022

Mikhail Yа. Kissin - Dr. Sci. Med., Prof.

9I Obvodnoy Canal Emb., Saint Petersburg, 191167; 6-8 Lev Tolstoy Str., Saint Petersburg, 197022

https://orcid.org/0000-0003-4639-6365ДмитренкоД. В.DmitrenkoD. V.

Дмитренко Диана Викторовна - д.м.н.

ул. Партизана Железняка, д. 1, Красноярск, 660022

WoS ResearcherID H-7787-2016

Diana V. Dmitrenko - Dr. Sci. Med.

1 Partizan Zheleznyak Str., Krasnoyarsk, 660022

WoS ResearcherID H-7787-2016

https://orcid.org/0000-0003-1874-9434НасыроваР. Ф.NasyrovaR. F.

Насырова Регина Фаритовна - д.м.н.

ул. Бехтерева, д. 3, Санкт-Петербург, 192019; пр-т Ленина, д. 92, Тула, 300012

WoS ResearcherID H-7787-2016

Regina F. Nasyrova - Dr. Sci. Med.

3 Bekhterev Str., Saint Petersburg, 192019; 92 Lenin Ave., Tula, 300012

WoS ResearcherID H-7787-2016

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет им. профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской ФедерацииРоссияBekhterev National Medical Research Centre for Psychiatry and Neurology; Voino-Yasenetsky Krasnoyarsk State Medical UniversityRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации; Санкт-Петербургское государственное казенное учреждение здравоохранения «Городская психиатрическая больница № 6 (стационар с диспансером)»РоссияBekhterev National Medical Research Centre for Psychiatry and Neurology; City Psychiatric Hospital No. 6 (hospital with dispensary)Russian FederationСанкт-Петербургское государственное казенное учреждение здравоохранения «Городская психиатрическая больница № 6 (стационар с диспансером)»; Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова» Министерства здравоохранения Российской ФедерацииРоссияCity Psychiatric Hospital No. 6 (hospital with dispensary); Pavlov First Saint Petersburg State Medical UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет им. профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской ФедерацииРоссияVoino-Yasenetsky Krasnoyarsk State Medical UniversityRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Министерства здравоохранения Российской Федерации; Федеральное государственное бюджетное образовательное учреждение высшего образования «Тульский государственный университет»РоссияBekhterev National Medical Research Centre for Psychiatry and Neurology; Tula State UniversityRussian Federation202418012025164349361Copyright © Shnayder N.A., Grechkina V.V., Kissin M.Y., Dmitrenko D.V., Nasyrova R.F., 20252025Шнайдер Н.А., Гречкина В.В., Киссин М.Я., Дмитренко Д.В., Насырова Р.Ф.Shnayder N.A., Grechkina V.V., Kissin M.Y., Dmitrenko D.V., Nasyrova R.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/1145Background

Background. Eating behaviour disorder (EBD) induced by valproic acid (VPA) is one of the components of the pathogenesis of a serious complication of therapy with VPA and its salts such as VPA-induced metabolic syndrome (MetS). About 20% of patients receiving VPA have weight gain, which is also a consequence of altered eating behaviour in such patients. Substances such as neuropeptide Y (NPY), leptin, orexin and ghrelin are involved in the regulation of eating behaviour. NPY has received special attention in recent years because it is one of the most potent brain orexigenic peptides and its expression level directly affects the quantity and quality of food intake. NPY overexpression is associated with EBD, food preferences, obesity, and MetS.

Objective

Objective: to review preclinical and clinical studies of NPY role as a potential sensitive and specific serum biomarker of VPA-EBD, secondary weight gain and VPA-MetS development in children and adults with epilepsy.

Material and methods

Material and methods. We analyzed Russian and foreign publications submitted to eLibrary, PubMed/MEDLINE, Scopus, and Google Scholar databases between 2014 and 2024. The full-text articles in Russian and English (original studies, systematic reviews, meta-analyses, Cochrane reviews, and clinical cases) were analyzed. After the selection procedure, 53 out of 1105 publications retrieved by query keywords were included in the analysis.

Results

Results. VPA-EDB refers to multifactorial diseases, requiring to take into account the additive contribution of external (food education, eating habits of the patient and family members) and internal (key hormones and neuropeptides regulating appetite and food preferences, the dose and duration of VPA intake, the metabolic rate of VPA) factors while assessing a risk of its development. NPY-associated VPA-EDB affects dietary preferences in favor of high-calorie food and beverages, increases the frequency of meals, the risks of insulin resistance, hyperglycemia as one of the major domains in MetS pathogenesis.

Conclusion

Conclusion. VPA-EBD requires timely diagnosis, as it can cause VPA-MetS. NPY is an important biomarker of VPA-EBD, because recent studies have convincingly demonstrated that this neuropeptide is involved in the regulation of eating behavior in patients with epilepsy.

Актуальность

Актуальность. Индуцированное вальпроевой кислотой (ВК) расстройство пищевого поведения (РПП) является одной из составных частей патогенеза такого серьезного осложнения терапии ВК и ее солями, как ВК-индуцированный метаболический синдром (МетС). Около 20% пациентов, получающих ВК, имеют увеличение веса, которое также обусловлено изменением пищевого поведения у таких больных. В регуляции пищевого поведения участвуют такие вещества, как нейропептид Y (англ. neuropeptide Y, NPY), лептин, орексин и грелин. В последние годы особое внимание уделяется NPY, поскольку он представляет собой один из самых мощных орексигенных пептидов головного мозга, а уровень его экспрессии непосредственно влияет на количество и качество потребляемой пищи. Гиперэкспрессия NPY ассоциирована с РПП, пищевыми предпочтениями, развитием ожирения и МетС.

Цель

Цель: провести обзор результатов доклинических и клинических исследований роли NPY как потенциального чувствительного и специфического сывороточного биомаркера ВК-РПП, вторичного увеличения веса и развития ВК-МетС у детей и взрослых с эпилепсией.

Материал и методы

Материал и методы. Проанализированы отечественные и зарубежные публикации, поступившие в базы данных eLibrary, PubMed/MEDLINE, Scopus, Google Scholar за период 2014–2024 гг. Рассматривали полнотекстовые статьи на русском и английском языках (оригинальные исследования, систематические обзоры, метаанализы, кокрейновские обзоры, клинические случаи). После процедуры отбора из 1105 публикаций, найденных по ключевым словам, в анализ вошли 53.

Результаты

Результаты. ВК-РПП относится к мультифакторным заболеваниям, при оценке риска развития которых необходимо учитывать аддитивный вклад внешних (пищевое воспитание, пищевые привычки у пациента и членов семьи) и внутренних (ключевые гормоны и нейропептиды регуляции аппетита и пищевых предпочтений, доза и длительность приема ВК, скорость метаболизма ВК) факторов. NPY-ассоциированное ВК-РПП влияет на пищевые предпочтения в пользу высококалорийных пищи и напитков, увеличения частоты приемов пищи, повышает риски инсулинорезистентности, гипергликемии как одних из основных доменов патогенеза МетС.

Заключение

Заключение. ВК-РПП требует своевременной диагностики, поскольку может стать причиной ВК-МетС. NPY является важным биомаркером ВК-РПП, поскольку исследования последних лет убедительно продемонстрировали, что этот нейропептид участвует в регуляции пищевого поведения у больных эпилепсией.

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The authors declare that there are no conflicts of interest present.