Abstract
Background. University entry is accompanied by abrupt changes in social environment, lifestyle and cognitive load, which challenge stress-response systems, the autonomic nervous system (ANS), and immune-metabolic homeostasis. In Russian clinical practice, this symptom cluster is often labeled as “vegetovascular dystonia”, while a more accurate framework is autonomic dysfunction and/or somatoform autonomic disorder (ICD-10: F45.3). Digital and telemedicine approaches may enable early detection of ANS dysregulation and prevention of clinically significant functional disorders.
The aim. To evaluate a telemedicine-based early screening program with a 3-year follow-up in university students, focusing on detection of stress-related autonomic dysfunction, clinico-molecular risk stratification, and rationale for personalized prevention (behavioral and nutritional) to reduce symptom burden and adverse educational outcomes (including academic leave).
Material and methods. Prospective telemedicine cohort study. Assessments were performed before the start of education and repeatedly during 3 years using digital questionnaires, sleep and workload metrics, cardiovascular parameters, and heart rate variability (HRV) indices as a dynamic biomarker of ANS regulation.
Results. The study involved 3,155 people. 100 people were selected by random sampling for dynamic observation, of which 83 students completed the study. There were 50 (60.2%) girls and 33 (39.8%) boys among them. The average age of the observed patients was 19.4±0.8 years. There were 48 (57.8%) people from St. Petersburg and the Leningrad Region, 35 (42.2%) people from other cities. The selection criterion was to determine the high risk of developing diseases according to one of the pathology profiles based on the results of remote questionnaire screening. The risks of developing diseases were distributed as follows: cardiology 29 (35%); gastroenterology 20 people (24%); endocrinology 27 (33%); oncology 6 (7%); pulmonology 1 (1%). During the follow-up period, 48 (57.8%) sought medical help. Of these, 13 (27.1%) were students from St. Petersburg and Leningrad Region, and 35 (72.9%) were from other cities. In 17 cases, treatment required separation from the learning process. Among them, 38.5% were students from St. Petersburg and Leningrad Region, 62.9% were nonresident students. On average, each case required 15.7 days of treatment. During the follow-up period, 41.2% of the students were ill 2 or more times.
Conclusion. Telemedicine-based screening in students enables early identification of ANS dysregulation phenotypes and supports personalized preventive strategies integrating lifestyle interventions and targeted nutritional support.
Keywords
Authors and affiliations
P.V. Seliverstov(1), S.P. Salikova(1), O.V. Aleshko(2), A.S. Simakhodsky(3), V.V. Shapovalov(4),
T.S. Dyakov(3), D.V. Romakh(3), M.A. Roslyakova(5), V.E. Chernyakova(5), D.A. Golikova(6)
1-Federal State Budgetary Educational Institution of Higher Education “S.M. Kirov Military Medical Academy” of the Ministry of Health of the Russian Federation, Lebedeva St., 6, Saint-Petersburg, 194044, Russian Federation; 2-Saint-Petersburg State Healthcare Institution “City Polyclinic No.76”, Khlopina St., 11, Build. 1, Saint-Petersburg, 194021, Russian Federation; 3-FSFEI HE Pavlov First
Saint-Petersburg State Medical University, L’va Tolstogo str. 6–8, Saint-Petersburg, 197022, Russian Federation; 4I=ntelligent Software Systems Limited Liability Company, Kantemirovskaya Str., 37, Office 201, Saint-Petersburg, 194100, Russian Federation;
5-Saint-Petersburg State Pediatric Medical University of the Russian Ministry of Health, Litovskaya St., 2, Saint-Petersburg, 194100, Russian Federation; 6FSAEI HE I.M. Sechenov First Moscow State Medical University of the Ministry of Health
of the Russian Federation (Sechenov University), Trubetskaya st., 8, build. 2, Moscow, 119991, Russian Federation
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