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Цереброваскулярная болезнь, ассоциированная с метаболическим синдромом: подходы к профилактике и терапии
Цереброваскулярная болезнь, ассоциированная с метаболическим синдромом: подходы к профилактике и терапии
Воробьева О.В. Цереброваскулярная болезнь, ассоциированная с метаболическим синдромом: подходы к профилактике и терапии. Неврология и Ревматология (Прил. к журн. Consilium Medicum). 2018; 1: 16–20. DOI: 10.26442/2414-357X_2018.1.16-20
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Аннотация
Метаболический синдром (МС) негативно влияет на перфузию головного мозга через многие механизмы, но в первую очередь за счет повышения тромбогенности циркулирующей крови. Ведение пациента с МС требует своевременной оценки риска цереброваскулярной болезни. Обсуждаются клинические подходы к диагностике МС и ассоциированных сосудистых нарушений. Своевременная комплексная терапия – решающий фактор обратного развития компонентов МС и надежная профилактика цереброваскулярной болезни. Препарат дипиридамол, обладающий классическими и плейотропными эффектами, является патогенетически обоснованным лекарством для лечения МС и первичной профилактики связанных с ним сосудистых нарушений.
Ключевые слова: цереброваскулярная болезнь, церебральная микроангиопатия, метаболический синдром, дипиридамол.
Key words: cerebrovascular disease, cerebral microangiopathy, metabolic syndrome, dipyridamole.
Ключевые слова: цереброваскулярная болезнь, церебральная микроангиопатия, метаболический синдром, дипиридамол.
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Key words: cerebrovascular disease, cerebral microangiopathy, metabolic syndrome, dipyridamole.
Полный текст
Список литературы
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2. Lozano R, Naghavi M, Foreman K et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380: 2095–128.
3. Makin S, Turpin S, Dennis M, Wardlaw J. Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke sub-types. J Neurol Neurosurg Psychiatry 2013; 84: 893–900.
4. Valdes Hernandez MC, Maconick LC, Munoz Maniega S et al. Acomparison of location of acute symptomatic versus ‘silent’small vessel lesions. Int J Stroke 2015; 10: 1044–50.
5. Alessi MC, Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. Thromb Haemost 2008; 99 (6): 995–1000.
6. Benarroch E. Neurovascular unit dysfunction. Neurology 2007; 68: 1730–2.
7. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008; 28 (4): 629–36.
8. Lovre D, Mauvais-Jarvis F. Trends in prevalence of the metabolic syndrome. JAMA 2015; 314 (9): 950.
9. Gustafson B, Hammarstedt A, Andersson CX et al. Inflamed adipose tissue: a culprit underlying the metabolic syndrome and atherosclerosis. Arterioscler Thromb Vasc Biol 2007; 27 (11): 2276–83.
10. Despres JP, Lemieux I, Bergeron J et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol 2008; 28 (6): 1039–49.
11. Turkoglu C, Duman BS, Gunay D et al. Effect of abdominal obesity on insulin resistance and the components of the metabolic syndrome: evidence supporting obesity as the central feature. Obes Surg 2003; 13 (5): 699–705.
12. Serne EH, de Jongh RT, Eringa EC et al. Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome. Hypertension 2007; 50 (1): 204–11.
13. Joy T, Lahiry P, Pollex RL et al. Genetics of metabolic syndrome. Curr Diab Rep 2008; 8 (2): 141–8.
14. Tasali E, Ip MS. Obstructive sleep apnea and metabolic syndrome: alterations in glucose metabolism and inflammation. Proc Am Thorac Soc 2008; 5 (2): 207–17.
15. Lam JC, Ip MS. An update on obstructive sleep apnea and the metabolic syndrome. Curr Opin Pulm Med 2007; 13 (6): 484–9.
16. Heima NE, Eekhoff EM, Oosterwerff MM et al. Thyroid function and the metabolic syndrome in older persons: a population-based study. Eur J Endocrinol 2013; 168 (1): 59–65.
17. Puig JG, Martinez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol 2008; 20 (2): 187–91.
18. Towfighi A, Ovbiagele B. Metabolic syndrome and stroke. Curr Diab Rep 2008; 8 (1): 37–41.
19. Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes Care 2007; 30 (12): 3131–40.
20. Taylor VH, MacQueen GM. Cognitive dysfunction associated with metabolic syndrome. Obes Rev 2007; 8 (5): 409–18.
21. Yaffe K. Metabolic syndrome and cognitive decline. Curr Alzheimer Res 2007; 4 (2): 123–6.
22. Esposito K, Ciotola M, Giugliano D. Mediterranean diet and the metabolic syndrome. Mol Nutr Food Res 2007; 51 (10): 1268–74.
23. Vrolix R, van Meijl LE, Mensink RP. The metabolic syndrome in relation with the glycemic index and the glycemic load. Physiol Behav 2008; 94 (2): 293–9.
24. Buitrago-Lopez A, Sanderson J, Johnson L et al. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ 2011; 26 (343): d4488.
25. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 2007; 56 (11): 2655–67.
26. Shuval K, Finley CE, Chartier KG et al. Cardiorespiratory fitness, alcohol intake, and metabolic syndrome incidence in men. Med Sci Sports Exerc 2012; 44 (11): 2125–31.
27. Broekhuizen LN, Boekholdt SM, Arsenault BJ et al. Physical activity, metabolic syndrome, and coronary risk: the EPIC-Norfolk prospective population study. Eur J Cardiovasc Prev Rehabil 2011; 18 (2): 209–17.
28. Aktas B, Utz A, Hoenig-Liedl P et al. Dipyridamole enhances NO/cGMP-mediated vasodilator-stimulated phosphoprotein phosphorylation and signaling in human platelets: in vitro and in vivo/ex vivo studies. Stroke 2003; 34: 764–9.
29. Chakrabarti S, Freedman JE. Dipyridamole, cerebrovascular disease, and the vasculature. Vascular Pharmacology 2008; 48: 143–9.
30. Nelson CW, Wei EP, Povlishock JT et al. Oxygen radicals in cerebral ischemia. Am J Physiol 1992; 263: H1356–H1362.
31. Weisbrot-Lefkowitz M, Reuhl K, Perry B et al. Overexpression of human glutathione peroxidase protects transgenic mice against focal cerebral ischemia/reperfusion damage. Brain Res Mol Brain Res 1998; 53: 333–8.
32. Balakumar P, Nyo YH, Renushia R et al. Classical and pleiotropic actions of dipyridamole: Not enough light to illuminate the dark tunnel? Pharmacol Res 2014; 87: 144–50.
2. Lozano R, Naghavi M, Foreman K et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380: 2095–128.
3. Makin S, Turpin S, Dennis M, Wardlaw J. Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke sub-types. J Neurol Neurosurg Psychiatry 2013; 84: 893–900.
4. Valdes Hernandez MC, Maconick LC, Munoz Maniega S et al. Acomparison of location of acute symptomatic versus ‘silent’small vessel lesions. Int J Stroke 2015; 10: 1044–50.
5. Alessi MC, Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. Thromb Haemost 2008; 99 (6): 995–1000.
6. Benarroch E. Neurovascular unit dysfunction. Neurology 2007; 68: 1730–2.
7. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008; 28 (4): 629–36.
8. Lovre D, Mauvais-Jarvis F. Trends in prevalence of the metabolic syndrome. JAMA 2015; 314 (9): 950.
9. Gustafson B, Hammarstedt A, Andersson CX et al. Inflamed adipose tissue: a culprit underlying the metabolic syndrome and atherosclerosis. Arterioscler Thromb Vasc Biol 2007; 27 (11): 2276–83.
10. Despres JP, Lemieux I, Bergeron J et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol 2008; 28 (6): 1039–49.
11. Turkoglu C, Duman BS, Gunay D et al. Effect of abdominal obesity on insulin resistance and the components of the metabolic syndrome: evidence supporting obesity as the central feature. Obes Surg 2003; 13 (5): 699–705.
12. Serne EH, de Jongh RT, Eringa EC et al. Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome. Hypertension 2007; 50 (1): 204–11.
13. Joy T, Lahiry P, Pollex RL et al. Genetics of metabolic syndrome. Curr Diab Rep 2008; 8 (2): 141–8.
14. Tasali E, Ip MS. Obstructive sleep apnea and metabolic syndrome: alterations in glucose metabolism and inflammation. Proc Am Thorac Soc 2008; 5 (2): 207–17.
15. Lam JC, Ip MS. An update on obstructive sleep apnea and the metabolic syndrome. Curr Opin Pulm Med 2007; 13 (6): 484–9.
16. Heima NE, Eekhoff EM, Oosterwerff MM et al. Thyroid function and the metabolic syndrome in older persons: a population-based study. Eur J Endocrinol 2013; 168 (1): 59–65.
17. Puig JG, Martinez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol 2008; 20 (2): 187–91.
18. Towfighi A, Ovbiagele B. Metabolic syndrome and stroke. Curr Diab Rep 2008; 8 (1): 37–41.
19. Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes Care 2007; 30 (12): 3131–40.
20. Taylor VH, MacQueen GM. Cognitive dysfunction associated with metabolic syndrome. Obes Rev 2007; 8 (5): 409–18.
21. Yaffe K. Metabolic syndrome and cognitive decline. Curr Alzheimer Res 2007; 4 (2): 123–6.
22. Esposito K, Ciotola M, Giugliano D. Mediterranean diet and the metabolic syndrome. Mol Nutr Food Res 2007; 51 (10): 1268–74.
23. Vrolix R, van Meijl LE, Mensink RP. The metabolic syndrome in relation with the glycemic index and the glycemic load. Physiol Behav 2008; 94 (2): 293–9.
24. Buitrago-Lopez A, Sanderson J, Johnson L et al. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ 2011; 26 (343): d4488.
25. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 2007; 56 (11): 2655–67.
26. Shuval K, Finley CE, Chartier KG et al. Cardiorespiratory fitness, alcohol intake, and metabolic syndrome incidence in men. Med Sci Sports Exerc 2012; 44 (11): 2125–31.
27. Broekhuizen LN, Boekholdt SM, Arsenault BJ et al. Physical activity, metabolic syndrome, and coronary risk: the EPIC-Norfolk prospective population study. Eur J Cardiovasc Prev Rehabil 2011; 18 (2): 209–17.
28. Aktas B, Utz A, Hoenig-Liedl P et al. Dipyridamole enhances NO/cGMP-mediated vasodilator-stimulated phosphoprotein phosphorylation and signaling in human platelets: in vitro and in vivo/ex vivo studies. Stroke 2003; 34: 764–9.
29. Chakrabarti S, Freedman JE. Dipyridamole, cerebrovascular disease, and the vasculature. Vascular Pharmacology 2008; 48: 143–9.
30. Nelson CW, Wei EP, Povlishock JT et al. Oxygen radicals in cerebral ischemia. Am J Physiol 1992; 263: H1356–H1362.
31. Weisbrot-Lefkowitz M, Reuhl K, Perry B et al. Overexpression of human glutathione peroxidase protects transgenic mice against focal cerebral ischemia/reperfusion damage. Brain Res Mol Brain Res 1998; 53: 333–8.
32. Balakumar P, Nyo YH, Renushia R et al. Classical and pleiotropic actions of dipyridamole: Not enough light to illuminate the dark tunnel? Pharmacol Res 2014; 87: 144–50.
________________________________________________
2. Lozano R, Naghavi M, Foreman K et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2013; 380: 2095–128.
3. Makin S, Turpin S, Dennis M, Wardlaw J. Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke sub-types. J Neurol Neurosurg Psychiatry 2013; 84: 893–900.
4. Valdes Hernandez MC, Maconick LC, Munoz Maniega S et al. Acomparison of location of acute symptomatic versus ‘silent’small vessel lesions. Int J Stroke 2015; 10: 1044–50.
5. Alessi MC, Juhan-Vague I. Metabolic syndrome, haemostasis and thrombosis. Thromb Haemost 2008; 99 (6): 995–1000.
6. Benarroch E. Neurovascular unit dysfunction. Neurology 2007; 68: 1730–2.
7. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008; 28 (4): 629–36.
8. Lovre D, Mauvais-Jarvis F. Trends in prevalence of the metabolic syndrome. JAMA 2015; 314 (9): 950.
9. Gustafson B, Hammarstedt A, Andersson CX et al. Inflamed adipose tissue: a culprit underlying the metabolic syndrome and atherosclerosis. Arterioscler Thromb Vasc Biol 2007; 27 (11): 2276–83.
10. Despres JP, Lemieux I, Bergeron J et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler Thromb Vasc Biol 2008; 28 (6): 1039–49.
11. Turkoglu C, Duman BS, Gunay D et al. Effect of abdominal obesity on insulin resistance and the components of the metabolic syndrome: evidence supporting obesity as the central feature. Obes Surg 2003; 13 (5): 699–705.
12. Serne EH, de Jongh RT, Eringa EC et al. Microvascular dysfunction: a potential pathophysiological role in the metabolic syndrome. Hypertension 2007; 50 (1): 204–11.
13. Joy T, Lahiry P, Pollex RL et al. Genetics of metabolic syndrome. Curr Diab Rep 2008; 8 (2): 141–8.
14. Tasali E, Ip MS. Obstructive sleep apnea and metabolic syndrome: alterations in glucose metabolism and inflammation. Proc Am Thorac Soc 2008; 5 (2): 207–17.
15. Lam JC, Ip MS. An update on obstructive sleep apnea and the metabolic syndrome. Curr Opin Pulm Med 2007; 13 (6): 484–9.
16. Heima NE, Eekhoff EM, Oosterwerff MM et al. Thyroid function and the metabolic syndrome in older persons: a population-based study. Eur J Endocrinol 2013; 168 (1): 59–65.
17. Puig JG, Martinez MA. Hyperuricemia, gout and the metabolic syndrome. Curr Opin Rheumatol 2008; 20 (2): 187–91.
18. Towfighi A, Ovbiagele B. Metabolic syndrome and stroke. Curr Diab Rep 2008; 8 (1): 37–41.
19. Air EL, Kissela BM. Diabetes, the metabolic syndrome, and ischemic stroke: epidemiology and possible mechanisms. Diabetes Care 2007; 30 (12): 3131–40.
20. Taylor VH, MacQueen GM. Cognitive dysfunction associated with metabolic syndrome. Obes Rev 2007; 8 (5): 409–18.
21. Yaffe K. Metabolic syndrome and cognitive decline. Curr Alzheimer Res 2007; 4 (2): 123–6.
22. Esposito K, Ciotola M, Giugliano D. Mediterranean diet and the metabolic syndrome. Mol Nutr Food Res 2007; 51 (10): 1268–74.
23. Vrolix R, van Meijl LE, Mensink RP. The metabolic syndrome in relation with the glycemic index and the glycemic load. Physiol Behav 2008; 94 (2): 293–9.
24. Buitrago-Lopez A, Sanderson J, Johnson L et al. Chocolate consumption and cardiometabolic disorders: systematic review and meta-analysis. BMJ 2011; 26 (343): d4488.
25. Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes 2007; 56 (11): 2655–67.
26. Shuval K, Finley CE, Chartier KG et al. Cardiorespiratory fitness, alcohol intake, and metabolic syndrome incidence in men. Med Sci Sports Exerc 2012; 44 (11): 2125–31.
27. Broekhuizen LN, Boekholdt SM, Arsenault BJ et al. Physical activity, metabolic syndrome, and coronary risk: the EPIC-Norfolk prospective population study. Eur J Cardiovasc Prev Rehabil 2011; 18 (2): 209–17.
28. Aktas B, Utz A, Hoenig-Liedl P et al. Dipyridamole enhances NO/cGMP-mediated vasodilator-stimulated phosphoprotein phosphorylation and signaling in human platelets: in vitro and in vivo/ex vivo studies. Stroke 2003; 34: 764–9.
29. Chakrabarti S, Freedman JE. Dipyridamole, cerebrovascular disease, and the vasculature. Vascular Pharmacology 2008; 48: 143–9.
30. Nelson CW, Wei EP, Povlishock JT et al. Oxygen radicals in cerebral ischemia. Am J Physiol 1992; 263: H1356–H1362.
31. Weisbrot-Lefkowitz M, Reuhl K, Perry B et al. Overexpression of human glutathione peroxidase protects transgenic mice against focal cerebral ischemia/reperfusion damage. Brain Res Mol Brain Res 1998; 53: 333–8.
32. Balakumar P, Nyo YH, Renushia R et al. Classical and pleiotropic actions of dipyridamole: Not enough light to illuminate the dark tunnel? Pharmacol Res 2014; 87: 144–50.
Авторы
О.В.Воробьева*
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ovvorobeva@mail.ru
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ovvorobeva@mail.ru
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ovvorobeva@mail.ru
________________________________________________
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ovvorobeva@mail.ru
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