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Течение желчнокаменной болезни у лиц с метаболическими нарушениями
Осадчук М.А., Миронова Е.Д., Балашов Д.В., Осадчук М.М. Течение желчнокаменной болезни у лиц с метаболическими нарушениями. Consilium Medicum. 2019; 21 (8): 74–77. DOI: 10.26442/20751753.2019.8.190548
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Osadchuk M.A., Mironova E.D., Balashov D.V., Osadchuk М.М. Course of gallstone disease in persons with metabolic disorders. Consilium Medicum. 2019; 21 (8): 74–77. DOI: 10.26442/20751753.2019.8.190548
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Аннотация
Цель. Определить факторы, влияющие на течение желчнокаменной болезни (ЖКБ) у лиц с метаболическими нарушениями.
Материалы и методы. Под наблюдением находились 103 пациента с ЖКБ в возрасте от 23 до 65 лет. Все пациенты обследованы в соответствии с целью и задачами настоящей работы с анализом клинико-инструментальных и лабораторных данных. Учитывались анамнестические (наличие острого холецистита и артериальной гипертензии в анамнезе), антропометрические (рост, масса тела, индекс массы тела, объем талии), биохимические (общий холестерин, холестерин липопротеидов высокой плотности – ХС ЛПВП, триглицериды – ТГ, глюкоза) и инструментальные (определение конкрементов в желчном пузыре по данным ультразвукового исследования органов брюшной полости) показатели. Верификация метаболических нарушений проводилась на основании критериев метаболического синдрома (МС) JIS (Joint Interim Societies, 2009 г.).
Результаты. У больных ЖКБ с острым холециститом (ЖКБОХ) в анамнезе чаще встречались как отдельные метаболические нарушения, так и МС. Статистически значимое влияние на течение ЖКБОХ оказывали ТГ, ХС ЛПВП, а также интегральный показатель МС.
Заключение. МС и его отдельные компоненты можно рассматривать как факторы риска острого холецистита у больных ЖКБ. Необходимы дальнейшие исследования, чтобы уточнить клиническую важность этой ассоциации в ближайшей и отдаленной перспективе и возможности медикаментозной литической терапии препаратами желчных кислот и превентивных мероприятий, связанных с нормализацией массы тела, ХС ЛПВП и ТГ.
Ключевые слова: желчнокаменная болезнь, метаболический синдром, метаболические нарушения, холецистит, острый холецистит.
Материалы и методы. Под наблюдением находились 103 пациента с ЖКБ в возрасте от 23 до 65 лет. Все пациенты обследованы в соответствии с целью и задачами настоящей работы с анализом клинико-инструментальных и лабораторных данных. Учитывались анамнестические (наличие острого холецистита и артериальной гипертензии в анамнезе), антропометрические (рост, масса тела, индекс массы тела, объем талии), биохимические (общий холестерин, холестерин липопротеидов высокой плотности – ХС ЛПВП, триглицериды – ТГ, глюкоза) и инструментальные (определение конкрементов в желчном пузыре по данным ультразвукового исследования органов брюшной полости) показатели. Верификация метаболических нарушений проводилась на основании критериев метаболического синдрома (МС) JIS (Joint Interim Societies, 2009 г.).
Результаты. У больных ЖКБ с острым холециститом (ЖКБОХ) в анамнезе чаще встречались как отдельные метаболические нарушения, так и МС. Статистически значимое влияние на течение ЖКБОХ оказывали ТГ, ХС ЛПВП, а также интегральный показатель МС.
Заключение. МС и его отдельные компоненты можно рассматривать как факторы риска острого холецистита у больных ЖКБ. Необходимы дальнейшие исследования, чтобы уточнить клиническую важность этой ассоциации в ближайшей и отдаленной перспективе и возможности медикаментозной литической терапии препаратами желчных кислот и превентивных мероприятий, связанных с нормализацией массы тела, ХС ЛПВП и ТГ.
Ключевые слова: желчнокаменная болезнь, метаболический синдром, метаболические нарушения, холецистит, острый холецистит.
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Aim. To identify factors affecting the course of gallstone disease (GD) in persons with metabolic disorders.
Materials and methods. 103 patients with GD aged 23 to 65 years were examined. All patients were examined in accordance with the purpose and objectives of this work with the analysis of clinical, instrumental and laboratory data. Anthropometric indicators (height, weight, body mass index, waist volume) were taken into account; biochemical data – total cholesterol, high density lipoprotein cholesterol, triglycerides, glucose; Ultrasound of the abdominal organs. The verification of metabolic disorders was carried out on the basis of the criteria of JIS metabolic syndrome (MS), 2009.
Results. In patients with gallstone disease accompanied by acute cholecystitis (GDAC), metabolic disturbances and MS were more common. Statistically significant influence on the course of GDAC was rendered by triglycerides, high density lipoprotein cholesterol as well as MS.
Conclusion. MS and its individual components can be considered as risk factors for acute cholecystitis in patients with gastrointestinal tract. Further research is needed to clarify the clinical importance of this Association in the near and trimmed perspective and the possibility of drug lytic therapy with bile acids and preventive measures related to the normalization of weight, high density lipoprotein cholesterol and triglycerides.
Key words: gallstone disease, metabolic syndrome, metabolic disorders, cholecystitis, acute cholecystitis.
Materials and methods. 103 patients with GD aged 23 to 65 years were examined. All patients were examined in accordance with the purpose and objectives of this work with the analysis of clinical, instrumental and laboratory data. Anthropometric indicators (height, weight, body mass index, waist volume) were taken into account; biochemical data – total cholesterol, high density lipoprotein cholesterol, triglycerides, glucose; Ultrasound of the abdominal organs. The verification of metabolic disorders was carried out on the basis of the criteria of JIS metabolic syndrome (MS), 2009.
Results. In patients with gallstone disease accompanied by acute cholecystitis (GDAC), metabolic disturbances and MS were more common. Statistically significant influence on the course of GDAC was rendered by triglycerides, high density lipoprotein cholesterol as well as MS.
Conclusion. MS and its individual components can be considered as risk factors for acute cholecystitis in patients with gastrointestinal tract. Further research is needed to clarify the clinical importance of this Association in the near and trimmed perspective and the possibility of drug lytic therapy with bile acids and preventive measures related to the normalization of weight, high density lipoprotein cholesterol and triglycerides.
Key words: gallstone disease, metabolic syndrome, metabolic disorders, cholecystitis, acute cholecystitis.
Полный текст
Список литературы
1. Peery AF, Crockett SD, Barritt AS et al. Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology 2015; 149 (7): 1731–41.e3
2. Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet 2006; 368 (9531): 230–9.
3. Chowdhury MZI, Anik AM, Farhana Z et al. Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies. BMC Public Health 2018; 18: 308.
4. Lin I-C, Yang Y-W, Wu M-F et al. The association of metabolic syndrome and its factors with gallstone disease. BMC Fam Pract 2014; 15: 138.
5. Zhu Q, Sun X, Ji X et al. The association between gallstones and metabolic syndrome in urban Han Chinese: a longitudinal cohort study. Sci Rep 2016; 22 (6): 29937.
6. Shen H-C, Hu Y-C, Chen Y-F, Tung T-H. Prevalence and Associated Metabolic Factors of Gallstone Disease in the Elderly Agricultural and Fishing Population of Taiwan. Gastroenterol Res Pract 2014; 2014: 876918.
7. Осадчук М.А., Киреева Н.В., Васильева И.Н., Миронова Е.Д. Влияние степени выраженности метаболических нарушений на диаметр конкрементов в желчном пузыре: клинико-инструментальные и лабораторные данные. Терапия. 2019; 5 (3): 55–9.
[Osadchuk M.A., Kireeva N.V., Vasilyeva I.N., Mironova E.D. Effect of severity of metabolic disorders on the diameter of stones in the gallbladder: clinical, instrumental and laboratory data. Terapiya. 2019; 3 (29): 55–9 (in Russian).]
8. Chen L-Y, Qiao Q-H, Zhang S-C et al. Metabolic syndrome and gallstone disease. World J Gastroenterol 2012; 18 (31): 4215–20.
9. Shabanzadeh DM, Skaaby T, Sørensen LT et al. Metabolic biomarkers and gallstone disease – a population-based study. Scand J Gastroenterol 2017; 52 (11): 1270–7.
10. Chang Y, Sung E, Ryu S et al. Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean men. J Korean Med Sci 2008; 23 (4): 644–50.
11. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005; 7 (2): 132–40.
12. Osadchuk MA, Mironova ED, Vasileva IN et al. Oral medical dissolution of gallstones in patients with gallstone disease. Pren Méd Argent 2019; 105 (1): 34–40.
13. Ata N, Kucukazman M, Yavuz B et al. The metabolic syndrome is associated with complicated gallstone disease. Can J Gastroenterol 2011; 25 (5): 274–6.
14. Ahmed MJ, Mahmood R, Rana RS et al. Metabolic Syndrome: An Indicator of Complicated Gall Stone Disease? Cureus 2018; 10 (11): e3659
15. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52 (5): 1313–25.
16. Schmidt M, Hausken T, Glambek I et al. A 24-year controlled follow-up of patients with silent gallstones showed no long-term risk of symptoms or adverse events leading to cholecystectomy. Scand J Gastroenterol 2011; 46 (7–8): 949–54.
17. Shabanzadeh DM, Sørensen LT, Jørgensen T. Determinants for symptomatic gallstone disease readmissions – results from a cohort with screen-detected gallstone disease. J Visc Surg 2019; S1878–7886(19): 30025–6
18. Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology 1999; 117 (3): 632–9.
19. Alberti KGMM, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120 (16): 1640–5.
20. Amigo L, Zanlungo S, Mendoza H et al. Risk factors and pathogenesis of cholesterol gallstones: state of the art. Eur Rev Med Pharmacol Sci 1999; 3 (6): 241–6.
21. Marques P, Collado A, Martinez-Hervás S et al. Systemic Inflammation in Metabolic Syndrome: Increased Platelet and Leukocyte Activation, and Key Role of CX3CL1/CX3CR1 and CCL2/CCR2 Axes in Arterial Platelet-Proinflammatory Monocyte Adhesion. J Clin Med 2019; 8 (5).
22. Collado A, Marques P, Escudero P et al. Functional role of endothelial CXCL16/CXCR6-platelet-leucocyte axis in angiotensin II-associated metabolic disorders. Cardiovasc Res 2018; 114 (13): 1764–75.
23. Mazidi M, Toth PP, Banach M. C-reactive Protein Is Associated With Prevalence of the Metabolic Syndrome, Hypertension, and Diabetes Mellitus in US Adults. Angiology 2018; 69 (5): 438–42.
24. Fairfield CJ, Wigmore SJ, Harrison EM. Gallstone Disease and the Risk of Cardiovascular Disease. Sci Rep 2019; 9: 5830.
25. Liew P-L, Wang W, Lee Y-C et al. Gallbladder disease among obese patients in Taiwan. Obes Surg 2007; 17 (3): 383–90.
26. Fiorito G, Vlaanderen J, Polidoro S et al. Oxidative stress and inflammation mediate the effect of air pollution on cardio- and cerebrovascular disease: A prospective study in nonsmokers. Environ Mol Mutagen 2018; 59 (3): 234–46.
27. Greenwood B, Tremblay L, Davison JS. Sympathetic control of motility, fluid transport, and transmural potential difference in the rabbit ileum. Am J Physiol 1987; 253 (6 Pt 1): G726–729.
28. Karhapää P, Malkki M, Laakso M. Isolated low HDL cholesterol. An insulin-resistant state. Diabetes 1994; 43 (3): 411–7.
29. Smelt AHM. Triglycerides and gallstone formation. Clin Chim Acta 2010; 411 (21–22): 1625–31.
30. Alipour A, van Oostrom AJHHM, Izraeljan A et al. Leukocyte activation by triglyceride-rich lipoproteins. Arterioscler Thromb Vasc Biol 2008; 28 (4): 792–7.
2. Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet 2006; 368 (9531): 230–9.
3. Chowdhury MZI, Anik AM, Farhana Z et al. Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies. BMC Public Health 2018; 18: 308.
4. Lin I-C, Yang Y-W, Wu M-F et al. The association of metabolic syndrome and its factors with gallstone disease. BMC Fam Pract 2014; 15: 138.
5. Zhu Q, Sun X, Ji X et al. The association between gallstones and metabolic syndrome in urban Han Chinese: a longitudinal cohort study. Sci Rep 2016; 22 (6): 29937.
6. Shen H-C, Hu Y-C, Chen Y-F, Tung T-H. Prevalence and Associated Metabolic Factors of Gallstone Disease in the Elderly Agricultural and Fishing Population of Taiwan. Gastroenterol Res Pract 2014; 2014: 876918.
7. Осадчук М.А., Киреева Н.В., Васильева И.Н., Миронова Е.Д. Влияние степени выраженности метаболических нарушений на диаметр конкрементов в желчном пузыре: клинико-инструментальные и лабораторные данные. Терапия. 2019; 5 (3): 55–9.
[Osadchuk M.A., Kireeva N.V., Vasilyeva I.N., Mironova E.D. Effect of severity of metabolic disorders on the diameter of stones in the gallbladder: clinical, instrumental and laboratory data. Terapiya. 2019; 3 (29): 55–9 (in Russian).]
8. Chen L-Y, Qiao Q-H, Zhang S-C et al. Metabolic syndrome and gallstone disease. World J Gastroenterol 2012; 18 (31): 4215–20.
9. Shabanzadeh DM, Skaaby T, Sørensen LT et al. Metabolic biomarkers and gallstone disease – a population-based study. Scand J Gastroenterol 2017; 52 (11): 1270–7.
10. Chang Y, Sung E, Ryu S et al. Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean men. J Korean Med Sci 2008; 23 (4): 644–50.
11. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005; 7 (2): 132–40.
12. Osadchuk MA, Mironova ED, Vasileva IN et al. Oral medical dissolution of gallstones in patients with gallstone disease. Pren Méd Argent 2019; 105 (1): 34–40.
13. Ata N, Kucukazman M, Yavuz B et al. The metabolic syndrome is associated with complicated gallstone disease. Can J Gastroenterol 2011; 25 (5): 274–6.
14. Ahmed MJ, Mahmood R, Rana RS et al. Metabolic Syndrome: An Indicator of Complicated Gall Stone Disease? Cureus 2018; 10 (11): e3659
15. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52 (5): 1313–25.
16. Schmidt M, Hausken T, Glambek I et al. A 24-year controlled follow-up of patients with silent gallstones showed no long-term risk of symptoms or adverse events leading to cholecystectomy. Scand J Gastroenterol 2011; 46 (7–8): 949–54.
17. Shabanzadeh DM, Sørensen LT, Jørgensen T. Determinants for symptomatic gallstone disease readmissions – results from a cohort with screen-detected gallstone disease. J Visc Surg 2019; S1878–7886(19): 30025–6
18. Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology 1999; 117 (3): 632–9.
19. Alberti KGMM, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120 (16): 1640–5.
20. Amigo L, Zanlungo S, Mendoza H et al. Risk factors and pathogenesis of cholesterol gallstones: state of the art. Eur Rev Med Pharmacol Sci 1999; 3 (6): 241–6.
21. Marques P, Collado A, Martinez-Hervás S et al. Systemic Inflammation in Metabolic Syndrome: Increased Platelet and Leukocyte Activation, and Key Role of CX3CL1/CX3CR1 and CCL2/CCR2 Axes in Arterial Platelet-Proinflammatory Monocyte Adhesion. J Clin Med 2019; 8 (5).
22. Collado A, Marques P, Escudero P et al. Functional role of endothelial CXCL16/CXCR6-platelet-leucocyte axis in angiotensin II-associated metabolic disorders. Cardiovasc Res 2018; 114 (13): 1764–75.
23. Mazidi M, Toth PP, Banach M. C-reactive Protein Is Associated With Prevalence of the Metabolic Syndrome, Hypertension, and Diabetes Mellitus in US Adults. Angiology 2018; 69 (5): 438–42.
24. Fairfield CJ, Wigmore SJ, Harrison EM. Gallstone Disease and the Risk of Cardiovascular Disease. Sci Rep 2019; 9: 5830.
25. Liew P-L, Wang W, Lee Y-C et al. Gallbladder disease among obese patients in Taiwan. Obes Surg 2007; 17 (3): 383–90.
26. Fiorito G, Vlaanderen J, Polidoro S et al. Oxidative stress and inflammation mediate the effect of air pollution on cardio- and cerebrovascular disease: A prospective study in nonsmokers. Environ Mol Mutagen 2018; 59 (3): 234–46.
27. Greenwood B, Tremblay L, Davison JS. Sympathetic control of motility, fluid transport, and transmural potential difference in the rabbit ileum. Am J Physiol 1987; 253 (6 Pt 1): G726–729.
28. Karhapää P, Malkki M, Laakso M. Isolated low HDL cholesterol. An insulin-resistant state. Diabetes 1994; 43 (3): 411–7.
29. Smelt AHM. Triglycerides and gallstone formation. Clin Chim Acta 2010; 411 (21–22): 1625–31.
30. Alipour A, van Oostrom AJHHM, Izraeljan A et al. Leukocyte activation by triglyceride-rich lipoproteins. Arterioscler Thromb Vasc Biol 2008; 28 (4): 792–7.
________________________________________________
1. Peery AF, Crockett SD, Barritt AS et al. Burden of Gastrointestinal, Liver, and Pancreatic Diseases in the United States. Gastroenterology 2015; 149 (7): 1731–41.e3
2. Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet 2006; 368 (9531): 230–9.
3. Chowdhury MZI, Anik AM, Farhana Z et al. Prevalence of metabolic syndrome in Bangladesh: a systematic review and meta-analysis of the studies. BMC Public Health 2018; 18: 308.
4. Lin I-C, Yang Y-W, Wu M-F et al. The association of metabolic syndrome and its factors with gallstone disease. BMC Fam Pract 2014; 15: 138.
5. Zhu Q, Sun X, Ji X et al. The association between gallstones and metabolic syndrome in urban Han Chinese: a longitudinal cohort study. Sci Rep 2016; 22 (6): 29937.
6. Shen H-C, Hu Y-C, Chen Y-F, Tung T-H. Prevalence and Associated Metabolic Factors of Gallstone Disease in the Elderly Agricultural and Fishing Population of Taiwan. Gastroenterol Res Pract 2014; 2014: 876918.
7. Osadchuk M.A., Kireeva N.V., Vasilyeva I.N., Mironova E.D. Effect of severity of metabolic disorders on the diameter of stones in the gallbladder: clinical, instrumental and laboratory data. Terapiya. 2019; 3 (29): 55–9 (in Russian).
8. Chen L-Y, Qiao Q-H, Zhang S-C et al. Metabolic syndrome and gallstone disease. World J Gastroenterol 2012; 18 (31): 4215–20.
9. Shabanzadeh DM, Skaaby T, Sørensen LT et al. Metabolic biomarkers and gallstone disease – a population-based study. Scand J Gastroenterol 2017; 52 (11): 1270–7.
10. Chang Y, Sung E, Ryu S et al. Insulin resistance is associated with gallstones even in non-obese, non-diabetic Korean men. J Korean Med Sci 2008; 23 (4): 644–50.
11. Shaffer EA. Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century? Curr Gastroenterol Rep 2005; 7 (2): 132–40.
12. Osadchuk MA, Mironova ED, Vasileva IN et al. Oral medical dissolution of gallstones in patients with gallstone disease. Pren Méd Argent 2019; 105 (1): 34–40.
13. Ata N, Kucukazman M, Yavuz B et al. The metabolic syndrome is associated with complicated gallstone disease. Can J Gastroenterol 2011; 25 (5): 274–6.
14. Ahmed MJ, Mahmood R, Rana RS et al. Metabolic Syndrome: An Indicator of Complicated Gall Stone Disease? Cureus 2018; 10 (11): e3659
15. Sakorafas GH, Milingos D, Peros G. Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy. Dig Dis Sci 2007; 52 (5): 1313–25.
16. Schmidt M, Hausken T, Glambek I et al. A 24-year controlled follow-up of patients with silent gallstones showed no long-term risk of symptoms or adverse events leading to cholecystectomy. Scand J Gastroenterol 2011; 46 (7–8): 949–54.
17. Shabanzadeh DM, Sørensen LT, Jørgensen T. Determinants for symptomatic gallstone disease readmissions – results from a cohort with screen-detected gallstone disease. J Visc Surg 2019; S1878–7886(19): 30025–6
18. Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology 1999; 117 (3): 632–9.
19. Alberti KGMM, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120 (16): 1640–5.
20. Amigo L, Zanlungo S, Mendoza H et al. Risk factors and pathogenesis of cholesterol gallstones: state of the art. Eur Rev Med Pharmacol Sci 1999; 3 (6): 241–6.
21. Marques P, Collado A, Martinez-Hervás S et al. Systemic Inflammation in Metabolic Syndrome: Increased Platelet and Leukocyte Activation, and Key Role of CX3CL1/CX3CR1 and CCL2/CCR2 Axes in Arterial Platelet-Proinflammatory Monocyte Adhesion. J Clin Med 2019; 8 (5).
22. Collado A, Marques P, Escudero P et al. Functional role of endothelial CXCL16/CXCR6-platelet-leucocyte axis in angiotensin II-associated metabolic disorders. Cardiovasc Res 2018; 114 (13): 1764–75.
23. Mazidi M, Toth PP, Banach M. C-reactive Protein Is Associated With Prevalence of the Metabolic Syndrome, Hypertension, and Diabetes Mellitus in US Adults. Angiology 2018; 69 (5): 438–42.
24. Fairfield CJ, Wigmore SJ, Harrison EM. Gallstone Disease and the Risk of Cardiovascular Disease. Sci Rep 2019; 9: 5830.
25. Liew P-L, Wang W, Lee Y-C et al. Gallbladder disease among obese patients in Taiwan. Obes Surg 2007; 17 (3): 383–90.
26. Fiorito G, Vlaanderen J, Polidoro S et al. Oxidative stress and inflammation mediate the effect of air pollution on cardio- and cerebrovascular disease: A prospective study in nonsmokers. Environ Mol Mutagen 2018; 59 (3): 234–46.
27. Greenwood B, Tremblay L, Davison JS. Sympathetic control of motility, fluid transport, and transmural potential difference in the rabbit ileum. Am J Physiol 1987; 253 (6 Pt 1): G726–729.
28. Karhapää P, Malkki M, Laakso M. Isolated low HDL cholesterol. An insulin-resistant state. Diabetes 1994; 43 (3): 411–7.
29. Smelt AHM. Triglycerides and gallstone formation. Clin Chim Acta 2010; 411 (21–22): 1625–31.
30. Alipour A, van Oostrom AJHHM, Izraeljan A et al. Leukocyte activation by triglyceride-rich lipoproteins. Arterioscler Thromb Vasc Biol 2008; 28 (4): 792–7.
Авторы
М.А. Осадчук*1, Е.Д. Миронова1, Д.В.Балашов2, М.М. Осадчук2
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ГБУЗ «Городская поликлиника №52» Департамента здравоохранения г. Москвы, Москва, Россия
*osadchuk.mikhail@yandex.ru
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ГБУЗ «Городская поликлиника №52» Департамента здравоохранения г. Москвы, Москва, Россия
*osadchuk.mikhail@yandex.ru
________________________________________________
Mikhail A. Osadchuk*1, Ekaterina D. Mironova1, Dmitrii V. Balashov2, Maksim M. Osadchuk2
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 City Clinical Hospital №52, Moscow, Russia
*osadchuk.mikhail@yandex.ru
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 City Clinical Hospital №52, Moscow, Russia
*osadchuk.mikhail@yandex.ru
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