Metabesity – патогенетические основы и возможности предикции

Оразов М.Р., Радзинский В.Е., Хамошина М.Б., Долгов Е.Д., Муллина И.А., Артеменко Ю.С., Рябова В.А. Metabesity – патогенетические основы и возможности предикции. Гинекология. 2023;25(4):416–423.
DOI: 10.26442/20795696.2023.4.202520

© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.

________________________________________________

Orazov MR, Radzinsky VE, Khamoshina MB, Dolgov ED, Mullina IA, Artemenko YuS, Ryabova VA. Metabesity: pathogenetic bases and predictive capabilities. A review. Gynecology. 2023;25(4):416–423.
DOI: 10.26442/20795696.2023.4.202520

Читать PDF

Аннотация

Одной из самых актуальных проблем современности является ожирение, признанное Всемирной организацией здравоохранения пандемией XXI века. Важно помнить, что ожирение является полноценной нозологической единицей, однако многие женщины полагают, что ожирение – лишь проблема красоты и эстетики. Необходимо отметить, что данная нозология влечет за собой ряд грозных последствий: начиная с развития сердечно-сосудистых заболеваний и заканчивая онкологическими. Однако «проблемой в проблеме» является так называемый metabesity – новый термин, отображающий целый ряд заболеваний, в основе патогенеза которых лежит метаболический синдром. Ожирение, метаболический синдром и metabesity – вроде бы разные понятия, однако абсолютная идентичность патогенетической основы характеризует их как последовательные стадии одного глобального процесса. В этой связи освещены ключевые механизмы развития описанных нарушений и рассмотрена концепция клинического менеджмента пациенток данной когорты.

Ключевые слова: ожирение, артериальная гипертония, инсулинорезистентность, metabesity

________________________________________________

One of the most pressing problems of our time is obesity, recognized by the WHO as a pandemic of the XXI century. It is important to remember that obesity is a full-fledged nosological entity, but many women think that obesity is just a problem of beauty and aesthetics. It is important to note that this nosology has a number of serious consequences, starting with the development of cardiovascular disease and ending with cancer. However, the “problem in the problem” is the so-called “metabesity” – a new term that reflects a number of diseases, the pathogenesis of which is based on the metabolic syndrome. Obesity, metabolic syndrome and metabesity seem to be different concepts, but the absolute identity of the pathogenetic basis characterizes them as successive stages of one global process. In this regard, it is necessary to highlight the key mechanisms of the development of the described disorders and to consider the concept of clinical management of patients in this cohort.

Keywords: obesity, arterial hypertension, insulin resistance, metabesity, peptide therapy

Полный текст

Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.

Список литературы

1. World health organization, 2022.
2. WHO. Obesity and overweight. Available at: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight. Accessed: 15.03.2023.
3. Успенский Ю.П., Петренко Ю.В., Гулунов З.Х., и др. Метаболический синдром. Учебное пособие. СПб. 2017 [Uspenskii IuP, Petrenko IuV, Gulunov ZKh, et al. Metabolicheskii sindrom. Uchebnoie posobiye. Saint Petersburg. 2017 (in Russian)].
4. Fasshauer M, Blüher M. Adipokines in health and disease. Trends in Pharmacological Sciences. 2015;36(7):461-70.
5. Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clinical Chemistry. 2004;50(9):1511-25.
6. Hetemäki N, Mikkola TS, Tikkanen MJ, et al. Adipose tissue estrogen production and metabolism in premenopausal women. The Journal of Steroid Biochemistry and Molecular Biology. 2021;209:105849.
7. Радзинский В., Хамошина М., Раевская О., и др. Очерки по эндокринной гинекологии. От синдрома к диагнозу и выбору терапии. М. 2020 [Radzinskii V, Khamoshina M, Rayevskaya O, et al. Ocherki po endokrinnoi ginekologii. Ot sindroma k diagnozu i vyboru terapii. Moscow. 2020 (in Russian)].
8. Mazon JN, de Mello AH, Ferreira GK, Rezin GT. The impact of obesity on neurodegenerative diseases. Life Sciences. 2017;182:22-8.
9. Fan YC, Chou CC, You SL, et al. Impact of worsened metabolic syndrome on the risk of dementia: a nationwide cohort study. J Am Heart Assoc. 2017;6(9):e004749. DOI:10.1161/JAHA.116.004749
10. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol. 2011;11(2):85-97.
11. Kahn CR, Wang G, Lee KY. Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome. J Clin Investig. 2019;129(10):3990-4000.
12. Feinstein R, Kanety H, Papa MZ, et al. Tumor necrosis factor-α suppresses insulin-induced tyrosine phosphorylation of insulin receptor and its substrates. J Biol Chem. 1993;268(35):26055-8.
13. Lee YS, Li P, Huh JY, et al. Inflammation is necessary for long-term but not short-term high-fat diet-induced insulin resistance. Diabetes. 2011;60(10):2474-83.
14. Fahed G, Aoun L, Bou Zerdan M, et al. Metabolic syndrome: Updates on pathophysiology and management in 2021. Int J Mol Sci. 2022;23(2):786.
15. Avgerinos KI, Spyrou N, Mantzoros CS, Dalamaga M. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism. 2019;92:121-35.
16. Оразов М.Р., Радзинский В.Е., Хамошина М.Б., и др. Metabesity у женщин: долгосрочные последствия для здоровья. Доктор.Ру. 2023;22(1):11-5 [Orazov MR, Radzinsky VE, Khamoshina MB, et al. Metabesity in women: long-term health effects. Doctor.Ru. 2023;22(1):11-5 (in Russian)]. DOI:10.31550/1727-2378-2023-22-1-11-15
17. Global Cancer Observatory. Available at: https://gco.iarc.fr. Accessed: 15.03.2023.
18. Tahergorabi Z, Khazaei M, Moodi M, Chamani E. From obesity to cancer: a review on proposed mechanisms. Cell Biochemistry and Function. 2016;34(8):533-45.
19. Raza SA, Mirza AMB, Hafizullah M, et al. Metabesity guideline: a pakistan perspective. Journal of the Pakistan Medical Association. 2021;71(5):S17-33.
20. Мироненко А.Ю., Шаргакшанова И.З., Крохмаль Е.В., и др. Индекс инсулинорезистентности в диагностике гестационного сахарного диабета. Медицина завтрашнего дня. 2017:159-60 [Mironenko AIu, Shargakshanova IZ, Krokhmal' EV, et al. Indeks insulinorezistentnosti v diagnostike gestatsionnogo sakharnogo diabeta. Meditsina zavtrashnego dnia. 2017:159-60 (in Russian)].
21. Мадянов И.В. Косвенные способы оценки инсулинорезистентности при метаболическом синдроме. РМЖ. 2021;2:10-2 [Madyanov IV. Indirect methods for assessing insulin resistance in metabolic syndrome. RMJ. 2021;2:10-2 (in Russian)].
22. National Institute for Health and Care Excellence: «Obesity: identification, assessment and management». 2022.
23. Di Vincenzo O, Marra M, Sacco AM, et al. Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review. Clin Nutr. 2021;40(9):5238-48.
24. Eckel RH, Alberti KG, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2010;375(9710):181-3.
25. Шпилевская Ю.Р., Штонда М.В. Метаболический синдром: современные аспекты диагностики и лечения. Медицинские новости. 2021;5(320) [Shpilevskaya IuR, Shtonda MV. Metabolicheskii sindrom: sovremennyie aspekty diagnostiki i lecheniia. Meditsinskiie novosti. 2021;5(320) (in Russian)].
26. le Roux CW, Astrup A, Fujioka K, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017;8:1399-409. DOI:10.1016/S0140-6736(17)30069-7
27. Wilding JPH. STEP 1+2: signifikante Gewichtsreduktion unter Semaglutid vs. Placebo. J Med. 2021;384:989-1002.
28. Krome S. STEP 4: langfristig abnehmen mit Semaglutid. Diabetologie und Stoffwechsel. 2021;16(04):256.
29. Garvey T, Batterham R, Bhatta M, et al. Wirkung von Semaglutid 2, 4 mg vs. Placebo über 2 Jahre bei Erwachsenen mit Adipositas (STEP 5)(#7). Adipositas-Ursachen, Folgeerkrankungen, Therapie. 2022;16(03):V-06.

________________________________________________

1. World health organization, 2022.
2. WHO. Obesity and overweight. Available at: https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight. Accessed: 15.03.2023.
3. Uspenskii IuP, Petrenko IuV, Gulunov ZKh, et al. Metabolicheskii sindrom. Uchebnoie posobiye. Saint Petersburg. 2017 (in Russian).
4. Fasshauer M, Blüher M. Adipokines in health and disease. Trends in Pharmacological Sciences. 2015;36(7):461-70.
5. Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clinical Chemistry. 2004;50(9):1511-25.
6. Hetemäki N, Mikkola TS, Tikkanen MJ, et al. Adipose tissue estrogen production and metabolism in premenopausal women. The Journal of Steroid Biochemistry and Molecular Biology. 2021;209:105849.
7. Radzinskii V, Khamoshina M, Rayevskaya O, et al. Ocherki po endokrinnoi ginekologii. Ot sindroma k diagnozu i vyboru terapii. Moscow. 2020 (in Russian).
8. Mazon JN, de Mello AH, Ferreira GK, Rezin GT. The impact of obesity on neurodegenerative diseases. Life Sciences. 2017;182:22-8.
9. Fan YC, Chou CC, You SL, et al. Impact of worsened metabolic syndrome on the risk of dementia: a nationwide cohort study. J Am Heart Assoc. 2017;6(9):e004749. DOI:10.1161/JAHA.116.004749
10. Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol. 2011;11(2):85-97.
11. Kahn CR, Wang G, Lee KY. Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome. J Clin Investig. 2019;129(10):3990-4000.
12. Feinstein R, Kanety H, Papa MZ, et al. Tumor necrosis factor-α suppresses insulin-induced tyrosine phosphorylation of insulin receptor and its substrates. J Biol Chem. 1993;268(35):26055-8.
13. Lee YS, Li P, Huh JY, et al. Inflammation is necessary for long-term but not short-term high-fat diet-induced insulin resistance. Diabetes. 2011;60(10):2474-83.
14. Fahed G, Aoun L, Bou Zerdan M, et al. Metabolic syndrome: Updates on pathophysiology and management in 2021. Int J Mol Sci. 2022;23(2):786.
15. Avgerinos KI, Spyrou N, Mantzoros CS, Dalamaga M. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism. 2019;92:121-35.
16. Orazov MR, Radzinsky VE, Khamoshina MB, et al. Metabesity in women: long-term health effects. Doctor.Ru. 2023;22(1):11-5 (in Russian). DOI:10.31550/1727-2378-2023-22-1-11-15
17. Global Cancer Observatory. Available at: https://gco.iarc.fr. Accessed: 15.03.2023.
18. Tahergorabi Z, Khazaei M, Moodi M, Chamani E. From obesity to cancer: a review on proposed mechanisms. Cell Biochemistry and Function. 2016;34(8):533-45.
19. Raza SA, Mirza AMB, Hafizullah M, et al. Metabesity guideline: a pakistan perspective. Journal of the Pakistan Medical Association. 2021;71(5):S17-33.
20. Mironenko AIu, Shargakshanova IZ, Krokhmal' EV, et al. Indeks insulinorezistentnosti v diagnostike gestatsionnogo sakharnogo diabeta. Meditsina zavtrashnego dnia. 2017:159-60 (in Russian).
21. Madyanov IV. Indirect methods for assessing insulin resistance in metabolic syndrome. RMJ. 2021;2:10-2 (in Russian).
22. National Institute for Health and Care Excellence: «Obesity: identification, assessment and management». 2022.
23. Di Vincenzo O, Marra M, Sacco AM, et al. Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review. Clin Nutr. 2021;40(9):5238-48.
24. Eckel RH, Alberti KG, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2010;375(9710):181-3.
25. Shpilevskaya IuR, Shtonda MV. Metabolicheskii sindrom: sovremennyie aspekty diagnostiki i lecheniia. Meditsinskiie novosti. 2021;5(320) (in Russian).
26. le Roux CW, Astrup A, Fujioka K, et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial. Lancet. 2017;8:1399-409. DOI:10.1016/S0140-6736(17)30069-7
27. Wilding JPH. STEP 1+2: signifikante Gewichtsreduktion unter Semaglutid vs. Placebo. J Med. 2021;384:989-1002.
28. Krome S. STEP 4: langfristig abnehmen mit Semaglutid. Diabetologie und Stoffwechsel. 2021;16(04):256.
29. Garvey T, Batterham R, Bhatta M, et al. Wirkung von Semaglutid 2, 4 mg vs. Placebo über 2 Jahre bei Erwachsenen mit Adipositas (STEP 5)(#7). Adipositas-Ursachen, Folgeerkrankungen, Therapie. 2022;16(03):V-06.

Авторы

М.Р. Оразов*, В.Е. Радзинский, М.Б. Хамошина, Е.Д. Долгов, И.А. Муллина, Ю.С. Артеменко, В.А. Рябова

ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия
*omekan@mail.ru

________________________________________________

Mekan R. Orazov*, Viktor E. Radzinsky, Marina B. Khamoshina, Evgeny D. Dolgov, Irina A. Mullina, Yulia S. Artemenko, Valentina A. Ryabova

People’s Friendship University of Russia (RUDN University), Moscow, Russia
*omekan@mail.ru

Назад к списку

Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.