Почечные исходы бариатрических операций у пациентов с сахарным диабетом 2-го типа
Почечные исходы бариатрических операций у пациентов с сахарным диабетом 2-го типа
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Аннотация
В статье приведен обзор литературы, посвященной проблеме влияния бариатрических операций на течение диабетической нефропатии у больных сахарным диабетом 2-го типа после достижения хирургически индуцированной ремиссии. Показаны положительные аспекты радикальной лечебной тактики, такие как снижение уровня креатинина, уменьшение альбуминурии, увеличение скорости клубочковой фильтрации, нормализация гликемии и артериального давления, прямое влияние «инкретинового эффекта» на почки. Представлены описания предполагаемых на настоящий момент патогенетических механизмов, участвующих в достижении наблюдаемого улучшения микрососудистых осложнений диабета, а именно – диабетической болезни почек.
Ключевые слова: сахарный диабет 2-го типа, осложнения, морбидное ожирение, бариатрические операции, хроническая болезнь почек, глюкагоноподобный пептид 1-го типа, рецептор(ы) глюкагоноподобного пептида-1, инкретины.
Keywords: diabetes mellitus type 2, complications, morbid obesity, bariatric surgery, chronic kidney disease, glucagon-like peptide-1, glucagon-like peptide-1 receptor, incretins.
Ключевые слова: сахарный диабет 2-го типа, осложнения, морбидное ожирение, бариатрические операции, хроническая болезнь почек, глюкагоноподобный пептид 1-го типа, рецептор(ы) глюкагоноподобного пептида-1, инкретины.
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Keywords: diabetes mellitus type 2, complications, morbid obesity, bariatric surgery, chronic kidney disease, glucagon-like peptide-1, glucagon-like peptide-1 receptor, incretins.
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2. [Shestakova MV, Shamkhalova MSh, Yarek-Martynova IYa, Klefortova II, Sukhareva OYu, Vikulova OYu, Zaitseva NV, Martynov SA, Kvaratskheliya MV, Tarasov EV, Trubitcyna NP. Diabetes mellitus and chronic kidney disease: achievements, unresolved problems, and prospects for therapy. Sakharnyy Diabet = Diabetes Mellitus. 2011;14(1):81-88 (In Russ.)]. doi: 10.14341/2072-0351-6254
3. Friedman AN, Wolfe B. Is Bariatric Surgery an Effective Treatment for Type II Diabetic Kidney Disease? Clin J Am Soc Nephrol. 2016;11(3):528-535. doi: 10.2215/CJN.07670715
4. Cohen R, Pechy F, Petry T, Correa JL, Caravatto PP, Tzanno-Martins C. Bariatric and metabolic surgery and microvascular complications of type 2 diabetes mellitus. J Bras Nefrol. 2015;37(3). doi: 10.5935/0101-2800.20150061
5. Ritz E. Bariatric surgery and the kidney – much benefit, but also potential harm. Clin Kidney J. 2013;6(4):368-372. doi: 10.1093/ckj/sfs161
6. Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD. Obesity-related glomerulopathy: an emerging epidemic. Kidney Int. 2001;59(4):1498-1509.
7. Li K, Zou J, Ye Z, et al. Effects of Bariatric Surgery on Renal Function in Obese Patients: A Systematic Review and Meta Analysis. Joles JA, ed. PLoS One. 2016;11(10):e0163907. doi: 10.1371/journal.pone.0163907
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9. [Shestakova MV, Sklyanik IA, Dedov II. Is prolonged remission or cure of type 2 diabetes mellitus possible in the 21st century? Terapevticheskiy Arkhiv = Therapeutic Archive. 2017;89(10):4-11 (In Russ.)]. doi: 10.17116/terarkh201789104-11
10. Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes. N Engl J Med. 2013;369(2):145-154. doi: 10.1056/NEJ Moa1212914
11. Effect of a long-term behavioural weight loss intervention on nephropathy in overweight or obese adults with type 2 diabetes: a secondary analysis of the Look AHEAD randomised clinical trial. Lancet Diabetes Endocrinol. 2014;2(10):801-809. doi: 10.1016/S2213-8587(14)70156-1
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43. Hou C-C, Shyu R-S, Lee W-J, Ser K-H, Lee Y-C, Chen S-C. Improved renal function 12 months after bariatric surgery. Surg Obes Relat Dis. 2013;9(2):202-206. doi: 10.1016/j.soard.2012.10.005
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45. Bueter M, Dubb SS, Gill A, et al. Renal cytokines improve early after bariatric surgery. Br J Surg. 2010;97(12):1838-1844. doi: 10.1002/bjs.7264
46. Brethauer SA, Aminian A, Romero-Talamás H, et al. Can Diabetes Be Surgically Cured? Long-Term Metabolic Effects of Bariatric Surgery in Obese Patients with Type 2 Diabetes Mellitus. Ann Surg. 2013 Sep:1. doi: 10.1097/SLA.0b013e3182a5034b.
47. Jose B, Ford S, Super P, Thomas GN, Dasgupta I, Taheri S. The effect of biliopancreatic diversion surgery on renal function-
a retrospective study. Obes Surg. 2013 May;23(5):634-637. doi: 10.1007/s11695-012-0851-5
48. Chang AR, Chen Y, Still C, et al. Bariatric surgery is associated with improvement in kidney outcomes. Kidney Int. 2016;90(1):164-171. doi: 10.1016/j.kint.2016.02.039
49. Afsar B, Vaziri ND, Aslan G, Tarim K, Kanbay M. Gut hormones and gut microbiota: implications for kidney function and hypertension. J Am Soc Hypertens. 2016;10(12):954-961. doi: 10.1016/j.jash.2016.10.007
50. [Yashkov YuI, Ershova EV. Metabolic Surgery. Ozhirenie i Metabolizm = Obesity and Metabolism. 82011;8(3):13-17 (In Russ.)]. doi: 10.14341/2071-8713-4831
51. Laferrere B, Heshka S, Wang K, et al. Incretin Levels and Effect Are Markedly Enhanced 1 Month After Roux-en-Y Gastric Bypass Surgery in Obese Patients With Type 2 Diabetes. Diabetes Care. 2007;30(7):1709-1716. doi: 10.2337/dc06-1549
52. Lang F, Ottl I, Häussinger D, Deetjen P, Ahloulay M, Bankir L. Renal hemodynamic response to intravenous and oral amino acids in animals. Semin Nephrol. 1995 Sep;15(5):415-8.
53. Moreno C, Mistry M, Roman RJ. Renal effects of glucagon-like peptide in rats. Eur J Pharmacol. 2002;434(3):163-167. doi: 10.1016/S0014-2999(01)01542-4
54. Buchwald H, Estok R, Fahrbach K, Banel D, Sledge I. Trends in mortality in bariatric surgery: A systematic review and meta-analysis. Surgery. 2007;142(4):621-635. doi: 10.1016/j.surg.2007.07.018
55. [Shestakova EA, Il'in AV, Shestakova MV, Dedov II. Glucose-dependent insulinotropic polypeptide — a new link in the development of obesity. Ozhirenie i Metabolizm = Obesity and Metabolism. 2015;12(1):16-19 (In Russ.)]. doi: 10.14341/OMET2015116-19
56. Tanner RM, Brown TM, Muntner P. Epidemiology of Obesity, the Metabolic Syndrome, and Chronic Kidney Disease. Curr Hypertens Rep. 2012;14(2):152-159. doi: 10.1007/s11906-012-0254-y
57. Fujita H, Morii T, Fujishima H, et al. The protective roles of GLP-1R signaling in diabetic nephropathy: possible mechanism and therapeutic potential. Kidney Int. 2014;85(3):579-589. doi: 10.1038/ki.2013.427
58. Schlatter P, Beglinger C, Drewe J, Gutmann H. Glucagon-like peptide 1 receptor expression in primary porcine proximal tubular cells. Regul Pept. 2007;141(1-3):120-128. doi: 10.1016/j.regpep.2006.12.016
59. Miyawaki K, Yamada Y, Ban N, et al. Inhibition of gastric inhibitory polypeptide signaling prevents obesity. Nat Med. 2002;8(7):738-742. doi: 10.1038/nm727
60. Fulurija A, Lutz TA, Sladko K, et al. Vaccination against GIP for the Treatment of Obesity. Bartolomucci A, ed. PLoS One. 2008;3(9):e3163. doi: 10.1371/journal.pone.0003163
61. Ronn J, Jensen EP, Wewer Albrechtsen NJ, Holst JJ, Sorensen CM. Glucagon-like peptide-1 acutely affects renal blood flow and urinary flow rate in spontaneously hypertensive rats despite significantly reduced renal expression of GLP-1 receptors. Physiol Rep. 2017;5(23):e13503. doi: 10.14814/phy2.13503
62. Kim M, Platt MJ, Shibasaki T, et al. GLP-1 receptor activation and Epac2 link atrial natriuretic peptide secretion to control of blood pressure. Nat Med. 2013;19(5):567-575. doi: 10.1038/nm.3128
63. Yu M, Moreno C, Hoagland KM, Dahly A, Ditter K, Mistry M, Roman RJ. Antihypertensive effect of glucagon-like peptide 1 in Dahl salt-sensitive rats. J Hypertens. 2003 Jun;21(6):1125-1135. doi: 10.1097/01.hjh.0000059046.65882.49
64. Gutzwiller JP, Tschopp S, Bock A, Zehnder CE, Huber AR, Kreyenbuehl M, Gutmann H, Drewe J, Henzen C, Goeke B, Beglinger C. Glucagon-like peptide 1 induces natriuresis in healthy subjects and in insulin-resistant obese men. J Clin Endocrinol Metab. 2004 Jun;89(6):3055-3061. doi: 10.1210/jc.2003-031403
65. Tonneijck L, Smits MM, Muskiet MHA, et al. Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients: a randomised, double-blind, placebo-controlled trial. Diabetologia. 2016;59(7):1412-1421. doi: 10.1007/s00125-016-3938-z
66. Skov J, Pedersen M, Holst JJ, et al. Short-term effects of liraglutide on kidney function and vasoactive hormones in type 2 diabetes: a randomized clinical trial. Diabetes Obes Metab. 2016;18(6):581-589. doi: 10.1111/dom.12651
67. Von Scholten BJ, Persson F, Rosenlund S, et al. The effect of liraglutide on renal function: A randomized clinical trial. Diabetes Obes Metab. 2017;19(2):239-247. doi: 10.1111/dom.12808
68. Thakar CV, Kharat V, Blanck S, Leonard AC. Acute kidney injury after gastric bypass surgery. Clin J Am Soc Nephrol. 2007 May;2(3):426-430.
69. [Petrosyan EK. Podocyte: a structure and a role in development nephrotic syndrome. Review. Nefrologiya i Dializ = Nephrology and Dialysis. 2006;8(2):112-121 (In Russ.)].
70. Zhang Q, Davis KJ, Hoffmann D, Vaidya VS, Brown RP, Goering PL. Urinary biomarkers track the progression of nephropathy in hypertensive and obese rats. Biomark Med. 2014;8(1):85-94. doi: 10.2217/bmm.13.106
71. Canales BK, Reyes L, Reinhard MK, Khan SR, Goncalves CG, Meguid MM. Renal glomerular and tubular injury after gastric bypass in obese rats. Nutrition. 2012;28(1):76-80. doi: 10.1016/j.nut.2011.03.003
72. Koukoulaki M, Spyropoulos C, Hondrogiannis P, et al. Neutrophil Gelatinase-Associated Lipocalin as a Biomarker of Acute Kidney Injury in Patients with Morbid Obesity Who Underwent Bariatric Surgery. Nephron Extra. 2013;3(1):101-105. doi: 10.1159/000354892
73. Prajczer S, Heidenreich U, Pfaller W, Kotanko P, Lhotta K, Jennings P. Evidence for a role of uromodulin in chronic kidney disease progression. Nephrol Dial Transplant. 2010;25(6):1896-1903. doi: 10.1093/ndt/gfp748
74. De Silva PMCS, Mohammed Abdul KS, Eakanayake EMDV, et al. Urinary Biomarkers KIM-1 and NGAL for Detection of Chronic Kidney Disease of Uncertain Etiology (CKDu) among Agricultural Communities in Sri Lanka. Vinetz JM, ed. PLoS Negl Trop Dis. 2016;10(9):e0004979. doi: 10.1371/journal.pntd.0004979
Авторы
И.И. Ларина, А.С. Северина, М.Ш. Шамхалова, М.В. Шестакова
ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, Москва, Россия
National Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia
ФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава России, Москва, Россия
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National Endocrinology Research Center, Ministry of Health of Russia, Moscow, Russia
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