medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-075medsovet-10018Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTСохранение репродуктивного здоровья женщин в контексте медикаментозной коррекции ожирения (тирзепатид)Maintaining women’s reproductive health in the context of drug-induced obesity correction (tirzepatide)https://orcid.org/0000-0002-7430-1207ЯкушевскаяО. В.YakushevskayaO. V.

Якушевская Оксана Владимировна, к.м.н., научный сотрудник отделения гинекологической эндокринологии

117997, Россия, Москва, ул. Академика Опарина, д. 4

Oksana V. Yakushevskaya, Cand. Sci. (Med.), Researcher at the Department of Gynecological Endocrinology

4, Academician Oparin St., Moscow, 117997, Russia

aluckyone777@gmail.comНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation202611052026043341Copyright © Якушевская О.В., 20262026Якушевская О.В.Yakushevskaya O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10018

Избыточный вес и ожирение – болезнь XXI в., при которой количественные и качественные метаморфозы жировой ткани способствуют развитию неблагоприятных метаболических, соматических и психосоциальных последствий. Вектор влияния ожирения на репродуктивное здоровье женщин носит многонаправленный характер и варьирует от проблем с фертильностью (дисфункция яичников, низкое качество ооцитов, нарушение имплантации, самопроизвольные выкидыши и даже проблемы со здоровьем плода) до развития гипер- и неопластических процессов в органах репродуктивной системы. Однако с появлением нового класса лекарственных средств (агонисты рецепторов глюкагоноподобного пептида-1, аГПП-1) можно добиться значительной потери веса, поддержать функциональный оптимум органов репродуктивной системы и снизить соответствующие кардиометаболические и онкологические риски. По мнению экспертов, их применение следует рассматривать на этапе предварительного консультирования. В настоящее время для эффективного снижения веса разработан тирзепатид, имеющий конкурентные преимущества перед аГПП-1. Это двойной агонист рецепторов ГПП-1 и глюкозозависимого инсулинотропного полипептида (ГИП) длительного действия. Тирзепатид снижает массу тела (6–30% от исходной общей массы тела) за счет увеличения секреции инсулина и чувствительности тканей к нему, снижения секреции глюкагона, задержки опорожнения желудка, липогенеза и влияния на пищевое поведение (снижение патологической тяги к еде и аппетита, повышение чувства насыщения). До появления аГПП-1 и тирзепатида бариатрическая хирургия считалась наиболее эффективным методом снижения веса, которая могла привести к значительной потере веса. Учитывая присущие хирургическому вмешательству риски, развитие дефицитных состояний по витаминам и минералам, бариатрическую хирургию не следует рассматривать в качестве терапии первой линии для коррекции ожирения. В настоящей статье будут представлены основные преимущества тирзепатида, которые можно продуктивно использовать с целью коррекции ожирения у женщин, имеющих те или иные нарушения репродуктивного здоровья.

Overweight and obesity are diseases of the 21st century, in which quantitative and qualitative changes in adipose tissue contribute to adverse metabolic, somatic, and psychosocial consequences. The impact of obesity on reproductive health is multifaceted and ranges from fertility problems to the development of hyperplastic and neoplastic processes in the reproductive organs. However, with the advent of a new class of pharmacological agents (glucagon-like peptide-1 receptor agonists, GLP-1RAs), significant weight loss can be achieved, optimal reproductive function can be maintained, and associated cancer and cardiometabolic risks can be reduced. Experts believe their use should be considered during preliminary consultation. Currently, tirzepatide, which has competitive advantages over GLP-1RAs, has been developed for effective weight loss. It is a dual agonist of the GLP-1 receptor and a long-acting glucose-dependent insulinotropic polypeptide (GIP) receptor. Tirzepatide reduces body weight by increasing insulin secretion and tissue sensitivity, reducing glucagon secretion, delaying gastric emptying, promoting lipogenesis, and influencing eating behavior. Before the advent of GLP-1 agonists and tirzepatide, bariatric surgery was considered the most effective weight loss method, capable of achieving significant weight loss. Given the inherent risks of surgery and the potential for vitamin and mineral deficiencies, bariatric surgery should not be considered a first-line treatment for obesity. This article will present the key benefits of tirzepatide, which can be effectively used to treat obesity in women with various reproductive health conditions.

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The authors declare that there are no conflicts of interest present.