medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-324medsovet-10423Research ArticleКАРДИОЛОГИЯCARDIOLOGYЭффективность и безопасность тирзепатида в лечении ожирения и ассоциированных с ним коморбидных состоянийEfficacy and safety of tirzepatide in the treatment of obesity and obesity-associated comorbiditieshttps://orcid.org/0000-0002-7102-5323СахноваЕ. Е.SakhnovaE. E.

Сахнова Екатерина Евгеньевна, соискатель кафедры терапии и полиморбидной патологии имени академика М.С. Вовси, Российская медицинская академия непрерывного профессионального образования; врачэндокринолог, ООО «Скандинавский Центр Здоровья»

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

111024, Москва, ул. 2-я Кабельная, д. 2, стр. 25, 26, 37

 

Ekaterina E. Sakhnova, Applicant of the Department of Internal Medicine and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Endocrinologist, Scandinavian Health Center LLC

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

2, Bldg. 25, 26, 37, 2nd Kabelnaya St., Moscow, 111024

sakhnova.ee@gmail.comhttps://orcid.org/0000-0003-4624-9189ГавриловаН. Е.GavrilovaN. E.

Гаврилова Наталья Евгеньевна, д.м.н., профессор кафедры терапии и полиморбидной патологии имени академика М.С. Вовси, Российская медицинская академия непрерывного профессионального образования; генеральный директор, главный врач, ООО «Скандинавский Центр Здоровья»

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

111024, Москва, ул. 2-я Кабельная, д. 2, стр. 25, 26, 37

 

Natalia E. Gavrilova, Dr. Sci. (Med.), Professor of the Department of Internal Medicine and Polymorbid Pathology named after AcademicianM.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Chief Executive Officer, Chief Physician, Scandinavian Health Center LLC

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

2, Bldg. 25, 26, 37, 2nd Kabelnaya St., Moscow, 111024

gavrilova_n@scz.ruhttps://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна, д.м.н., профессор, заведующая кафедрой терапии и полиморбидной патологии имени академика М.С. Вовси, Российская медицинская академия непрерывного профессионального образования; профессор кафедры клинической фармакологии и пропедевтики внутренних болезней, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет);

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Department of Internal Medicine and Polymorbid Pathology named after AcademicianM.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, Sechenov First Moscow State Medical University (Sechenov University)

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

8, Bldg. 2, Trubetskaya St., Moscow, 119048

ostroumova.olga@mail.ruhttps://orcid.org/0000-0001-5801-3742КочетковА. И.KochetkovА. I.

Кочетков Алексей Иванович, к.м.н., доцент, доцент кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

 

Alexey I. Kochetkov, Cand. Sci. (Med.), Associate Professor of the Department of Internal Medicine and Polymorbid Pathology named after Academician M.S. Vovsi

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

ak_info@list.ruhttps://orcid.org/0000-0003-1439-7371ТелковаС. С.TelkovaS. S.

Телкова Светлана Сергеевна, ассистент, старший лаборант, аспирант кафедры терапии и полиморбидной патологии имени академика М.С. Вовси

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Svetlana S. Telkova, Assistant Professor, Senior Laboratory Assistant, Postgraduate Student of the Department of Internal Medicine and Polymorbid Pathology named after Academician M.S. Vovsi

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

svetlana.t03@yandex.ruhttps://orcid.org/0009-0009-0029-4209МоряковаЮ. С.MoryakovaYu. S.

Морякова Юлия Станиславовна, соискатель кафедры терапии и полиморбидной патологии имени академика М.С. Вовси, Российская медицинская академия непрерывного профессионального образования; врач-кардиолог, ООО «Скандинавский Центр Здоровья»

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1,

111024, Москва, ул. 2-я Кабельная, д. 2, стр. 25, 26, 37

Yulia S. Moryakova, Applicant of the Department of Internal Medicine and Polymorbid Pathology named after Academician M.S. Vovsi, Russian Medical Academy of Continuous Professional Education; Cardiologist, Scandinavian Health Center LLC

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993,

2, Bldg. 25, 26, 37, 2nd Kabelnaya St., Moscow, 111024

Serebryakova-U20@mail.ruРоссийская медицинская академия непрерывного профессионального образования; ООО «Скандинавский Центр Здоровья»РоссияRussian Medical Academy of Continuous Professional Education; Scandinavian Health Center LLCRussian FederationРоссийская медицинская академия непрерывного профессионального образования; ООО «Скандинавский Центр Здоровья»РоссияRussian Medical Academy of Continuous Professional Education; Scandinavian Health Center LLCRussian FederationРоссийская медицинская академия непрерывного профессионального образования; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияRussian Medical Academy of Continuous Professional Education; Sechenov First Moscow State Medical University (Sechenov University)Russian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation2026210920260131526Copyright © Сахнова Е.Е., Гаврилова Н.Е., Остроумова О.Д., Кочетков А.И., Телкова С.С., Морякова Ю.С., 20262026Сахнова Е.Е., Гаврилова Н.Е., Остроумова О.Д., Кочетков А.И., Телкова С.С., Морякова Ю.С.Sakhnova E.E., Gavrilova N.E., Ostroumova O.D., Kochetkov А.I., Telkova S.S., Moryakova Y.S.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/10423

Цель настоящей публикации – продемонстрировать эффективность применения тирзепатида у пациента с ожирением и ассоциированными коморбидными состояниями в условиях реальной клинической практики. Представлено клиническое наблюдение пациента 36 лет с ожирением II степени, артериальной гипертензией, нарушенной толерантностью к глюкозе, гиперлипидемией, гиперурикемией и метаболически ассоциированной жировой болезнью печени. Исходно масса тела пациента составляла 126 кг, индекс массы тела – 38 кг/м2, окружность талии – 117 см. Пациенту были рекомендованы модификация образа жизни и терапия тирзепатидом с постепенной титрацией дозы до 12,5 мг 1 раз в неделю. Через 15 мес. терапии масса тела снизилась до 91 кг (-27,8%), индекс массы тела – до 27,8 кг/м2, окружность талии – до 94 см. Отмечено улучшение композиционного состава тела в виде уменьшения массы жировой ткани при сохранении мышечного компонента. На фоне лечения достигнута нормализация показателей углеводного обмена, липидного профиля, уровня мочевой кислоты и артериального давления. По данным эхокардиографии отмечалось уменьшение толщины эпикардиальной жировой ткани. Клинически значимых нежелательных явлений на протяжении периода наблюдения зарегистрировано не было. Тирзепатид является перспективным терапевтическим инструментом для лечения ожирения у пациентов с кардиометаболическими нарушениями. В условиях реальной практики применение препарата позволяет достигать выраженного снижения массы тела, сопровождающегося благоприятной динамикой показателей углеводного, липидного и пуринового обмена, а также снижением сердечно-сосудистого риска. Особый интерес представляет возможность уменьшения жирового компонента массы тела при сохранении мышечной ткани. Хорошая переносимость терапии и отсутствие значимых нежелательных явлений подтверждают высокий терапевтический потенциал тирзепатида у пациентов с осложненным ожирением и коморбидной патологией.

The aim of this publication is to demonstrate the efficacy of tirzepatide in a patient with obesity and obesity-associated comorbidities in a real-world clinical setting. A case report of a 36-year-old patient with obesity, arterial hypertension, impaired glucose tolerance, dyslipidemia, hyperuricemia, and metabolic dysfunction-associated steatotic liver disease is presented. At baseline, body weight was 126 kg, body mass index was 38 kg/m2, and waist circumference was 117 cm. The patient was recommended lifestyle modification and treatment with tirzepatide, with gradual dose escalation to 12.5 mg once weekly. After 15 months of therapy, body weight decreased to 91 kg (-27.8%), body mass index to 27.8 kg/m2, and waist circumference to 94 cm. Body composition analysis demonstrated a reduction in adipose tissue mass with preservation of skeletal muscle mass. Normalization of blood levels of glucose, lipids, uric acid, and blood pressure parameters was achieved during treatment. Echocardiography demonstrated a reduction in epicardial adipose tissue thickness. No clinically significant adverse events were observed throughout the treatment period. Tirzepatide may provide clinically meaningful benefits in the treatment of obesity in patients with cardiometabolic disorders. Its use is associated with substantial weight loss, improvement in glycemic control, lipid profile, and uric acid levels, as well as lower cardiovascular risk. Of particular interest is the reduction in adipose tissue mass while preserving skeletal muscle mass. Tirzepatide has shown multifaceted metabolic effects, along with manageable adverse profiles, which makes it a promising therapeutic agent for addressing obesity and associated comorbidities.

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