medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-12-82-86medsovet-3138Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYНАЖБП и сердечно-сосудистые риски: клиника, диагностика, особенности терапииNafld and cardiovascular risks: clinic, diagnostic, features of therapyМязинР. Г.MyazinR. G.

Мязин Роман Геннадиевич - кандидат медицинских наук, врач-гастроэнтеролог, врач-терапевт высшей квалификационной категории, кафедра пропедевтики внутренних болезней.

400131, Волгоград, пл. Павших борцов, д. 1; тел.: +7 (8442) 98-92-95

Myazin Roman Gennadyevich - PhD, gastroenterologist, therapist of high graduate category, propaedeutic of internal diseases department.

naclo@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education «Volgograd State Medical University» of the Ministry of Health of the Russian FederationRussian Federation2019300820190128286Copyright © Мязин Р.Г., 20192019Мязин Р.Г.Myazin R.G.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/3138

Рассмотрена взаимосвязь неалкогольной жировой болезни печени (НАЖБП) и сердечно-сосудистых заболеваний (ССЗ). Главными механизмами повышения сердечно-сосудистых рисков, индуцированных НАЖБП, являются инсулинорезистентность, оксидативный стресс, эндотелиальная дисфункция и воспаление. Дислипидемия, артериальная гипертензия, сахарный диабет 2-го типа, часто присутствующие у больных с НАЖБП, также способствуют повышению сердечно-сосудистых рисков. Показано, что при прогрессировании НАЖБП, риск развития ССЗ увеличивается. Смертность больных НАЖБП обусловлена преимущественно развитием осложнений ССЗ. Таким образом, НАЖБП следует рассматривать как независимый фактор риска ССЗ. Лечение НАЖБП включает в себя модификацию образа жизни (диетотерапию, физическую активность), а также применение лекарственных средств из разных групп: омега-3 полиненасыщенных жирных кислот, статинов, S-аденозилметионина, эссен-циальных фосфолипидов, урсодезоксихолевой кислоты, метадоксина, глицирризиновой кислоты, витамина Е, препаратов растительного происхождения. В частности, оправданно использование фосфолипидов, обладающих высоким профилем безопасности и хорошей переносимостью при его использовании, в том числе при сочетании НАЖБП и ССЗ.

The relationship between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD) is considered. The main mechanisms for increasing the cardiovascular risks induced by NAFLD are insulin resistance, oxidative stress, endothelial dysfunction and inflammation. Dyslipidemia, arterial hypertension, type 2 diabetes mellitus, often present in patients with NAFLD, also contribute to an increase in cardiovascular risks. It is shown that with the progression of NAFLD, the risk of developing CVDs increases. Mortality of patients with NAFLD is mainly due to the development of CVD complications. Thus, NAFLD should be considered as an independent risk factor for CVD.

Treatment of NAFLD includes lifestyle modification (diet therapy, physical activity), as well as the use of drugs from different groups: omega-3 polyunsaturated fatty acids, statins, S-adenosylmethionine, essential phospholipids, ursodeoxycholic acid, metadoxine, glycyrrhizic acid, vitamin E, herbal drugs. In particular, the use of phospholipides, which has a high safety profile and is well tolerated when used, including with a combination of NAFLD and CVD, is justified.

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