medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2022-061medsovet-7662Research ArticleШКОЛА ПЕДИАТРАPEDIATRICIAN SCHOOLРоль адипоцитокинов в развитии неалкогольной жировой болезни печени у детей и подростковThe role of adipocytokines in the development of non-alcoholic fatty liver disease in children and adolescentshttps://orcid.org/0000-0003-3992-9207СмирноваО. В.SmirnovaO. V.

Смирнова Ольга Валентиновна – доктор медицинских наук, профессор, заведующая лабораторией клинической патофизиологии.

660062, Красноярск, ул. Партизана Железняка, д. 3г

Olga V. Smirnova - Dr. Sci. (Med.), Professor, Head of the Laboratory of Clinical Pathophysiology, Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences, Separate Subdivision “Scientific Research Institute of medical problems of the North”.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

ovsmirnova71@mail.ruhttps://orcid.org/0000-0001-9464-6133КаспароваИ. Э.KasparovaI. E.

Каспарова Ирина Эдуардовна - кандидат медицинских наук, старший научный сотрудник лаборатории клинической патофизиологии.

660062, Красноярск, ул. Партизана Железняка, д. 3г

Irina E. Kasparova - Cand. Sci. (Med.), Senior Researcher Laboratory of Clinical Pathophysiology, Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences, Separate Subdivision “Scientific Research Institute of medical problems of the North”.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

impn@impn.ruОбособленное подразделение Федерального исследовательского центра «Красноярский научный центр» Сибирского отделения Российской академии наук «Научно-исследовательский институт медицинских проблем Севера»РоссияFederal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences, Separate Subdivision “Scientific Research Institute of medical problems of the North”Russian Federation202326072023012254262Copyright © Смирнова О.В., Каспарова И.Э., 20232023Смирнова О.В., Каспарова И.Э.Smirnova O.V., Kasparova I.E.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/7662

За последние 20 лет доля детей и подростков с избыточной массой тела и ожирением значительно увеличилась в большинстве стран. Ожирение представляет собой основной кардиометаболический риск и тесно связано с сопутствующими заболеваниями, такими как гипертония, гиперлипидемия, гиперинсулинемия, диабет 2-го типа и неалкогольная жировая болезнь печени (НАЖБП). Существует много неопределенности в отношении диагностики метаболического синдрома у детей, в основном из-за различных и противоречивых предложенных определений. Распространенность метаболического синдрома значительно различалась у детей (от 6 до 39%) в зависимости от применяемых критериев определения. В соответствии с этими определениями только 2% детей соответствовали всем критериям метаболического синдрома. В течение последнего десятилетия исследования показали, что параллельно с увеличением распространенности ожирения в педиатрической популяции НАЖБП стала наиболее распространенной формой заболевания печени в детском возрасте. При НАЖБП воспалительные цитокины/адипокины и другие факторы приводят к стеатогепатиту и/или фиброзу. Недавно было идентифицировано несколько адипоцитокинов и воспалительных цитокинов со значительной положительной (лептин, хемерин, васпин, TNF-α, IL-6 и IL-8) или отрицательной (адипонектин) связью с метаболическими факторами риска. Некоторые из них можно рассматривать как патофизиологические факторы, связывающие ожирение и его осложнения, такие как резистентность к инсулину и НАЖБП. Однако данные о других адипоцитокинах и их роли в метаболизме остаются спорными и частично неизвестными, особенно в отношении их роли в детском возрасте (резистин, NAMPT, FGF-21, A-FABP, RBP4, липокалин-2, оментин-1, вчСРБ). Адипоцитокины являются новым и действенным инструментом не только для диагностики и стратификации НАЖБП и метаболического синдрома, но и как потенциальная терапевтическая мишень. Адипоцитокиновая терапия требует дальнейшего изучения у всех больных с метаболическим синдромом и НАЖБП, особенно у детей и подростков.

Over the past 20 years, the proportion of overweight and obese children and adolescents has increased significantly in most countries. Obesity represents a major cardiometabolic risk and is closely associated with comorbidities such as hypertension, hyperlipidemia, hyperinsulinemia, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD). There is a lot of uncertainty regarding the diagnosis of metabolic syndrome in children, mainly due to the various and conflicting definitions that have been proposed. The prevalence of metabolic syndrome varied significantly in children (from 6 to 39%) depending on the applied definition criteria. According to these definitions, only 2% of children met all the criteria for metabolic syndrome. Over the past decade, studies have shown that, in parallel with the increase in the prevalence of obesity in the pediatric population, NAFLD has become the most common form of liver disease in childhood. In NAFLD, inflammatory cytokines/adipokines and other factors lead to steatohepatitis and/or fibrosis. Recently, several adipocytokines and inflammatory cytokines have been identified with significant positive (leptin, chemerin, vaspin, TNF-α, IL-6 and IL-8) or negative (adiponectin) associations with metabolic risk factors. Some of them can be considered as pathophysiological factors linking obesity and its complications such as insulin resistance and NAFLD. However, data on other adipocytokines and their role in metabolism remain controversial and partially unknown, especially with regard to their role in childhood (resistin, NAMPT, FGF-21, A-FABP, RBP4, lipocalin-2, omentin-1, hsCRP). Adipocytokines are a novel and powerful tool not only for the diagnosis and stratification of NAFLD and the metabolic syndrome, but also as a potential therapeutic target. Adipocytokine therapy requires further study in all patients with metabolic syndrome and NAFLD, especially in children and adolescents.

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