medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-092medsovet-8162Research ArticleКОМОРБИДНЫЕ СОСТОЯНИЯCOMORBID CONDITIONSПостковидный синдром у больных сахарным диабетом 2-го типа: определение, эпидемиология, патофизиология, биомаркеры и генетические ассоциацииPost-COVID syndrome in patients with type 2 diabetes: definition, epidemiology, pathophysiology, biomarkers and genetic associationshttps://orcid.org/0000-0002-7080-8713СухановС. А.SukhanovS. A.

Суханов Сергей Александрович, ординатор

603005, Нижний Новгород, пл. Минина и Пожарского, д. 10/1

Sergey A. Sukhanov, Resident

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950

sukhanov.aleck@yandex.ruhttps://orcid.org/0000-0001-8430-237XСорокинаЮ. А.SorokinaYu. A.

Сорокина Юлия Андреевна, к.б.н., доцент, доцент кафедры общей и клинической фармакологии

603005, Нижний Новгород, пл. Минина и Пожарского, д. 10/1

Yulia A. Sorokina, Cand. Sci. (Biol.), Associate Professor of the Department of General and Clinical Pharmacology

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950

zwx@inbox.ruhttps://orcid.org/0000-0003-1830-3600ЗанозинаО. В.ZanozinaO. V.

Занозина Ольга Владимировна, д.м.н., доцент, профессор кафедры госпитальной терапии и общей врачебной практики имени В.Г. Вогралика, Приволжский исследовательский медицинский университет;  заведующая эндокринологическим отделением, Нижегородская областная клиническая больница им. Н.А. Семашко

603005, Нижний Новгород, пл. Минина и Пожарского, д. 10/1; 

603126, Нижний Новгород, ул. Родионова, д. 190

Olga V. Zanozina, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Hospital Therapy and General Medical Practice named after V.G. Vogralik, Privolzhsky Research Medical University; Head of the Endocrinology Department,Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950;

190, Rodionov St., Nizhny Novgorod, 603126

zwx2@mail.ruПриволжский исследовательский медицинский университетРоссияPrivolzhsky Research Medical UniversityRussian FederationПриволжский исследовательский медицинский университет; Нижегородская областная клиническая больница им. Н.А. СемашкоРоссияPrivolzhsky Research Medical University; Nizhny Novgorod Regional Clinical Hospital named after N.A. SemashkoRussian Federation202424042024068997Copyright © Суханов С.А., Сорокина Ю.А., Занозина О.В., 20242024Суханов С.А., Сорокина Ю.А., Занозина О.В.Sukhanov S.A., Sorokina Y.A., Zanozina O.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8162

В статье приводятся современные представления о постковидном синдроме, дается его определение, указываются его различные типы и классификации, эпидемиологические данные, в том числе среди больных сахарным диабетом 2-го типа. Группа пациентов с постковидным синдромом весьма неоднородна: синдром чаще встречается у пожилых, с коморбидной патологией, тяжелым течением. Рассмотрена патофизиология данного синдрома у больных сахарным диабетом 2-го типа, указаны факторы риска. Определены основные биомаркеры нарушений: моноциты и их коэффициенты, белки острой фазы, дислипидемия, некоторые биохимические показатели, включая разбор генетических ассоциаций с выраженностью постковидных нарушений (гена гамма-интерферона, гена метилентетрагидрофолатредуктазы, ингибитора ангиотензинпревращающего фермента 2). Генотипирование отобранных 26 однонуклеотидных полиморфизмов генов, ответственных за проникновение вируса, иммунный ответ и воспаление, были значимо связаны не только с риском долгосрочных симптомов COVID-19, но и с кумулятивной частотой возникновения постковидного синдрома. Повышенный уровень интерлейкина 6, С-реактивного белка и фактора некроза опухоли альфа может служить потенциальным диагностическим биомаркером при длительном течении COVID. Биомаркеры сосудистой трансформации крови имеют большой потенциал в диагностике, а модуляторы ангиогенеза могут иметь терапевтическую эффективность. Показано, что у подавляющего большинства пациентов, в частности страдающих сахарным диабетом 2-го типа, развивается постковидный синдром, а с учетом ранее существовавших заболеваний он не столь безобиден. Путем выделения общих биомаркеров и генетических ассоциаций возможно выявить общий молекулярный механизм постковидного синдрома и сахарного диабета. Новизна изучения ассоциаций болезней в контексте COVID-19 позволяет по-новому взглянуть на ведение быстроразвиваю щихся длительных синдромов COVID и пост-COVID, которые имеют серьезные глобальные последствия.

The article presents the modern ideas about post-COVID syndrome, indicates various types and classifications of post-COVID syndrome, provides epidemiological data, including the patients with type 2 diabetes, also the definition of post-COVID syndrome is given. The group of patients defined as patients with post-COVID syndrome is very heterogeneous. Post-COVID syndrome is more common in the elderly, with comorbid pathology, severe disease. The pathophysiology of this syndrome in patients with type 2 diabetes mellitus is analyzed, and risk factors are indicated. The main biomarkers of disorders were determined: monocytes and their coefficients, acute phase proteins, some biochemical indicators, including analysis of genetic associations with the severity of post-COVID disorders (interferon gamma gene, methylenetetrahydrofolate reductase gene, ACE2 inhibitor). Genotyping of a sample of 26 single nucleotide polymorphisms in genes implicated in viral entry, immune response, and inflammation were significantly associated not only with the risk of long-term COVID-19 symptoms, but also with the cumulative incidence of post-COVID syndrome. Elevated levels of interleukin 6, C-reactive protein and tumor necrosis factor alpha may serve as potential diagnostic biomarkers in long-term COVID biomarkers of blood vascular transformation have great potential for diagnosis, and angiogenesis modulators may have therapeutic efficacy It has been shown that the vast majority of patients, in particular those suffering from type 2 diabetes, develop post-COVID-19 syndrome, and taking into account pre-existing diseases, post-COVID syndrome is not so harmless. By identifying common biomarkers and genetic associations, it is possible to identify the common molecular mechanism of post-COVID syndrome COVID-19 and diabetes mellitus. The novelty of disease association studies in the context of COVID-19 provides new insights into the management of rapidly evolving long-term COVID and post-COVID syndromes that have significant global implications.

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