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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/ms2024-184</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-8355</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КОМОРБИДНЫЙ ПАЦИЕНТ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>COMORBID PATIENT</subject></subj-group></article-categories><title-group><article-title>Возможности применения лактитола при заболеваниях, ассоциированных с неправильным образом жизни</article-title><trans-title-group xml:lang="en"><trans-title>Lactitol properties in the treatment of patients with lifestyle-related diseases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8913-140X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Маевская</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Maevskaya</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Маевская Марина Викторовна, д.м.н., профессор, консультант лечебно-диагностического отделения Университетской клинической больницы №2,</p><p>119991, Москва, ул. Погодинская, д. 1, стр. 1</p></bio><bio xml:lang="en"><p>Marina V. Maevskaya, Dr. Sci. (Med.), Professor, Consultant, Diagnostic and Treatment Department, University Clinical Hospital No. 2,</p><p>1, Bldg. 1, Pogodinskaya St., Moscow, 119991</p></bio><email xlink:type="simple">mvmaevskaya@me.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4294-5531</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оковитый</surname><given-names>С. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Okovityi</surname><given-names>S. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Оковитый Сергей Владимирович, д.м.н., профессор, заведующий кафедрой фармакологии и  клинической фармакологии,</p><p>197022, Санкт-Петербург, ул. Профессора Попова, д. 14а</p></bio><bio xml:lang="en"><p>Sergey V. Okovityi, Dr. Sci. (Med.), Professor, Head of the Department of Pharmacology and Clinical Pharmacology, </p><p>14A, Professor Popov St., St Petersburg, 197022</p></bio><email xlink:type="simple">sergey.okovity@pharminnotech.com</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Санкт-Петербургский государственный химико-фармацевтический университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>St Petersburg State Chemical-Pharmaceutical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>10</day><month>06</month><year>2024</year></pub-date><volume>0</volume><issue>8</issue><fpage>162</fpage><lpage>169</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Маевская М.В., Оковитый С.В., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Маевская М.В., Оковитый С.В.</copyright-holder><copyright-holder xml:lang="en">Maevskaya M.V., Okovityi S.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/8355">https://www.med-sovet.pro/jour/article/view/8355</self-uri><abstract><p>В настоящее время здравоохранение России и большинства стран мира испытывает нагрузку из-за роста числа заболеваний, ассоциированных с неправильным образом жизни: сахарного диабета 2-го типа, ожирения, неалкогольной жировой болезни печени и др. Первое условие в лечении неалкогольной жировой болезни печени и других заболеваний, ассоциированных с неправильным образом жизни, – его модификация. Возможность сделать этот процесс более эффективным дает применение лактитола, он способен увеличивать продукцию бутирата, снижать повреждение структур кишечного барьера, взаимодействовать с рецепторами сладкого вкуса. Лактитол имеет низкий гликемический индекс, не всасывается в кишечнике и ферментируется подобно пищевым волокнам. Клинические исследования продемонстрировали, что у здоровых мужчин, не страдающих ожирением, метаболический ответ на этот препарат соответствует меньшему повышению концентрации глюкозы, инсулина и С-пептида плазмы крови по сравнению с приемом глюкозы. В эксперименте и у людей показано, что лактитол также уменьшает концентрацию триглицеридов в плазме, вероятно, за счет уменьшения их всасывания вследствие ускорения транзита кишечного содержимого. Важным свойством препарата служит его способность повышать концентрацию ГПП-1 и PYY, что сопровождается замедлением эвакуации из желудка, уменьшением чувства голода и актуально в лечении ожирения, сахарного диабета 2-го типа и неалкогольной жировой болезни печени. Эффективность, безопасность и переносимость лактитола оценивалась в рамках 120-дневного рандомизированного контролируемого исследования, включавшего 139 пациентов с неалкогольной жировой болезнью печени. Было показано, что добавление лактитола по 6 г 2 раза в сутки к мероприятиям по коррекции образа жизни повышает их эффективность в виде статистически значимого снижения уровня АЛТ и повышения соотношения АСТ/АЛТ по сравнению с контролем. Лактитол может рассматриваться в качестве метаболического корректора и применяться в лечении заболеваний, ассоциированных с неправильным образом жизни.</p></abstract><trans-abstract xml:lang="en"><p>Russia and most countries of the world are currently facing pressures on their health services because of the growing number of diseases associated with unhealthy lifestyles: type 2 diabetes, obesity, non-alcoholic fatty liver disease, etc. Lifestyle modification is the first prerequisite in the treatment of non-alcoholic fatty liver disease and other diseases associated with unhealthy lifestyle. The use of lactitol provides the opportunity to make this process more effective, as it is able to increase the production of butyrate, reduce the damage to the intestine barrier structure, and interact with sweet-taste receptors. Lactitol has a low glycaemic index, it is not absorbed in the intestine and is fermented like dietary fibres. The results of the studies showed that the metabolic response to this drug corresponds to a lower increase in plasma glucose, insulin and C-peptide levels compared to the use of glucose in healthy, non-obese men. It has been shown through various experiments in animals and in humans that lactitol also reduces the plasma triglyceride levels, probably due to reduced triglyceride absorption as a result of accelerated transit of intestinal contents. An important property of the drug is its ability to increase the glucagon-like peptide-1 (GLP-1) and PYY levels, which is accompanied by delayed gastric emptying and reduced hunger, which is essential in the treatment of obesity, type 2 diabetes mellitus and non-alcoholic fatty liver disease. A 120-day randomized controlled trial was conducted to assess the efficacy, safety, and tolerability of lactitol in 139 patients with nonalcoholic fatty liver disease. Twice-daily administration of lactitol 6 g in addition to lifestyle modification events has been shown to increase their efficacy expressed as a significant decrease in ALT levels and an increase in the AST/ALT ratio compared to control subjects. Lactitol can be considered as a metabolic corrector and used in the treatment of diseases associated with an unhealthy lifestyle.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ожирение</kwd><kwd>сахарный диабет 2-го типа</kwd><kwd>неалкогольная жировая болезнь печени</kwd><kwd>инкретины</kwd><kwd>кишечная микробиота</kwd><kwd>рецепторы сладкого вкуса</kwd><kwd>гликемия</kwd><kwd>уровень триглицеридов</kwd></kwd-group><kwd-group xml:lang="en"><kwd>obesity</kwd><kwd>type 2 diabetes mellitus</kwd><kwd>nonalcoholic fatty liver disease</kwd><kwd>incretins</kwd><kwd>intestinal microbiota</kwd><kwd>sweet receptors</kwd><kwd>glycemia</kwd><kwd>level of triglycerides</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D et al. 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