medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-481medsovet-8651Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTОжирение и дефицит железа: какая связь и как лечить?Obesity and iron deficiency: what is the connection and how to treat?https://orcid.org/0000-0001-6714-6344ФедороваТ. А.FedorovaT. A.

Федорова Татьяна Анатольевна, д.м.н., профессор, заместитель директора Института анестезиологии, реаниматологии и трансфузиологии

117997, Москва, ул. Академика Опарина, д. 4

Tatiana A. Fedorova, Dr. Sci. (Med.), Professor, Deputy Director of the Institute of Anesthesiology, Reanimatology and Transfusiology

4, Academician Oparin St., Moscow, 117997

tfedorova1@mail.ruhttps://orcid.org/0000-0002-6926-8414СтрельниковаЕ. В.StrelnikovaE. V.

Стрельникова Елена Владимировна, к.м.н., врач высшей категории отделения экстракорпоральных методов лечения и детоксикации

117997, Москва, ул. Академика Опарина, д. 4

Elena V. Strelnikova, Cand. Sci. (Med.), Highest Category Doctor of the Department of Extracorporeal Methods of Treatment and Detoxification

4, Academician Oparin St., Moscow, 117997

e_strelnikova@oparina4.ruhttps://orcid.org/0000-0003-3491-1868ГурбановаС. Р.GurbanovaS. R.

Гурбанова Самира Рашидовна, к.м.н., врач высшей категории отделения экстракорпоральных методов лечения и детоксикации

117997, Москва, ул. Академика Опарина, д. 4

Samira R. Gurbanova, Cand. Sci. (Med.), Highest Category Doctor of the Department of Extracorporeal Treatment and Detoxification Methods

4, Academician Oparin St., Moscow, 117997

s_gurbanova@oparina4.ruНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation2024071120240171723Copyright © Федорова Т.А., Стрельникова Е.В., Гурбанова С.Р., 20242024Федорова Т.А., Стрельникова Е.В., Гурбанова С.Р.Fedorova T.A., Strelnikova E.V., Gurbanova S.R.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/8651

Представлен обзор литературных и собственных данных об этиологии и патогенезе дефицита железа и железодефицитной анемии у пациенток с ожирением. Ожирение рассматривается как субклиническое системное хроническое воспаление, что связано с повышением уровня гепцидина, который является ключевым медиатором анемии при воспалении. Пациентам с ожирением следует проводить периодический скрининг статуса железа и феррокинетических показателей. Сегодня в клинической практике для лечения дефицита железа (ДЖ) и железодефицитной анемии (ЖДА) используются новые препараты железа для перорального применения с лучшей переносимостью и абсорбцией. К ним относятся препараты сукросомального железа (СЖ). СЖ представляет собой инновационный пероральный железосодержащий носитель, в котором пирофосфат железа заключен в фосфолипидный матрикс, покрытый сукрестером, что обеспечивает защиту сукросомального железа от воздействия желудочного сока, исключая контакт со слизистой желудочно-кишечного тракта. Резистентность к действию желудочного сока позволяет неповрежденным сукросомам достигать слизистой оболочки тонкого кишечника, где они всасываются через специальные М-клетки с последующим высвобождением железа в клетках печени. Это позволяет назначать препарат СЖ пациентам с ДЖ и ЖДА с воспалительными заболеваниями кишечника, целиакией, онкологическими заболеваниями и пациентам с ожирением. Препарат сукросомального железа рассматривается как альтернативный вариант лечения ДЖ и ЖДА у женщин с ожирением, позволяющий обойти «гепцидиновый барьер», хорошо переносимый и эффективный.

The article presents a review of the literature and our own data on the etiology and pathogenesis of iron deficiency and iron deficiency anemia in patients with obesity. Obesity is considered as a subclinical systemic chronic inflammation, which is associated with an increase in the level of hepcidin, which is a key mediator of anemia during inflammation. Patients with obesity should undergo periodic screening of iron status and ferrokinetic parameters. Today, new oral iron preparations with increased tolerability and improved absorption are used in clinical practice. These include sucrosomial iron preparations. Sucrosomial iron (SI) is an innovative oral iron-containing carrier in which iron pyrophosphate is enclosed in a phospholipid matrix coated with sucrester, which protects sucrosomial iron from the effects of gastric juice, excluding contact with the mucous membrane of the gastrointestinal tract. Resistance to the action of gastric juice allows intact sucrosomes to reach the mucous membrane of the small intestine, where they are absorbed through special M cells, followed by the release of iron in liver cells. This allows prescribing SI to patients with iron deficiency and inflammatory bowel diseases, celiac disease, cancer and patients with obesity. Sucrosomial iron should be considered as an alternative treatment for iron deficiency in obese women. SI is innovative, allowing to bypass the “hepcidin barrier”, convenient for administration, effective for treatment, well tolerated than traditional oral iron salts. 

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