medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-407medsovet-9535Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSПредиабет – окно возможностей для профилактических вмешательств. Часть 1Prediabetes is a window of opportunity for preventive interventions. Part 1https://orcid.org/0000-0002-3763-8994АдашеваТ. В.AdashevaT. V.

Адашева Татьяна Владимировна, д.м.н., профессор кафедры терапии и профилактической медицины

127006, Россия, Москва, ул. Долгоруковская, д. 4

Tatiana V. Adasheva, Dr. Sci. (Med.), Professor of the Department of Therapy and Preventive Medicine

4, Dolgorukovskaya St., Moscow, 127006, Russia

adashtv@mail.ruhttps://orcid.org/0009-0009-4149-9497ГубернатороваЕ. Е.GubernatorovaE. E.

Губернаторова Екатерина Евгеньевна, к.м.н., ассистент кафедры терапии и профилактической медицины

127006, Россия, Москва, ул. Долгоруковская, д. 4

Ekaterina E. Gubernatorova, Cand. Sci. (Med.), Assistant of the Department of Therapy and Preventive Medicine

4, Dolgorukovskaya St., Moscow, 127006, Russia

creativeone@list.ruhttps://orcid.org/0009-0005-9986-243XФоминаЕ. И.FominaE. I.

Фомина Елизавета Игоревна, врач-терапевт участковый

127572, Россия, Москва, ул. Абрамцевская, д. 16, стр. 1 

Elizaveta I. Fomina, Therapist

16, Bldg. 1, Abramtsevskaya St., Moscow, 127572, Russia

fomina.elizaveta.i@gmail.comhttps://orcid.org/0000-0002-3426-1853ЛобановаЕ. Г.LobanovaE. G.

Лобанова Елена Георгиевна, д.м.н., профессор кафедры фармакологии

127006, Россия, Москва, ул. Долгоруковская, д. 4

Elena G. Lobanova, Dr. Sci. (Med.), Professor of the Department of Pharmocology

20, Bldg. 1, Delegatskaya St., Moscow, 127473, Russia

e.g.lobanova@mail.ruРоссийский университет медицины (РосУниМед)РоссияRussian University of Medicine (ROSUNIMED)Russian FederationДиагностический центр № 5 с поликлиническим отделениемРоссияDiagnostic Center No. 5 with Polyclinic DepartmentRussian Federation202520112025016128–141Copyright © Адашева Т.В., Губернаторова Е.Е., Фомина Е.И., Лобанова Е.Г., 20252025Адашева Т.В., Губернаторова Е.Е., Фомина Е.И., Лобанова Е.Г.Adasheva T.V., Gubernatorova E.E., Fomina E.I., Lobanova E.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/9535

Предиабет (ПД) является ярким представителем состояний, именуемых в современной клинической медицине предболезнями. Распространенность нарушений углеводного обмена увеличивается с каждым годом. Патофизиологические изменения при предиабете многочисленны и представлены в том числе на генетическом уровне так называемой «метаболической памятью». Уже на этапе предиабета начинают формироваться изменения со стороны различных органов и систем, характерные для гипергликемии. Цель обзора – представить современные данные по эпидемиологии, патобиологии предиабета, его осложнениям. В статье представлены статистические и прогностические данные по распространенности предиабета, приведены эпидемиологические данные по России и в мире, обсуждаются современные представления о трансформации ранних нарушений углеводного обмена в диабет. Большой раздел посвящен описанию патофизиологии осложнений длительной гипергликемии со стороны сердечно-сосудистой системы, печени, репродуктивной системы, почек, онкогенеза. Представлены патофизиологические и клинические особенности ранних нарушений углеводного обмена – нарушенной гликемии натощак и нарушенной толерантности к глюкозе. В статье обсуждаются механизмы развития метаболической памяти и ее роль в развитии ранних осложнений предиабета. Проанализированы данные последних исследований, изучающих патогенез органных повреждений при предиабете – механизмы развития жировой болезни печени, факторы риска онкогенеза, репродуктивные нарушения, рассматриваются механизмы клеточного старения при предиабете, микрососудистые и макрососудистые осложнения с развитием сердечно-сосудистых заболеваний, патобиология нефропатии. Анализ современных эпидемиологических и прогностических данных, результатов фундаментальных и клинических исследований подтверждает актуальность проблемы ранней диагностики предиабета и обосновывает необходимость активной терапевтический тактики.

Prediabetes (PD) is a prominent example of conditions known as pre-existing disease in modern clinical medicine. The prevalence of carbohydrate metabolism disorders increases every year. Pathophysiological changes in prediabetes are numerous and are represented, among other things, at the genetic level, the so-called “metabolic memory”. Already at the prediabetes stage, changes in various organs and systems characteristic of hyperglycemia begin to form. The purpose of the review is to present modern data on the epidemiology, pathobiology of prediabetes, and its complications. The article presents statistical and prognostic data on the prevalence of prediabetes, provides epidemiological data for Russia and the world, and discusses modern ideas about the transformation of early carbohydrate metabolism disorders into diabetes. A large section is devoted to the description of the pathophysiology of complications of long-term hyperglycemia from the cardiovascular system, liver, reproductive system, kidneys, and oncogenesis. The pathophysiological and clinical features of early carbohydrate metabolism disorders – impaired fasting glycemia and impaired glucose tolerance – are presented. The article discusses the mechanisms of metabolic memory development and its role in the development of early complications of prediabetes. The data of the latest studies studying the pathogenesis of organ damage in prediabetes are analyzed – the mechanisms of fatty liver disease development, risk factors for oncogenesis, reproductive disorders, the mechanisms of cellular aging in prediabetes, microvascular and macrovascular complications with the development of cardiovascular diseases, the pathobiology of nephropathy are considered. The analysis of modern epidemiological and prognostic data, the results of fundamental and clinical studies confirms the relevance of the problem of early diagnosis of prediabetes and substantiates the need for active therapeutic tactics.

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