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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/ms2025-551</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-9760</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>ЭНДОКРИНОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ENDOCRINOLOGY</subject></subj-group></article-categories><title-group><article-title>Тирзепатид – альтернатива CPAP-терапии или новая возможность в лечении обструктивного апноэ сна?</article-title><trans-title-group xml:lang="en"><trans-title>Tirzepatide – alternative to CPAP-therapy or new opportunity in the therapy of obstructive sleep apnea?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1363-6860</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черкашин</surname><given-names>Д. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Cherkashin</surname><given-names>D. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Черкашин Дмитрий Викторович, д.м.н., профессор, начальник кафедры военно-морской терапии</p><p>194044, Санкт-Петербург, ул. Академика Лебедева, д. 6</p></bio><bio xml:lang="en"><p>Dmitriy V. Cherkashin, Dr. Sci. (Med.), Professor, Head of the Department of Naval Therapy</p><p>6, Akademik Lebedev St., St Petersburg, 194044</p></bio><email xlink:type="simple">cherkashin_dmitr@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Военно-медицинская академия имени С.М. Кирова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Military Medical Academy named after S.M. Kirov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>22</day><month>01</month><year>2026</year></pub-date><volume>0</volume><issue>23</issue><fpage>114</fpage><lpage>122</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Черкашин Д.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Черкашин Д.В.</copyright-holder><copyright-holder xml:lang="en">Cherkashin D.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/9760">https://www.med-sovet.pro/jour/article/view/9760</self-uri><abstract><p>Расстройство дыхания во сне является одним из самых распространенных расстройств, связанных со сном. По данным фундаментальных и клинических исследований, обструктивное апноэ сна (ОАС) тяжелой степени связано с увеличением смертности от всех причин. Другие неблагоприятные состояния, связанные с нелеченым ОАС, включают наличие сердечно-сосудистых заболеваний и их осложнений, развитие сахарного диабета 2-го типа, ожирения и продолжающегося набора веса, когнитивные нарушения, снижение качества жизни, развитие избыточной дневной сонливости и повышение риска дорожно-транспортных происшествий. При этом имеется тенденция к росту их распространенности с увеличением возраста. На сегодняшний день разработаны инструменты для точной диагностики ОАС и методы лечения данного заболевания. Одним из наиболее значимых и независимых факторов риска развития ОАС является ожирение. В связи с этим ключевым аспектом лечения пациентов c ОАС является снижение веса, поскольку доказано, что оно улучшает дневную дыхательную недостаточность, легочную гипертензию, показатели дыхания во время сна, а также улучшает сердечно-сосудистые и метаболические исходы. Настоящий обзор имеет цель обратить внимание на результаты исследования SURMOUNT-OSA, в ходе которого была дана оценка безопасности и эффективности препарата с инкретиновой активностью – первого двойного агониста рецепторов глюкозозависимого инсулинотропного полипептида / глюкагоноподобного пептида-1 – тирзепатида для лечения взрослых с ОАС и ожирением. Рассмотрены патогенетические механизмы ОАС при ожирении на основании последних фундаментальных исследований и механизмы, реализуемые тирзепатидом. У пациентов с ОАС средней и тяжелой степени тяжести и ожирением тирзепатид снижал индекс апноэ-гипопноэ, массу тела, гипоксическую нагрузку, концентрацию высокочувствительного СРБ и систолическое артериальное давление, а также улучшал результаты, связанные со сном, по оценке пациентов.</p></abstract><trans-abstract xml:lang="en"><p>Sleep-disordered breathing is one of the most common sleep-related disorders. According to basic and clinical research, severe obstructive sleep apnea (OSA) is associated with increased all-cause mortality. Other adverse conditions associated with untreated OSA include cardiovascular disease and its complications, the development of type 2 diabetes, obesity and continued weight gain, cognitive impairment, decreased quality of life, excessive daytime sleepiness, and an increased risk of motor vehicle accidents. Their prevalence tends to increase with age. Tools for accurately diagnosing OSA and treatment options have been developed. Obesity is one of the most significant and independent risk factors for the development of OSA. Weight loss is a key aspect of treating patients with OSA, as it has been shown to improve daytime respiratory failure, pulmonary hypertension, sleep-related breathing parameters, and cardiovascular and metabolic outcomes. This review focuses on the results of the SURMOUNT-OSA trial, which assessed the safety and efficacy of tirzepatide, a drug with incretin activity and the first dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1 receptor agonist, for the treatment of adults with OSA and obesity. The pathogenic mechanisms of OSA in obesity are discussed based on the latest fundamental research and the mechanisms mediated by tirzepatide. In patients with moderate to severe OSA and obesity, tirzepatide reduced the apneahypopnea index, body weight, hypoxic load, high-sensitivity CRP concentration, and systolic blood pressure, and improved patient-reported sleep-related outcomes.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ожирение</kwd><kwd>избыточная масса тела</kwd><kwd>CPAP-терапия</kwd><kwd>инкретин</kwd><kwd>глюкозозависимый инсулинотропный полипептид / глюкагоноподобный пептид-1</kwd><kwd>тирзепатид</kwd><kwd>обструктивное апноэ сна</kwd></kwd-group><kwd-group xml:lang="en"><kwd>obesity</kwd><kwd>overweight</kwd><kwd>CPAP therapy</kwd><kwd>incretin</kwd><kwd>glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1</kwd><kwd>tirzepatide</kwd><kwd>obstructive sleep apnea</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">GBD 2021 Risk Factor Collaborators. 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