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Ожирение у женщин: актуальные аспекты нарушений репродуктивного здоровья

https://doi.org/10.21518/2079-701X-2022-16-5-32-39

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Аннотация

В  последние десятилетия во  всем мире сформировалась устойчивая тенденция к  росту распространенности ожирения и избыточной массы тела, в том числе у женщин. Для лиц с ожирением характерна более высокая частота встречаемости болезней сердца и сосудов, инсульта, остеоартрита, диабета и репродуктивных нарушений. У тучных женщин, как правило, развивается дисфункция гипоталамо-гипофизарно-яичниковой оси, что проявляется расстройствами менструации, ановуляцией и бесплодием. Будучи эндокринным органом, жировая ткань высвобождает ряд биоактивных молекул, прежде всего адипокинов. Они по-разному взаимодействуют с  множеством молекулярных путей, способствуя развитию инсулинорезистентности, воспаления, артериальной гипертензии, повышению риска сердечно-сосудистых событий, нарушений свертывания крови, дифференцировки и созревания ооцитов. Кроме того, у женщин с ожирением и метаболическим синдромом чаще возникают проблемы с зачатием и вынашиванием беременности, связанные с дисфункцией эндометрия, у них значимо хуже результаты лечения при использовании вспомогательных репродуктивных технологий. Не менее важно пагубное влияние ожирения на эндометрий вне беременности, что повышает риски развития аномальных маточных кровотечений. Гормоны, синтезируемые жировой тканью, могут оказывать значительное влияние на функцию матки/эндометрия и, следовательно, влиять на количество менструальной кровопотери. Противоречивые результаты отмечаются у пациенток с эндометриозом. Корреляция индекса массы тела с риском возникновения эндометриоза не была доказана в клинических исследованиях, но отмечалась ассоциация между его значением и степенью тяжести заболевания. В обзоре показаны современные представления о патогенезе заболеваний органов репродуктивной системы и нарушений ее функций у пациенток с ожирением и избыточной массой тела.

Об авторах

Ю. С. Артеменко
Российский университет дружбы народов
Россия

Артеменко Юлия Сергеевна, аспирант кафедры акушерства и гинекологии с курсом перинатологии Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6



М. Б. Хамошина
Российский университет дружбы народов
Россия

Хамошина Марина Борисовна, д.м.н., профессор, профессор кафедры акушерства и гинекологии с курсом перинатологии Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6



В. А. Рябова
Научно-исследовательский институт общей патологии и патофизиологии
Россия

Рябова Валентина Андреевна, аспирант

125315, Москва, ул. Балтийская, д. 8



З. В. Зюкина
Российский университет дружбы народов
Россия

Зюкина Зоя Викторовна, ординатор кафедры акушерства и гинекологии с курсом перинатологии Медицинского института

117198, Москва, ул. Миклухо-Маклая, д. 6



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Артеменко Ю.С., Хамошина М.Б., Рябова В.А., Зюкина З.В. Ожирение у женщин: актуальные аспекты нарушений репродуктивного здоровья. Медицинский Совет. 2022;(5):32-39. https://doi.org/10.21518/2079-701X-2022-16-5-32-39

For citation:


Artemenko Yu.S., Khamoshina M.B., Ryabova V.A., Zyukina Z.V. Obesity in women: current aspects of reproductive health disorders. Meditsinskiy sovet = Medical Council. 2022;(5):32-39. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-5-32-39

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)