medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2021-29-13-20medalphabet-2255Research ArticleСтатьиКоморбидность неалкогольной жировой болезни печени и сердечно-сосудистых заболеваний: фокус на адеметионин и урсодезоксихолевую кислотуComorbidity of non-alcoholic fatty liver disease and cardiovascular disease: focus on ademetionine and ursodeoxycholic acidhttps://orcid.org/0000-0003-0491-8823ПоляковаО. А.PolyakovaO. A.

Полякова Ольга Александровна, врач-терапевт, ассистент кафедры терапии и полиморбидной патологии 

Москва

Polyakova Olga A., therapist, assistant at Dept of Therapy and Polymorbid Pathology 

Moscow

docpolyakova.olga@gmail.comhttps://orcid.org/0000-0002-0795-8225ОстроумоваО. Д.OstroumovaO. D.

Остроумова Ольга Дмитриевна, д.м.н., проф., зав. кафедрой терапии и полиморбидной патологии 

Москва

Ostroumova Olga D., DM Sci, professor, head of Dept of Therapy and Polymorbid Pathology 

Moscow

ostroumova.olga@mail.ruhttps://orcid.org/0000-0001-8795-6328КовалеваГ. П.KovalevaG. P.

Ковалева Галина Петровна, к.м.н., врач-терапевт

Московская обл., Сергиево-Посадский р-н, пос. Загорские дали 

Kovaleva Galina P., PhD Med, general practitioner

Moscow Region, Sergiev Posad District, Zagorskiye Dali, Russia

galinakovaleva678@gmail.comПавлееваЕ. Е.PavleevaE. E.

Павлеева Елена Евгеньевна, к.м.н., ассистент кафедры пропедевтики внутренних болезней и гастроэнтерологии

Москва

Pavleeva Elena E., PhD Med, assistant at Dept of Propedeutics of Internal Diseases and Gastroenterology

Moscow

ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияRussian Medical Academy for Continuing Professional EducationRussian FederationФГБУ «Санаторий „Загорские дали“» Управления делами Президента Российской ФедерацииРоссияZagorskiye Dali’ SanatoriumRussian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Минздрава РоссииРоссияMoscow State University of Medicine and Dentistry n.a. A.I. EvdokimovRussian Federation202119102021129Коморбидные состояния (2)1320Copyright © Полякова О.А., Остроумова О.Д., Ковалева Г.П., Павлеева Е.Е., 20212021Полякова О.А., Остроумова О.Д., Ковалева Г.П., Павлеева Е.Е.Polyakova O.A., Ostroumova O.D., Kovaleva G.P., Pavleeva E.E.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-alphabet.com/jour/article/view/2255

Изменение характера взаимодействия факторов риска и глобальное старение населения привели к стремительному росту пациентов с сочетанной патологией, возводимой в ранг новой неинфекционной эпидемии. Существовавшая ранее парадигма «одно заболевание – один пациент» теряет актуальность и больше не соответствует медицинским потребностям, поэтому пациенты с сочетанными заболеваниями нуждаются в более широком подходе и индивидуализированных схемах лечения, которые в настоящее время полностью не определены. Согласно современным представлениям сосуществование патогенетически и патофизиологически взаимосвязанных двух и более заболеваний у одного индивидуума определяется термином «коморбидность». Наиболее распространенным фенотипом коморбидности является кардиометаболический. Особый интерес представляет взаимосвязь сердечно-сосудистых заболеваний (ССЗ) и неалкогольной жировой болезни печени (НАЖБП), так как обе нозологии имеют высокую распространенность в популяции и общие факторы метаболического риска (ожирение, сахарный диабет, гипертония и дислипидемия). Кроме того, имеются сведения, что НАЖБП является независимым фактором риска развития ССЗ, что позволяет предположить не только наличие единых патогенетических механизмов, отличных от метаболических путей, но и вероятность того, что лечение заболевания печени может снизить бремя ССЗ. В связи с этим в настоящем обзоре всесторонне анализируется взаимосвязь НАЖБП и ССЗ и обсуждается возможная терапевтическая стратегия, включающая применение комбинации адеметионина с урсодезоксихолевой кислотой.

Changes in the nature of the interaction of risk factors and global aging of the population have led to a rapid increase in patients with combined pathology, elevated to the rank of a new non-infectious epidemic. The previously existing ‘one disease, one patient’ paradigm is losing its relevance and no longer meets medical needs, therefore patients with comorbidities need a broader approach and individualized treatment regimens, which are currently not fully defined. According to modern concepts, the coexistence of pathogenetically and pathophysiologically interrelated two or more diseases in one individual is defined by the term ‘comorbidity’. The most common comorbidity phenotype is cardiometabolic. Of particular interest is the relationship between cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD), since both diseases are highly prevalent in the population and have common metabolic risk factors (obesity, diabetes mellitus, hypertension, and dyslipidemia). In addition, there is evidence that NAFLD is an independent risk factor for CVD, which suggests not only the presence of common pathogenetic mechanisms other than metabolic pathways, but also the likelihood that treatment of liver disease can reduce the burden of CVD. In this regard, this review comprehensively analyzes the relationship between NAFLD and CVD and discusses a possible therapeutic strategy, including the use of a combination of ademetionine with ursodeoxycholic acid.

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