docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2024-23-4-27-31docru-114Research ArticleОБЗОРЫREVIEWSСовременные представления об ассоциации неалкогольной жировой болезни печени и сердечно-сосудистой патологииModern Views about the Association of Non-Alcoholic Fatty Liver Disease and Cardiovascular Pathologyhttps://orcid.org/0000-0001-7518-1895ТонкихЮ. Л.TonkikhYu. L.

Тонких Юлия Леонгардовна — к. м. н., ведущий научный сотрудник клинического отделения патологии пищеварительной системы у взрослых и детей

660022, г. Красноярск, ул. Партизана Железняка, д. 3г

Tonkikh, Yu.L.

3-g Partizan Zheleznyak Str., Krasnoyarsk, 660022

tjulia@bk.ruhttps://orcid.org/0000-0002-6481-3196ВасютинА. В.VasyutinA. V.

Васютин Александр Викторович — к. м. н., старший научный сотрудник клинического отделения патологии пищеварительной системы у взрослых и детей

660022, г. Красноярск, ул. Партизана Железняка, д. 3г

Vasyutin, A.V.

3-g Partizan Zheleznyak Str., Krasnoyarsk, 660022

alexander_vasyutin@mail.ruhttps://orcid.org/0000-0002-9980-2294ЦукановВ. В.TsukanovV. V.

Цуканов Владислав Владимирович — д. м. н., профессор, заведующий клиническим отделением патологии пищеварительной системы у взрослых и детей

660022, г. Красноярск, ул. Партизана Железняка, д. 3г

Tsukanov, V.V.

3-g Partizan Zheleznyak Str., Krasnoyarsk, 660022

gastro@impn.ruФГБНУ «Федеральный исследовательский центр «Красноярский научный центр Сибирского отделения Российской академии наук» обособленное подразделение «Научно-исследовательский институт медицинских проблем Севера»РоссияFederal Research Centre “Krasnoyarsk Science Centre” of the Siberian Branch of Russian Academy of Science, separate division “Scientific Research Institute of medical problems of the North”Russian Federation2024160220252342731Copyright © Тонких Ю.Л., Васютин А.В., Цуканов В.В., 20252025Тонких Ю.Л., Васютин А.В., Цуканов В.В.Tonkikh Y.L., Vasyutin A.V., Tsukanov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/114Цель обзора

Цель обзора. На основании современных литературных данных оценить ассоциацию между неалкогольной жировой болезнью печени (НАЖБП) и сердечно-сосудистыми заболеваниями (ССЗ), рассмотреть патофизиологические механизмы, лежащие в основе этой взаимосвязи, описать методы снижения кардиометаболического риска у больных НАЖБП.

Основные положения

Основные положения. НАЖБП занимает ведущую позицию в структуре хронических заболеваний печени, является одним из проявлений метаболического синдрома и тесно ассоциирована с ССЗ. Связь распространенности НАЖБП и ССЗ установлена в многочисленных исследованиях. У пациентов с НАЖБП ССЗ протекают значительно тяжелее. В ряде метаанализов зафиксирована прямая ассоциация НАЖБП с сердечно-сосудистой смертностью. Многие патофизиологические механизмы развития этих двух заболеваний совпадают. Некоторые молекулярные изменения, играющие важную роль при НАЖБП, участвуют также в формировании ССЗ. При НАЖБП часто встречается атеросклероз, который лежит в основе возникновения и ССЗ.

Заключение

Заключение. Во всех современных международных и российских рекомендациях по ведению больных с НАЖБП уделяется значительное внимание целесообразности скрининга ССЗ и необходимости снижения кардиометаболического риска у пациентов с НАЖБП при помощи модификации образа жизни (оптимизации диеты, уменьшения массы тела, повышения физической активности), применения медикаментозных средств из группы статинов, препаратов урсодезоксихолевой кислоты и адеметионина.

Aim

Aim. Based on current literature data, to evaluate the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD), to consider the pathophysiological mechanisms underlying this relationship, and to indicate methods for reducing cardiometabolic risk in patients with NAFLD.

Key points

Key points. NAFLD occupies a leading position in the structure of chronic liver diseases, is one of the manifestations of metabolic syndrome and is closely associated with CVD. The relationship between the prevalence of NAFLD and CVD has been established in numerous studies. CVD is significantly more severe in patients with NAFLD. A number of meta-analyses have documented a direct association between NAFLD and cardiovascular mortality. Many pathophysiological mechanisms of development of these two diseases coincide. Some molecular changes that play an important role in NAFLD are also involved in the formation of CVD. Patients with NAFLD often have atherosclerosis, which also underlies the formation of CVD.

Conclusion

Conclusion. All modern international and Russian recommendations for the management of patients with NAFLD pay significant attention to the advisability of CVD screening and the need to reduce cardiometabolic risk in patients with NAFLD through lifestyle modification (optimizing diet, weight loss, increasing physical activity), using statin medications, ursodeoxycholic acid and ademetionine.

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