endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2025-6-2-03endofocus-147Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEW«Кардиогенный диабет»: известное влияние, неизвестные механизмы"Cardiogenic diabetes": Known influence, unknown mechanismshttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна – д. м. н., профессор, заведующая кафедрой эндокринологии

г. Москва

Tatiana Yu. Demidova – Dr. Sci. (Med.), Prof., head of the Department of endocrinology

Moscow

t.y.demidova@gmail.comhttps://orcid.org/0009-0003-4222-8695ПантелееваС. В.PanteleevaS. V.

Пантелеева Софья Викторовна – клинический ординатор кафедры эндокринологии

г. Москва

Sofia V. Panteleeva – clinical resident of the Department of endocrinology

Moscow

sofia7652809@mail.ruhttps://orcid.org/0000-0001-5512-6899УшановаФ. О.UshanovaF. O.

Ушанова Фатима Омариевна – к. м. н., доцент кафедры эндокринологии

г. Москва

Fatima O. Ushanova – C. Sci. (Med.), associate professor of the Department of endocrinology

Moscow

fati_2526@mail.ruФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian Federation20252506202562Кардиоэндокринология21–28Copyright © Демидова Т.Ю., Пантелеева С.В., Ушанова Ф.О., 20252025Демидова Т.Ю., Пантелеева С.В., Ушанова Ф.О.Demidova T.Y., Panteleeva S.V., Ushanova F.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/147

Сахарный диабет (СД) и хроническая сердечная недостаточность (ХСН) приобретают статус эпидемии XXI в. Эти состояния взаимно отягощают друг друга и имеют тесную патофизиологическую взаимосвязь. СД оказывает существенное влияние на прогноз у лиц с различными вариантами ХСН, что создает огромные клинические и экономические трудности. Становится очевидным, что взаимосвязь между СД и ХСН основана на общих патофизиологических механизмах, влияющих на естественное течение обоих заболеваний. На настоящий момент существует множество исследований, изучающих влияние СД на развитие СН. В данной статье рассмотрены основные патофизиологические механизмы как формирования СН у пациентов с СД, так и развития СД у больных с предшествующей СН.

Diabetes mellitus (DM) and chronic heart failure (CHF) are becoming epidemics of the 21st century. These conditions mutually aggravate each other and have a close pathophysiological relationship. Diabetes has a significant impact on the prognosis of individuals with various types of heart failure, which creates enormous clinical and economic difficulties. Diabetes mellitus (DM) and chronic heart failure (CHF) are becoming epidemics of the 21st century. These conditions mutually aggravate each other and have a close pathophysiological relationship. Diabetes has a significant impact on the prognosis of individuals with various types of heart failure, which creates enormous clinical and economic difficulties.

сахарный диабетхроническая сердечная недостаточностьпатогенетические механизмыинсулинорезистентностьдиабетическая кардиомиопатиякардиогенный диабетdiabetes mellituschronic heart failurepathogenetic mechanismsinsulin resistanceReferencesIDF Diabetes Atlas, 9th edition. Brussels: International Diabetes Federation. 2019. URL: https://www.diabetesatlas.org/en (date of access – 02.04.2025).IDF Diabetes Atlas, 9th edition. Brussels: International Diabetes Federation. 2019. URL: https://www.diabetesatlas.org/en (date of access – 02.04.2025).GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159): 1789–858. doi: 10.1016/S0140-6736(18)32279-7.GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159): 1789–858. doi: 10.1016/S0140-6736(18)32279-7.Поляков Д.С., Фомин И.В., Валикулова Ф.Ю. с соавт. Эпидемиологическая программа ЭПОХА-ХСН: декомпенсация хронической сердечной недостаточности в реальной клинической практике (ЭПОХА-Д-ХСН). Журнал Сердечная Недостаточность. 2016; 17(5): 299–305. doi: 10.18087/rhfj.2016.5.2239.Поляков Д.С., Фомин И.В., Валикулова Ф.Ю. с соавт. Эпидемиологическая программа ЭПОХА-ХСН: декомпенсация хронической сердечной недостаточности в реальной клинической практике (ЭПОХА-Д-ХСН). Журнал Сердечная Недостаточность. 2016; 17(5): 299–305. doi: 10.18087/rhfj.2016.5.2239.Cavender MA, Steg PG, Smith SC Jr et al. Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: Outcomes at 4 years from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Circulation. 2015; 132(10): 923–31. doi: 10.1161/CIRCULATIONAHA.114.014796.Cavender MA, Steg PG, Smith SC Jr et al. Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: Outcomes at 4 years from the Reduction of Atherothrombosis for Continued Health (REACH) Registry. Circulation. 2015; 132(10): 923–31. doi: 10.1161/CIRCULATIONAHA.114.014796.Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: The Framingham study. Am J Cardiol. 1974; 34(1): 29–34. doi: 10.1016/0002-9149(74)90089-7.Kannel WB, Hjortland M, Castelli WP. Role of diabetes in congestive heart failure: The Framingham study. Am J Cardiol. 1974; 34(1): 29–34. doi: 10.1016/0002-9149(74)90089-7.Thrainsdottir IS, Aspelund T, Thorgeirsson G et al. The association between glucose abnormalities and heart failure in the population-based Reykjavik study. Diabetes Care. 2005; 28(3): 612–16. doi: 10.2337/diacare.28.3.612.Thrainsdottir IS, Aspelund T, Thorgeirsson G et al. The association between glucose abnormalities and heart failure in the population-based Reykjavik study. Diabetes Care. 2005; 28(3): 612–16. doi: 10.2337/diacare.28.3.612.Nichols GA, Hillier TA, Erbey JR, Brown JB. Congestive heart failure in type 2 diabetes: Prevalence, incidence and risk factors. Diabetes Care. 2001; 24(9): 1614–19. doi: 10.2337/diacare.24.9.1614.Nichols GA, Hillier TA, Erbey JR, Brown JB. Congestive heart failure in type 2 diabetes: Prevalence, incidence and risk factors. Diabetes Care. 2001; 24(9): 1614–19. doi: 10.2337/diacare.24.9.1614.Aronow WS, Ahn C. Incidence of heart failure in 2,737 older persons with and without diabetes. Chest. 1999; 115(3): 867–68. doi: 10.1378/chest.115.3.867.Aronow WS, Ahn C. Incidence of heart failure in 2,737 older persons with and without diabetes. Chest. 1999; 115(3): 867–68. doi: 10.1378/chest.115.3.867.Юрьева М.Ю., Дворяшина И.В. Значение гипергликемии и вариабельности гликемии у пациентов с декомпенсацией хронической сердечной недостаточности в зависимости от выраженности нарушений углеводного обмена. Кардиология. 2017; 57(4S): 38–46. doi: 10.18087/cardio.2403.Юрьева М.Ю., Дворяшина И.В. Значение гипергликемии и вариабельности гликемии у пациентов с декомпенсацией хронической сердечной недостаточности в зависимости от выраженности нарушений углеводного обмена. Кардиология. 2017; 57(4S): 38–46. doi: 10.18087/cardio.2403.Sacre JW, Magliano DJ, Shaw JE. Heart failure hospitalisation relative to major atherosclerotic events in type 2 diabetes with versus without chronic kidney disease: A meta-analysis of cardiovascular outcomes trials. Diabetes Metab. 2021; 47(5): 101249. doi: 10.1016/j.diabet.2021.101249.Sacre JW, Magliano DJ, Shaw JE. Heart failure hospitalisation relative to major atherosclerotic events in type 2 diabetes with versus without chronic kidney disease: A meta-analysis of cardiovascular outcomes trials. Diabetes Metab. 2021; 47(5): 101249. doi: 10.1016/j.diabet.2021.101249.Johansson I, Dahlstrom U, Edner M et al. Risk factors, treatment and prognosis in men and women with heart failure with and without diabetes. Heart. 2015; 101(14): 1139–48. doi: 10.1136/heartjnl-2014-307131.Johansson I, Dahlstrom U, Edner M et al. Risk factors, treatment and prognosis in men and women with heart failure with and without diabetes. Heart. 2015; 101(14): 1139–48. doi: 10.1136/heartjnl-2014-307131.Kristensen SL, Preiss D, Jhund PS et al. Risk related to pre-diabetes mellitus and diabetes mellitus in heart failure with reduced ejection fraction: insights from prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial. Circ Heart Fail. 2016; 9(1): e002560. doi: 10.1161/CIRCHEARTFAILURE.115.002560.Kristensen SL, Preiss D, Jhund PS et al. Risk related to pre-diabetes mellitus and diabetes mellitus in heart failure with reduced ejection fraction: insights from prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial. Circ Heart Fail. 2016; 9(1): e002560. doi: 10.1161/CIRCHEARTFAILURE.115.002560.Segar MW, Khan MS, Patel KV et al. Prevalence and prognostic implications of diabetes with cardiomyopathy in community-dwelling adults. J Am Coll Cardiol. 2021; 78(16): 1587–98. doi: 10.1016/j.jacc.2021.08.020.Segar MW, Khan MS, Patel KV et al. Prevalence and prognostic implications of diabetes with cardiomyopathy in community-dwelling adults. J Am Coll Cardiol. 2021; 78(16): 1587–98. doi: 10.1016/j.jacc.2021.08.020.Kaludercic N, Di Lisa F. Mitochondrial ROS formation in the pathogenesis of diabetic cardiomyopathy. Front Cardiovasc Med. 2020; 7: 12. doi: 10.3389/fcvm.2020.00012.Kaludercic N, Di Lisa F. Mitochondrial ROS formation in the pathogenesis of diabetic cardiomyopathy. Front Cardiovasc Med. 2020; 7: 12. doi: 10.3389/fcvm.2020.00012.De Geest B, Mishra M. Role of oxidative stress in diabetic cardiomyopathy. Antioxidants (Basel). 2022; 11(4): 784. doi: 10.3390/antiox11040784.De Geest B, Mishra M. Role of oxidative stress in diabetic cardiomyopathy. Antioxidants (Basel). 2022; 11(4): 784. doi: 10.3390/antiox11040784.Jia G, Hill MA, Sowers JR. Diabetic cardiomyopathy: An update of mechanisms contributing to this clinical entity. Circ Res. 2018; 122(4): 624–38. doi: 10.1161/CIRCRESAHA.117.311586.Jia G, Hill MA, Sowers JR. Diabetic cardiomyopathy: An update of mechanisms contributing to this clinical entity. Circ Res. 2018; 122(4): 624–38. doi: 10.1161/CIRCRESAHA.117.311586.Nakamura M, Sadoshima J. Cardiomyopathy in obesity, insulin resistance and diabetes. J Physiol. 2020; 598(14): 2977–93. doi: 10.1113/JP276747.Nakamura M, Sadoshima J. Cardiomyopathy in obesity, insulin resistance and diabetes. J Physiol. 2020; 598(14): 2977–93. doi: 10.1113/JP276747.Fu J, Yu MG, Li Q et al. Insulin's actions on vascular tissues: Physiological effects and pathophysiological contributions to vascular complications of diabetes. Mol Metab. 2021; 52: 101236. doi: 10.1016/j.molmet.2021.101236Fu J, Yu MG, Li Q et al. Insulin's actions on vascular tissues: Physiological effects and pathophysiological contributions to vascular complications of diabetes. Mol Metab. 2021; 52: 101236. doi: 10.1016/j.molmet.2021.101236Seferovic PM, Paulus WJ, Rosano G et al. Diabetic myocardial disorder. A clinical consensus statement of the Heart Failure Association of the ESC and the ESC Working Group on Myocardial & Pericardial Diseases. Eur J Heart Fail. 2024; 26(9): 1893–903. doi: 10.1002/ejhf.3347.Seferovic PM, Paulus WJ, Rosano G et al. Diabetic myocardial disorder. A clinical consensus statement of the Heart Failure Association of the ESC and the ESC Working Group on Myocardial & Pericardial Diseases. Eur J Heart Fail. 2024; 26(9): 1893–903. doi: 10.1002/ejhf.3347.Zinman B, Wanner C, Lachin JM et al. EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015; 373(22): 2117–28. doi: 10.1056/NEJMoa1504720.Zinman B, Wanner C, Lachin JM et al. EMPA-REG OUTCOME Investigators. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015; 373(22): 2117–28. doi: 10.1056/NEJMoa1504720.Radholm K, Figtree G, Perkovic V et al. Canagliflozin and heart failure in type 2 diabetes mellitus: Results from the CANVAS program. Circulation. 2018; 138(5): 458–68. doi: 10.1161/CIRCULATIONAHA.118.034222.Radholm K, Figtree G, Perkovic V et al. Canagliflozin and heart failure in type 2 diabetes mellitus: Results from the CANVAS program. Circulation. 2018; 138(5): 458–68. doi: 10.1161/CIRCULATIONAHA.118.034222.Wiviott SD, Raz I, Bonaca MP et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019; 380(4): 347–57. doi: 10.1056/NEJMoa1812389.Wiviott SD, Raz I, Bonaca MP et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019; 380(4): 347–57. doi: 10.1056/NEJMoa1812389.Kosiborod MN, Petrie MC, Borlaug BA et al.; STEP-HFpEF DM Trial Committees and Investigators. Semaglutide in patients with obesity-related heart failure and type 2 diabetes. N Engl J Med. 2024; 390(15): 1394–407. doi: 10.1056/NEJMoa2313917.Kosiborod MN, Petrie MC, Borlaug BA et al.; STEP-HFpEF DM Trial Committees and Investigators. Semaglutide in patients with obesity-related heart failure and type 2 diabetes. N Engl J Med. 2024; 390(15): 1394–407. doi: 10.1056/NEJMoa2313917.Matsue Y., Suzuki M., Nakamura Abe M. et al. Prevalence and prognostic implications of pre-diabetic state in patients with heart failure. Circ J. 2011; 75(12): 2833–39. doi: 10.1253/circj.cj-11-0754.Matsue Y., Suzuki M., Nakamura Abe M. et al. Prevalence and prognostic implications of pre-diabetic state in patients with heart failure. Circ J. 2011; 75(12): 2833–39. doi: 10.1253/circj.cj-11-0754.Nichols GA, Moler EJ. Cardiovascular disease, heart failure, chronic kidney disease and depression independently increase the risk of incident diabetes. Diabetologia. 2011; 54(3): 523–26. doi: 10.1007/s00125-010-1965-8Nichols GA, Moler EJ. Cardiovascular disease, heart failure, chronic kidney disease and depression independently increase the risk of incident diabetes. Diabetologia. 2011; 54(3): 523–26. doi: 10.1007/s00125-010-1965-8Amato L, Paolisso G, Cacciatore F et al. Congestive heart failure predicts the development of non-insulin-dependent diabetes mellitus in the elderly. The Osservatorio Geriatrico Regione Campania Group. Diabetes Metab. 1997; 23(3): 213–18.Amato L, Paolisso G, Cacciatore F et al. Congestive heart failure predicts the development of non-insulin-dependent diabetes mellitus in the elderly. The Osservatorio Geriatrico Regione Campania Group. Diabetes Metab. 1997; 23(3): 213–18.Luther JM. Effects of aldosterone on insulin sensitivity and secretion. Steroids. 2014; 91: 54–60. doi: 10.1016/j.steroids.2014.08.016.Luther JM. Effects of aldosterone on insulin sensitivity and secretion. Steroids. 2014; 91: 54–60. doi: 10.1016/j.steroids.2014.08.016.Uriel N, Naka Y, Colombo PC et al. Improved diabetic control in advanced heart failure patients treated with left ventricular assist devices. Eur J Heart Fail. 2011; 13(2): 195–99. doi: 10.1093/eurjhf/hfq204.Uriel N, Naka Y, Colombo PC et al. Improved diabetic control in advanced heart failure patients treated with left ventricular assist devices. Eur J Heart Fail. 2011; 13(2): 195–99. doi: 10.1093/eurjhf/hfq204.Andersson C, Norgaard ML, Hansen PR et al. Heart failure severity, as determined by loop diuretic dosages, predicts the risk of developing diabetes after myocardial infarction: a nationwide cohort study. Eur J Heart Fail. 2010; 12(12): 1333–38. doi: 10.1093/eurjhf/hfq160.Andersson C, Norgaard ML, Hansen PR et al. Heart failure severity, as determined by loop diuretic dosages, predicts the risk of developing diabetes after myocardial infarction: a nationwide cohort study. Eur J Heart Fail. 2010; 12(12): 1333–38. doi: 10.1093/eurjhf/hfq160.Yusuf S, Ostergren JB, Gerstein HC et al.; Candesartan in Heart Failure-Assessment of Reduction in Mortality and Morbidity Program Investigators. Effects of candesartan on the development of a new diagnosis of diabetes mellitus in patients with heart failure. Circulation. 2005; 112(1): 48–53. doi: 10.1161/CIRCULATIONAHA.104.528166.Yusuf S, Ostergren JB, Gerstein HC et al.; Candesartan in Heart Failure-Assessment of Reduction in Mortality and Morbidity Program Investigators. Effects of candesartan on the development of a new diagnosis of diabetes mellitus in patients with heart failure. Circulation. 2005; 112(1): 48–53. doi: 10.1161/CIRCULATIONAHA.104.528166.Vermes E, Ducharme A, Bourassa MG et al.; Studies Of Left Ventricular Dysfunction. Enalapril reduces the incidence of diabetes in patients with chronic heart failure: Insight from the Studies Of Left Ventricular Dysfunction (SOLVD). Circulation. 2003; 107(9): 1291–96. doi: 10.1161/01.cir.0000054611.89228.92.Vermes E, Ducharme A, Bourassa MG et al.; Studies Of Left Ventricular Dysfunction. Enalapril reduces the incidence of diabetes in patients with chronic heart failure: Insight from the Studies Of Left Ventricular Dysfunction (SOLVD). Circulation. 2003; 107(9): 1291–96. doi: 10.1161/01.cir.0000054611.89228.92.Баранова Е.И., Большакова О.О. Антигипертензивная терапия и риск развития сахарного диабета. Сахарный диабет. 2008; 11(1): 55–60. doi: 10.14341/2072-0351-5947.Баранова Е.И., Большакова О.О. Антигипертензивная терапия и риск развития сахарного диабета. Сахарный диабет. 2008; 11(1): 55–60. doi: 10.14341/2072-0351-5947.Torp-Pedersen C, Metra M, Charlesworth A et al.; COMET investigators. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: Data from the Carvedilol Or Metoprolol European Trial (COMET). Heart. 2007; 93(8): 968–73. doi: 10.1136/hrt.2006.092379.Torp-Pedersen C, Metra M, Charlesworth A et al.; COMET investigators. Effects of metoprolol and carvedilol on pre-existing and new onset diabetes in patients with chronic heart failure: Data from the Carvedilol Or Metoprolol European Trial (COMET). Heart. 2007; 93(8): 968–73. doi: 10.1136/hrt.2006.092379.Palazzuoli A, Iacoviello M. Diabetes leading to heart failure and heart failure leading to diabetes: epidemiological and clinical evidence. Heart Fail Rev. 2023; 28(3): 585–96. doi: 10.1007/s10741-022-10238-6.Palazzuoli A, Iacoviello M. Diabetes leading to heart failure and heart failure leading to diabetes: epidemiological and clinical evidence. Heart Fail Rev. 2023; 28(3): 585–96. doi: 10.1007/s10741-022-10238-6.

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