endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2026-7-1-08endofocus-159Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSНеалкогольная жировая болезнь печени у лиц с нарушенной толерантностью к глюкозе и сахарным диабетом 2 типа: современные подходы к терапииNon-alcoholic fatty liver disease in people with impaired glucose tolerance and type 2 diabetes mellitus: Modern approaches to therapyhttps://orcid.org/0009-0001-2444-8251СарычеваК. М.SarychevaK. M.

Ксения Михайловна Сарычева, аспирант

кафедра госпитальной терапии имени академика Г.И. Сторожакова

117593; Литовский бульвар, дом 1А.; Москва

Kseniia M. Sarycheva, postgraduate student

Department of hospital therapy named after G.I. Storozhakov

117593; 1А, Lithuanian Boulevard; Moscow

ksu664@gmail.comhttps://orcid.org/0000-0003-1699-0881НикитинИ. Г.NikitinI. G.

Игорь Геннадьевич Никитин, д. м. н., профессор

Москва

Igor G. Nikitin, Dr. Sci. (Med.), professor

Moscow

igor.nikitin.64@mail.ruРоссийский национальный исследовательский медицинский университет имени Н. И. Пирогова (Пироговский университет)Pirogov Russian National Research Medical University202603052026715865Copyright © Сарычева К.М., Никитин И.Г., 20262026Сарычева К.М., Никитин И.Г.Sarycheva K.M., Nikitin I.G.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/159

   Неалкогольная жировая болезнь печени (НАЖБП) – хроническое заболевание печени, которое характеризуется накоплением липидов в гепатоцитах, вызванным метаболическими нарушениями. Эта болезнь широко распространена по всему миру, и ее подлинные масштабы начинают оцениваться только сейчас. В связи с эпидемией ассоциированных с ней заболеваний, таких как ожирение и сахарный диабет 2 типа (СД2), вопросы патогенеза и лечения НАЖБП приобретают все большую актуальность. Основными патофизиологическими механизмами НАЖБП выступают инсулинорезистентность, глюкотоксичность и липотоксичность, нарушение метаболизма инсулина, что объясняет взаимосвязь между НАЖБП и СД2. В данный момент активно ищутся новые подходы к медикаментозной коррекции НАЖБП. Ингибиторы натрий-глюкозного котранспортера 2 типа (иНГЛТ-2) являются современным классом препаратов, которые используются для лечения СД2 и широкого круга связанных с ним осложнений (например, хронической болезни почек или сердечной недостаточности). Механизм действия иНГЛТ-2 основан на снижении реабсорбции глюкозы почками и увеличении выведения глюкозы с мочой путем подавления двух переносчиков глюкозы в почках: натрий-глюкозному котранспортеру 1 и 2 типа (SGLT1 и SGLT2). Использование этой группы лекарственных средств уже вышло за рамки эндокринной патологии, в связи с их доказанными кардио- и нефропротективными свойствами. В связи с улучшением метаболического профиля на фоне их приема активно обсуждается вопрос об использовании иНГЛТ2 в качестве самостоятельных средств терапии НАЖБП.

   Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease characterized by the accumulation of lipids in hepatocytes caused by metabolic disorders. This disease is widespread all over the world, and its scale is only now beginning to be assessed. Due to the epidemic of associated diseases such as obesity and type 2 diabetes mellitus (T2DM2), the issues of the pathogenesis and treatment of NAFLD are becoming increasingly relevant. The main pathophysiological mechanisms of NAFLD are insulin resistance, glucotoxicity and lipotoxicity, and impaired insulin metabolism, which explains the relationship between NAFLD and T2DM. At the moment, new approaches to the drug correction of NAFLD are being actively sought. Sodium glucose cotransporter type 2 (SGLT2) inhibitors are a modern class of drugs that are used to treat T2DM2 and a wide range of related complications, such as chronic kidney disease or heart failure. The mechanism of action of SGLT2 inhibitors is based on a decrease in glucose reabsorption by the kidneys and an increase in glucose excretion in the urine by suppressing two glucose transporters in the kidneys: sodium-glucose cotransporter types 1 and 2 (SGLT1 and SGLT2). The use of this group of drugs has already gone beyond endocrine pathology, due to their proven cardio- and nephroprotective properties. Due to the improvement of the metabolic profile when using them, the question of using SGLT2 inhibitors as an independent therapy for NAFLD is being actively discussed.

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