endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2025-6-3-11endofocus-171Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWНовые грани мультиорганной эффективности ингибиторов дипептидилпептидазы-4New facets of the multiorgan effectiveness of dipeptidyl peptidase-4 inhibitorshttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

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

Scopus Author ID: 7003771623

г. Москва

Tatyana Yu. Demidova – D. Sci. (Med.), Prof., Head of the Department of endocrinology, Institute of Clinical Medicine

Moscow

t.y.demidova@gmail.comhttps://orcid.org/0000-0002-1385-0245ИзмайловаМ. Я.IzmailovaM. Ya.

Измайлова Марьям Ярагиевна – ассистент кафедры эндокринологии ИКМ 

г. Москва

 

Maryam Ya. Izmailova – assistant at the Department of endocrinology, Institute of Clinical Medicine

Moscow

maremizm@gmail.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава России (Пироговский университет)Pirogov Russian National Research Medical University202513112025634758Copyright © Демидова Т.Ю., Измайлова М.Я., 20252025Демидова Т.Ю., Измайлова М.Я.Demidova T.Y., Izmailova M.Y.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/171

Ингибиторы дипептидилпептидазы-4 (иДПП-4) представляют собой относительно новый класс сахароснижающих препаратов, отличающийся благоприятным профилем безопасности и нейтральным влиянием на массу тела. Они характеризуются низкой частотой побочных эффектов и хорошей переносимостью, в том числе у пациентов с терминальной стадией хронической болезни почек. Доклинические и клинические исследования выявили у этих препаратов широкий спектр плейотропных эффектов, затрагивающих сердечно-сосудистую, центральную нервную систему и другие органы. Одним из ключевых механизмов, объясняющих кардиопротекторные свойства иДПП-4, считается их противовоспалительное действие, которое ассоциируется со снижением системных маркеров воспаления, таких как C-реактивный белок и отдельные провоспалительные интерлейкины, что потенциально создает условия для снижения риска атерогенеза и его осложнений. Помимо этого, иДПП-4 улучшают функцию эндотелия за счет повышения биодоступности оксида азота и уменьшения адгезии лейкоцитов к сосудистой стенке, способствуя вазодилатации и снижению вероятности сосудистых осложнений. В обзоре представлены основные сведения об иДПП-4, рассмотрены клинические перспективы их применения и обоснованы преимущества комбинированной терапии, а также основные плейотропные эффекты этих лекарственных средств в отношении сердечно-сосудистой системы и головного мозга.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are a relatively new class of sugar-lowering drugs characterized by a favorable safety profile and  a neutral effect on body weight. They are characterized by low incidence of side effects and good tolerability, even in patients with endstage chronic kidney disease. Preclinical and clinical studies have shown that these drugs have a wide range of pleiotropic effects on the cardiovascular and central nervous systems, and other organs. One key mechanism explaining the cardioprotective properties of DPP-4 inhibitors is their anti-inflammatory effect. The use of these drugs has been associated with decreased systemic markers of inflammation such as C-reactive protein and pro-inflammatory cytokines, potentially reducing the risk of atherosclerosis and its complications. In addition, DPP-4 inhibitors improve endothelial function by increasing the bioavailability of nitric oxide and reducing the adhesion of leukocytes to the vascular wall, which contributes to vasodilation and reduces the likelihood of vascular complications. This review provides basic information about DPP-4 inhibitors, examines the clinical prospects for its use, and substantiates the benefits of combination therapy as well as the main pleiotropic effects on the cardiovascular system and brain.

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