endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.15829/1560-4071-2023-22OJWOOWendofocus-22Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWПринципы управления риском сердечно-сосудистых заболеваний у женщин с сахарным диабетом 2 типа в перименопаузальном периодеPrinciples of cardiovascular risk management in perimenopausal women with type 2 diabeteshttps://orcid.org/0000-0001-5512-6899УшановаФ. О.UshanovaF. O.

к.м.н., ассистент кафедры эндокринологии лечебного факультета

Москва

Moscow

fati_2526@mail.ruhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

д.м.н., профессор, зав. кафедрой эндокринологии лечебного факультета

Москва

Moscow

https://orcid.org/0000-0002-3684-9992КоротковаТ. Н.KorotkovaT. N.

зав. лабораторией клинической биохимии, иммунологии и аллергологии

Москва

Moscow

ФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова Минздрава РоссииPirogov Russian National Research Medical UniversityФГБУН Федеральный исследовательский центр питания, биотехнологии и безопасности пищиFederal Research Center for Nutrition, Biotechnology and Food Safety20231005202342Кардиоэндокринология1929Copyright © Ушанова Ф.О., Демидова Т.Ю., Короткова Т.Н., 20232023Ушанова Ф.О., Демидова Т.Ю., Короткова Т.Н.Ushanova F.O., Demidova T.Y., Korotkova T.N.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/22

Сердечно-сосудистые заболевания (ССЗ) являются основной причиной смертности у пациентов с сахарным диабетом (СД). Установлено, что период менопаузы, связанный с увеличением возраста и изменением метаболического фона, повышает риски развития ССЗ у женщин с СД. Несмотря на предварительные ожидания, терапия гормональными препаратами, содержащими эстроген, в настоящее время не рекомендована с целью первичной профилактики ССЗ при отсутствии специфических показаний. Терапия эстрогенсодержащими препаратами может быть рекомендована в данной группе для минимизации симптомов менопаузального синдрома. При этом риск неблагоприятных событий, связанных с применением менопаузальной гормональной терапии, можно оценить с помощью расчетных методов определения сердечно-сосудистого риска и риска рака молочной железы с использованием специфических калькуляторов, особенно в группе женщин с СД 2 типа. Основные принципы управления сердечно-сосудистыми рисками по-прежнему сосредоточены на модификации образа жизни и достижении целевых уровней таких параметров, как уровень липидов, гликемия и артериальное давление. Использование фармакологической терапии, направленной на основные факторы риска, в т.ч. некоторых сахароснижающих препаратов с плейотропным действием, может обеспечить дополнительные возможности для профилактики ССЗ.

Cardiovascular disease is the leading cause of death in patients with diabetes mellitus. It has been established that the period of menopause, associated with an increase in age and a change in the metabolic background, increases the risk of developing cardiovascular diseases in women with diabetes mellitus. Despite tentative expectations, a number of studies have shown conflicting evidence regarding the beneficial effects of menopausal hormone therapy on CV risk markers in diabetes mellitus. In this connection, therapy with hormonal preparations containing estrogen is currently not recommended for the prevention of cardiovascular diseases in the absence of specific indications. At the same time, estrogen therapy can be used in this group to minimize menopausal symptoms. At the same time, the risk of adverse events associated with the use of menopausal hormone therapy can be estimated using calculation methods for determining cardiovascular risk and breast cancer risk using specific calculators, especially in the group of women with type 2 diabetes.The main principles of cardiovascular risk management continue to focus on lifestyle modification and achieving target levels of cardiovascular risk parameters such as lipid levels, glycemia, and blood pressure. The use of pharmacological therapy to address these risk factors, especially some pleiotropic antihyperglycemic drugs, may provide additional options for the prevention of cardiovascular disease.

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