endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.15829/1560-4071-2023-24OSKPXCendofocus-24Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWПредиабет: фактор риска сердечно-сосудистых заболеваний и "окно возможностей" для их профилактикиPrediabetes: a risk factor for cardiovascular diseases and a window of opportunity for their preventionhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

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

Москва

Moscow

https://orcid.org/0000-0003-3826-0935ПлахотняяВ. М.PlakhotnyayaV. M.

врач-эндокринолог амбулаторно-поликлинического отделения

Москва

Moscow

vplahotnyaya@gmail.comФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова Минздрава РоссииPirogov Russian National Research Medical UniversityООО "Поликлиника 101" (Медицинский центр Major Clinic)Major Clinic Serpukhovskaya20231005202342Кардиоэндокринология611Copyright © Демидова Т.Ю., Плахотняя В.М., 20232023Демидова Т.Ю., Плахотняя В.М.Demidova T.Y., Plakhotnyaya V.M.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/24

Известно, что сахарный диабет предрасполагает к более быстрому развитию и прогрессированию сердечно-сосудистых заболеваний (ССЗ) и кардиомиопатии. Однако патологические изменения, лежащие в их основе, начинают формироваться еще на этапе ранних нарушений углеводного обмена. На сегодняшний день известно, что по сравнению с общей популяцией лица с предиабетом более подвержены риску возникновения атеросклероза и хронической сердечной недостаточности, а также имеют повышенные показатели смертности от ССЗ и смерти от всех причин. Настоящий обзор посвящен разбору патофизиологических механизмов, которые приводят к развитию ССЗ у лиц с ранними нарушениями углеводного обмена. Кроме того, в статье освещены вопросы профилактики развития кардиоваскулярной патологии в данной группе пациентов с акцентом на активное воздействие на основные факторы сердечно-сосудистого риска.

It’s well known, that diabetes mellitus predisposes to more rapid development and progression of cardiovascular disease (CVD) and cardiomyopathy. However, the pathological changes underlying them begin to form much earlier — at the stage of prediabetes. Individuals with prediabetes have a higher risk of atherosclerosis and chronic heart failure, as well as increased rates of mortality from CVD and all-cause death. This review is devoted to the analysis of pathophysiological mechanisms that lead to developing CVD in patients with early prediabetes. In addition, the article highlights the issues of preventing the development of cardiovascular pathology in this group of patients with an emphasis on the active impact on the main factors of cardiovascular risk.

предиабетнарушение толерантности к глюкозенарушенная гликемия натощаксердечно-сосудистые заболеванияхроническая сердечная недостаточностьпрофилактикаprediabetesimpaired glucose toleranceimpaired fasting glycemiacardiovascular diseasesheart failurepreventionReferencesLiang Y, Wang M, Wang C, et al. The Mechanisms of the Development of Atherosclerosis in Prediabetes. International Journal of Molecular Sciences. 2021;22(8):4108. doi:10.3390/ijms22084108.Liang Y, Wang M, Wang C, et al. The Mechanisms of the Development of Atherosclerosis in Prediabetes. International Journal of Molecular Sciences. 2021;22(8):4108. doi:10.3390/ijms22084108.Чазова И. Е., Шестакова М. В., Жернакова Ю. В. и др. Евразийские рекомендации по профилактике и лечению сердечно-сосудистых заболеваний у больных с диабетом и предиабетом (2021). Евразийский Кардиологический Журнал. 2021;2:6-61. doi:10.38109/2225-1685-2021-2-6-61.Chazova IE, Shestakova MV, Zhernakova YuV, et al. Eurasian association of cardiology (EAC) guidelines for the prevention and treatment of cardiovascular diseases in patients with diabetes and prediabetes (2021). Eurasian heart journal. 2021;2:6-61. (In Russ.)Joseph JJ, Deedwania P, Acharya T, et al. Comprehensive Management of Cardiovascular Risk Factors for Adults With Type 2 Diabetes: A Scientific Statement From the American Heart Association. Circulation. 2022;145(9):e722-e759. doi:10.1161/CIR.0000000000001040.Joseph JJ, Deedwania P, Acharya T, et al. Comprehensive Management of Cardiovascular Risk Factors for Adults With Type 2 Diabetes: A Scientific Statement From the American Heart Association. Circulation. 2022;145(9):e722-e759. doi:10.1161/CIR.0000000000001040.Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). European Heart Journal. 2020;41(2):255-323. doi:10.1093/eurheartj/ehz486.Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). European Heart Journal. 2020;41(2):255-323. doi:10.1093/eurheartj/ehz486.Cai X, Zhang Y, Li M, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370:m2297. doi:10.1136/bmj.m2297.Cai X, Zhang Y, Li M, et al. Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis. BMJ. 2020;370:m2297. doi:10.1136/bmj.m2297.Michel A, Mando R, Waheed M, et al. Prediabetes associated with an increase in major adverse cardiovascular events. J Am Coll Cardiol. 2021;77(18, Suppl. 2):14. doi:10.1016/S0735-1097(21)01357-7.Michel A, Mando R, Waheed M, et al. Prediabetes associated with an increase in major adverse cardiovascular events. J Am Coll Cardiol. 2021;77(18, Suppl. 2):14. doi:10.1016/S0735-1097(21)01357-7.Барбараш О. Л., Воевода М. И., Галстян Г. Р. и др. Предиабет как междисциплинарная проблема: определение, риски, подходы к диагностике и профилактике сахарного диабета 2 типа и сердечно-сосудистых осложнений. Российский кардиологический журнал. 2019;(4):83-91. doi:10.15829/1560-4071-2019-4-83-91.Barbarash OL, Voyevoda MI, Galstyan GR, et al. Pre-diabetes as an interdisciplinary problem: definition, risks, approaches to the diagnostics and prevention of type 2 diabetes and cardiovascular complications. Russian Journal of Cardiology. 2019;(4):83-91. (In Russ.)Sinha A, Ning H, Ahmad FS, et al. Association of fasting glucose with lifetime risk of incident heart failure: the Lifetime Risk Pooling Project. Cardiovasc Diabetol. 2021;20(1):66. doi:10.1186/s12933-021-01265-y.Sinha A, Ning H, Ahmad FS, et al. Association of fasting glucose with lifetime risk of incident heart failure: the Lifetime Risk Pooling Project. Cardiovasc Diabetol. 2021;20(1):66. doi:10.1186/s12933-021-01265-y.Cai X, Liu X, Sun L, et al. Prediabetes and the risk of heart failure: A meta-analysis. Diabetes Obes Metab. 2021;23(8):1746-53. doi:10.1111/dom.14388.Cai X, Liu X, Sun L, et al. Prediabetes and the risk of heart failure: A meta-analysis. Diabetes Obes Metab. 2021;23(8):1746-53. doi:10.1111/dom.14388.Wu Jd, Liang Dl, Xie Y. Prediabetes and risk of heart failure: the link grows stronger. Cardiovasc Diabetol. 2021;20:112. doi:10.1186/s12933-021-01302-w.Wu Jd, Liang Dl, Xie Y. Prediabetes and risk of heart failure: the link grows stronger. Cardiovasc Diabetol. 2021;20:112. doi:10.1186/s12933-021-01302-w.Huang JY, Tse YK, Li HL, et al. Prediabetes Is Associated With Increased Risk of Heart Failure Among Patients With Atrial Fibrillation. Diabetes Care. 2023;46(1):190-6. doi:10.2337/dc22-1188.Huang JY, Tse YK, Li HL, et al. Prediabetes Is Associated With Increased Risk of Heart Failure Among Patients With Atrial Fibrillation. Diabetes Care. 2023;46(1):190-6. doi:10.2337/dc22-1188.Jackson AM, Rørth R, Liu J, et al. Diabetes and pre-diabetes in patients with heart failure and preserved ejection fraction. Eur J Heart Fail. 2022;24:497-509. doi:10.1002/ejhf.2403.Jackson AM, Rørth R, Liu J, et al. Diabetes and pre-diabetes in patients with heart failure and preserved ejection fraction. Eur J Heart Fail. 2022;24:497-509. doi:10.1002/ejhf.2403.Brannick B, Dagogo-Jack S. Prediabetes and Cardiovascular Disease: Pathophy-siology and Interventions for Prevention and Risk Reduction. Endocrinology and metabolism clinics of North America. 2018;47(1):33-50. doi:10.1016/j.ecl.2017.10.001.Brannick B, Dagogo-Jack S. Prediabetes and Cardiovascular Disease: Pathophy-siology and Interventions for Prevention and Risk Reduction. Endocrinology and metabolism clinics of North America. 2018;47(1):33-50. doi:10.1016/j.ecl.2017.10.001.Ormazabal V, Nair S, Elfeky O, et al. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17:122. doi:10.1186/s12933-018-0762-4.Ormazabal V, Nair S, Elfeky O, et al. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018;17:122. doi:10.1186/s12933-018-0762-4.Бирюкова Е. В., Морозова И. А., Капустина Л. А. Сахарный диабет 2 типа и сердечно-сосудистые заболевания. Поликлиника. 2020;5:14-9.Biryukova YeV, Morozova IA, Kapustina LA. Type 2 diabetes and cardiovascular diseases. Poliklinika. 2020;5: 14-9. (in Russ.)Kansal S, Kamble TK. Lipid Profile in Prediabetes. J Assoc Physicians India. 2016; 64(3):18-21.Kansal S, Kamble TK. Lipid Profile in Prediabetes. J Assoc Physicians India. 2016; 64(3):18-21.Айтбаев К. А., Муркамилов И. Т., Фомин В. В. и др. МикроРНК при ишемическом инсульте. Журнал неврологии и психиатрии им. С. С. Корсакова. Спецвыпуски. 2018; 118(32):48-56. doi:10.17116/jnevro20181183248-56.Aitbaev KA, Murkamilov IT, Fomin VV, et al. MicroRNA in ischemic stroke. Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova. 2018;118(32):48-56. (In Russ.)Kirabo A, Harrison DG. Hypertension as a Risk Factor for Atherosclerosis. Atherosclerosis (Risks, Mechanisms, and Therapies). 2015:63-75. doi:10.1002/9781118828533.ch6.Kirabo A, Harrison DG. Hypertension as a Risk Factor for Atherosclerosis. Atherosclerosis (Risks, Mechanisms, and Therapies). 2015:63-75. doi:10.1002/9781118828533.ch6.Ning B, Chen Y, Wagar AB, et al. Hypertension Enhances Advanced Atherosclerosis and Induces Cardiac Death in Watanabe Heritable Hyperlipidemic Rabbits. The American journal of pathology. 2018;188(12):2936-47. doi:10.1016/j.ajpath.2018.08.007.Ning B, Chen Y, Wagar AB, et al. Hypertension Enhances Advanced Atherosclerosis and Induces Cardiac Death in Watanabe Heritable Hyperlipidemic Rabbits. The American journal of pathology. 2018;188(12):2936-47. doi:10.1016/j.ajpath.2018.08.007.Pop-Busui R, Januzzi JL, Bruemmer D, et al. Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association. Diabetes Care. 2022;45(7):1670-90. doi:10.2337/dci22-0014.Pop-Busui R, Januzzi JL, Bruemmer D, et al. Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association. Diabetes Care. 2022;45(7):1670-90. doi:10.2337/dci22-0014.Jaquenod De Giusti C, Palomeque J, Mattiazzi A. Ca2+ mishandling and mitochondrial dysfunction: a converging road to prediabetic and diabetic cardiomyopathy. Pflugers Arch. 2022;474:33-61. doi:10.1007/s00424-021-02650-y.Jaquenod De Giusti C, Palomeque J, Mattiazzi A. Ca2+ mishandling and mitochondrial dysfunction: a converging road to prediabetic and diabetic cardiomyopathy. Pflugers Arch. 2022;474:33-61. doi:10.1007/s00424-021-02650-y.Pandey A, Vaduganathan M, Patel KV, et al. Biomarker-Based Risk Prediction of Incident Heart Failure in Pre-Diabetes and Diabetes. JACC Heart Fail. 2021;9(3):215-23. doi:10.1016/j.jchf.2020.10.013.Pandey A, Vaduganathan M, Patel KV, et al. Biomarker-Based Risk Prediction of Incident Heart Failure in Pre-Diabetes and Diabetes. JACC Heart Fail. 2021;9(3):215-23. doi:10.1016/j.jchf.2020.10.013.Perreault L, Temprosa M, Mather KJ, et al. Regression from prediabetes to normal glucose regulation is associated with reduction in cardiovascular risk: results from the Diabetes Prevention Program outcomes study. Diabetes Care. 2014;37(9):2622-31. doi:10.2337/dc14-0656.Perreault L, Temprosa M, Mather KJ, et al. Regression from prediabetes to normal glucose regulation is associated with reduction in cardiovascular risk: results from the Diabetes Prevention Program outcomes study. Diabetes Care. 2014;37(9):2622-31. doi:10.2337/dc14-0656.Ушанова Ф. О., Демидова Т. Ю. Предиабет: самостоятельное заболевание или фактор риска сердечно-сосудистых заболеваний? FOCUS Эндокринология. 2020;1:27-35. doi:10.47407/ef2020.1.1.0004.Ushanova FO, Demidova TYu. Prediabetes: independent disease or cardiovascular risk factor? FOCUS Endocrinology. 2020;1:27-35. (in Russ.)Beulens J, Rutters F, Rydén L, et al. Risk and management of pre-diabetes. European Journal of Preventive Cardiology. 2019;26(2_suppl):47-54. doi:10.1177/2047487319880041.Beulens J, Rutters F, Rydén L, et al. Risk and management of pre-diabetes. European Journal of Preventive Cardiology. 2019;26(2_suppl):47-54. doi:10.1177/2047487319880041.

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