Сахарный диабет 2 типа, неалкогольная жировая болезнь печени и сердечно-сосудистые заболевания: причинно-следственные связи и роль противодиабетических препаратов

Во всем мире количество пациентов, страдающих сахарным диабетом 2 типа, неалкогольной жировой болезнью печени и сердечно-сосудистыми заболевания увеличивается с каждым днем. При этом они не просто сосуществуют параллельно друг с другом, как самостоятельные заболевания, но также имеют множество точек пересечения в патогенезе и прогрессировании, таких как дислипидемия, протромботические процессы, инсулинорезистентность и гипергликемия, хроническое субклиническое воспаление. Тем самым они утяжеляют течение друг друга и увеличивают количество неблагоприятных исходов, в т.ч. общую и сердечно-сосудистую смертность. Всё это является стимулом для более детального изучения сложной взаимосвязи данных заболеваний с целью оптимизации диагностики и лечения. В связи с актуальностью данного вопроса влияние большинства из существующих в настоящее время сахароснижающих препаратов на неалкогольную жировую болезнь печени и сердечно-сосудистые заболевания уже было отражено во многих исследованиях и метаанализах. В данном обзоре будут рассмотрены основные группы препаратов, а именно бигуаниды, тиазолидиндионы, ингибиторы натрий-глюкозного котранспортера 2 типа, ингибиторы дипептидилпептидазы-4 и агонисты рецепторов глюкагоноподобного пептида-1, применение которых патогенетически обосновано у коморбидных пациентов.

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