ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet13013ometendo-13013Research ArticleОБЗОРREVIEWО роли дисметаболической перегрузки железом в формировании неалкогольной жировой болезни печени и индукции нарушений углеводного обменаThe role of dysmetabolic iron overload syndrome in non-alcoholic fatty liver disease and carbohydrate metabolism disorders inductionhttps://orcid.org/0000-0001-7148-6739МусинаН. Н.MusinaN. N.

Мусина Надежда Нурлановна, к.м.н.

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634050, Томск, Московский тракт, д. 2

Nadezhda N. Musina, MD, PhD

2 Moscowski Trakt, 634050 Tomsk

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nadiezhda-musina@mail.ruhttps://orcid.org/0000-0003-4670-5076СлавкинаЯ. С.SlavkinaYa. S.

Славкина Яна Сергеевна

eLibrary SPIN: 2194-2470

Томск

Yana S. Slavkina, MD

Tomsk

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yanochka_31104@mail.ruhttps://orcid.org/0009-0003-1887-3782ПетрухинаД. А.PetrukhinaD. A.

Петрухина Дарья Андреевна

Томск

Daria A. Petrukhina, MD

Tomsk

petrukhina_dasha98@mail.ruhttps://orcid.org/0000-0002-9034-7264ЗимаА. П.ZimaA. P.

Зима Анастасия Павловна, д.м.н., профессор

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Томск

Anastasiia P. Zima, MD, PhD, Professor

Tomsk

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zima2302@gmail.comhttps://orcid.org/0000-0002-8016-4755ПрохоренкоТ. С.ProkhorenkoT. S.

Прохоренко Татьяна Сергеевна, к.м.н.

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Томск

Tatiana S. Prokhorenko, MD, PhD

Tomsk

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mmikld.ssmu@gmail.comhttps://orcid.org/0000-0001-9011-8720СапринаТ. В.SaprinaT. V.

Саприна Татьяна Владимировна, д.м.н., профессор

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Томск

Tatiana V. Saprina, MD, PhD, Professor

Tomsk

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tanja.v.saprina@mail.ruСибирский государственный медицинский университетРоссияSiberian State Medical UniversityRussian FederationТомский региональный центр кровиРоссияTomsk Regional Blood CenterRussian Federation202314112023203259268Copyright © Мусина Н.Н., Славкина Я.С., Петрухина Д.А., Зима А.П., Прохоренко Т.С., Саприна Т.В., 20232023Мусина Н.Н., Славкина Я.С., Петрухина Д.А., Зима А.П., Прохоренко Т.С., Саприна Т.В.Musina N.N., Slavkina Y.S., Petrukhina D.A., Zima A.P., Prokhorenko T.S., Saprina T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/13013

Железо оказывает влияние на формирование и клиническое течение таких хронических метаболических заболеваний, как ожирение, атеросклероз, неалкогольная жировая болезнь печени и сахарный диабет 2 типа. Высокая прооксидантная активность железа физиологически контролируется механизмами, регулирующими поступление, циркуляцию и потерю данного металла организмом. Эти механизмы включают взаимодействие железа с ферритином, трансферрином, гепсидином, инсулином, а также адипокинами и провоспалительными молекулами. Дисбаланс регулирующих обмен железа факторов приводит к развитию системного и паренхиматозного сидероза. Перегрузка железом обладает повреждающим эффектом в отношении основных тканей, участвующих в обмене липидов и глюкозы, — β-клеток поджелудочной железы, печени, мышечной и жировой тканей, а также в отношении органов, подверженных поражению в условиях хронической гипергликемии, — головного мозга, сетчатки и почек. Гиперферритинемия приводит к снижению секреции инсулина, формированию инсулинорезистентности и усилению глюконеогенеза в печени. Молекулярные механизмы данных эффектов железа разнообразны, и их изучение может способствовать ранней диагностике и профилактике нарушений углеводного обмена, а также расширению представлений о патогенезе других заболеваний, ассоциированных, как и сахарный диабет 2 типа, с питанием, старением и уровнем железа. В обзоре литературы приведены данные мировых исследований, посвященных взаимному влиянию метаболизма глюкозы и перегрузки железом, а также обсуждаются различия между наследственными и приобретенными нарушениями обмена железа с позиции их влияния на углеводный обмен.

Iron affects the pathogenesis and clinical course of several chronic metabolic diseases such as obesity, atherosclerosis, non-alcoholic fatty liver disease and type 2 diabetes mellitus. High pro-oxidant iron activity is physiologically controlled by mechanisms regulating entry, recycling, and loss of body iron. These mechanisms include the interplay of iron with ferritin, transferrin, hepcidin, insulin, as well as with adipokines and proinflammatory molecules. An imbalance of these regulatory mechanisms results in both systemic and parenchymal siderosis. Iron overload has a toxic effect on the major tissues involved in lipid and glucose metabolism — pancreatic β cells, liver, muscle, and adipose tissue — as well as the organs affected by chronic hyperglycemia — brain, retina and kidneys. Hyperferremia leads to a decrease in insulin secretion, the formation of insulin resistance and increased liver gluconeogenesis. Molecular mechanisms for these effects are diverse. Elucidating them will implicate both for carbohydrate metabolism disorders prevention and for the pathogenesis of other diseases that are, like diabetes mellitus type 2, associated with nutrition, aging and iron. The literature review presents data from world studies on the mutual influence of glucose metabolism and iron overload, and discusses the differences between hereditary and acquired disorders of iron metabolism from the standpoint of their influence on carbohydrate metabolism.

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