ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet13128ometendo-13128Research ArticleОБЗОРЫREVIEWSПерспективы применения полифенолов винограда у пациентов с сахарным диабетом 1 типаProspects for the use of grape polyphenols in patients with type 1 diabetes mellitushttps://orcid.org/0000-0002-5486-7262ЯцковИ. А.YatskovI. A.

Яцков Игорь Анатольевич - к.м.н.; Кафедра внутренней медицины №2. Scopus Author ID: 57218873902.

295051, Симферополь, ул. Бульвар Ленина, д. 5/7

Igor A. Yatskov - PhD; Department of Internal Medicine №2. Scopus Author ID: 57218873902

5/7 Lenin Boulevard street, 295051 Simferopol

egermd@yandex.ruhttps://orcid.org/0000-0001-9640-754XБелоглазовВ. А.BeloglazovV. A.

Белоглазов Владимир Алексеевич - д.м.н., профессор; Кафедра внутренней медицины №2. Scopus Author ID: 7007129056.

Симферополь

Vladimir A. Beloglazov - MD, PhD, Professor; Department of Internal Medicine №2. Scopus Author ID: 7007129056.

Simferopol

biloglazov@mail.ruhttps://orcid.org/0009-0002-6717-3857РойС.RoyS.

Рой Сандипан – студент. Кафедра внутренней медицины №2.

Симферополь

Sandipan Roy – student, Department of Internal Medicine №2

Simferopol

ordarulit21@mail.ruОрдена Трудового Красного Знамени Медицинский институт им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского»Россия«Order of the Red Banner of Labor S.I. Georgievsky Medical Institute» V.I. Vernadsky Crimean Federal UniversityRussian Federation202503092025222123133Copyright © Яцков И.А., Белоглазов В.А., Рой С., 20252025Яцков И.А., Белоглазов В.А., Рой С.Yatskov I.A., Beloglazov V.A., Roy S.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/13128

Согласно данным эпидемиологических исследований, количество пациентов с сахарным диабетом 1 типа (СД1) в Российской Федерации составляет 277,1 тысячи человек. Число больных продолжает расти, как и показатели распространенности и смертности, в особенности показатель среднего возраста умерших от СД1, в частности для представительниц женского пола за период с 2010 по 2022 гг. этот показатель снизился с 62,1 года до 56,0 лет. Гликирование структурных молекул органов и тканей приводит к их дисфункции и последующей инвалидизации пациента. Несмотря на развитие фармакологической промышленности и повсеместной доступности препаратов инсулина, далеко не все пациенты достигают целевых значений гликированного гемоглобина. Развитие вторичных нарушений, опосредованных дефицитом инсулина и нарушением гликемии, таких как дислипидемия, низкоинтенсивное воспаление, метаболическая эндотоксинемия и окислительный стресс приводит к повреждению стенок сосудистого русла, значительно увеличивая кардиоваскулярный риск у пациентов с СД1. Учитывая весь спектр патогенетических нарушений у пациентов с СД1, перспективным направлением является поиск дополнительных путей регуляции, в том числе с применением биологически активных соединений, содержащихся в растительном сырье, а в частности полифенолов. Данные литературы подтверждают противовоспалительный, антиоксидантный и гипогликемический эффекты полифенолов. Учитывая широкую доступность полифенолов в рационе, их многофакторное воздействие на метаболические пути, данные соединения являются перспективным инструментом влияния на патогенез различных патологий, в том числе СД1. В связи с вышеизложенным данный обзор посвящен влиянию полифенолов растительного происхождения, а в частности полифенолов винограда, на патогенез СД1 и возможные пути применения богатых полифенолами продуктов/препаратов с целью снижения рисков у пациентов с СД1. Путем анализа баз данных MedLine (PubMed) был проведен поиск по ключевым словам: «diabetes type 1», «polyphenols», «inflammation» и «dyslipidemia», а также поиск в библиотеке eLibrary по ключевым словам: «диабет 1 типа», «полифенолы», «воспаление» и «дислипидемия». Большинство научных статей, представленных в данном литературном обзоре, опубликовано за последние 5 лет.

Данные, представленные в обзоре, дают право назвать полифенолы винограда потенциальным средством, которое в комбинации с основной терапией заболевания способно воздействовать на основные патогенетические механизмы СД1, приводя к улучшенному контролю гликемии, достижению целевых цифр липидного профиля и снижению оксидативного стресса. Дальнейшее изучение полифенолов, содержащихся в винограде и продуктах его переработки, позволит создать эффективное и, главное, безопасное терапевтическое средство для снижения сердечно-сосудистого риска у пациентов с СД1.

According to epidemiological studies, the number of patients with type 1 diabetes mellitus (DM1) in the Russian Federation is 277.1 thousand people. The number of patients continues to grow, as well as the prevalence and mortality rates, especially the negative trend is the average age of those who died from DM1, in particular for the female sex for the period from 2010 to 2022 this indicator decreased from 62.1 to 56.0 years. Glycation of structural molecules of organs and tissues leads to their dysfunction and subsequent disability of the patient. Despite the development of pharmacological industry and widespread availability of insulin preparations, not all patients reach target values of glycated hemoglobin. The development of secondary disorders mediated by insulin deficiency and impaired glycemia, such as dyslipidemia, low-intensity inflammation, metabolic endotoxinemia, and oxidative stress leads to vascular channel wall damage, significantly increasing cardiovascular risk in patients with DM1. Taking into account the whole spectrum of pathogenetic disorders in patients with DM1, a promising direction is the search for additional ways of regulation, including the use of biologically active compounds contained in plant materials, and in particular polyphenols. Literature data confirm the anti-inflammatory, antioxidant and hypoglycemic effects of polyphenols. Given the wide availability of polyphenols in the diet, their multifactorial impact on metabolic pathways, these compounds are a promising tool to influence the pathogenesis of various pathologies, including DM1. In view of the above, this review focuses on the influence of plant polyphenols, in particular grape polyphenols, on the pathogenesis of DM1, and possible ways of using polyphenol-rich foods/drugs to reduce risks in patients with DM1. By analyzing the MedLine (PubMed) databases, a search was conducted using the keywords, «diabetes type 1», «polyphenols», «inflammation» and «dyslipidemia» and a search of the eLibrary library using the keywords, «diabetes type 1», «polyphenols», «inflammation» and «dyslipidemia». Most of the scientific articles presented in this literature review were published in the last 5 years. The data presented in this review suggest that grape polyphenols are a potential agent that, in combination with mainstream disease therapy, can influence the underlying pathogenetic mechanisms of DM1, leading to improved glycemic control, achievement of lipid profile targets, and reduction of oxidative stress. Further study of polyphenols contained in grapes and grapes products will make it possible to create an effective and, most importantly, safe therapeutic agent for the reduction of cardiorespiratory stress.

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