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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">ometendo</journal-id><journal-title-group><journal-title xml:lang="ru">Ожирение и метаболизм</journal-title><trans-title-group xml:lang="en"><trans-title>Obesity and metabolism</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2071-8713</issn><issn pub-type="epub">2306-5524</issn><publisher><publisher-name>Endocrinology Research Centre</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14341/omet13288</article-id><article-id custom-type="elpub" pub-id-type="custom">ometendo-13288</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL STUDIES</subject></subj-group></article-categories><title-group><article-title>Снижение экспрессии генов PPARG, ADIPOQ и SLC2A4 в подкожной жировой ткани у бариатрических пациентов с морбидным ожирением и сахарным диабетом 2 типа</article-title><trans-title-group xml:lang="en"><trans-title>Decreased expression of the PPARG, ADIPOQ, and SLC2A4 genes in subcutaneous adipose tissue in bariatric patients with morbid obesity and type 2 diabetes mellitus</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3160-2314</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мирошникова</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Miroshnikova</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мирошникова Валентина Вадимовна, к.б.н. </p><p>ResearcherID: AGO-6202-2022; Scopus Author ID: 37115710400</p><p>197022, Санкт-Петербург, ул. Л. Толстого, д. 6-8</p></bio><bio xml:lang="en"><p>Valentina V. Miroshnikova, PhD </p><p>ResearcherID: AGO-6202-2022; Scopus Author ID: 37115710400 </p><p>6-8 L’va Tolstogo street, 197022 Saint Petersburg </p></bio><email xlink:type="simple">mutantropol@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6972-7924</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Драчева</surname><given-names>К. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dracheva</surname><given-names>K. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Драчева Ксения Владимировна , к.б.н.</p><p>Researcher ID: HNB-9471-2023; Scopus Author ID: 57222013410</p><p>Гатчина</p></bio><bio xml:lang="en"><p>Kseniia V. Dracheva, PhD </p><p>Researcher ID: HNB-9471-2023; Scopus Author ID: 57222013410 </p><p>Saint Petersburg</p></bio><email xlink:type="simple">fatal-ks@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1186-1303</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Грунина</surname><given-names>М. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Grunina</surname><given-names>M. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Грунина Мария Николаевна , к.б.н.</p><p>Гатчина; Санкт-Петербург</p></bio><bio xml:lang="en"><p>Maria N. Grunina, PhD </p><p>Saint Petersburg; Gatchina</p></bio><email xlink:type="simple">grunina_mn@pnpi.nrcki.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6042-322X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Анисимова</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Anisimova</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Анисимова Кристина Александровна , к.м.н.</p><p>Гатчина</p></bio><bio xml:lang="en"><p>Kristina A. Anisimova, PhD </p><p>Saint Petersburg</p></bio><email xlink:type="simple">anisimova-k-a@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2919-1878</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Изюмченко</surname><given-names>А. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Izumchenko</surname><given-names>A. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Изюмченко Артем Дмитриевич</p><p>Гатчина; Санкт-Петербург</p></bio><bio xml:lang="en"><p>Artem D. Izumchenko </p><p>Saint Petersburg; Gatchina</p></bio><email xlink:type="simple">artemiz98@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-0639-6316</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Берулава</surname><given-names>Е. Т.</given-names></name><name name-style="western" xml:lang="en"><surname>Berulava</surname><given-names>E. T.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Берулава Елена Тристановна</p><p>Гатчина</p></bio><bio xml:lang="en"><p>Elena T. Berulava </p><p>Saint Petersburg</p></bio><email xlink:type="simple">elenaberulava19977991@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5306-5332</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баландов</surname><given-names>С. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Balandov</surname><given-names>S. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Баландов Станислав Георгиевич , к.м.н.</p><p>Гатчина</p></bio><bio xml:lang="en"><p>Stanislav G. Balandov </p><p>Saint Petersburg</p></bio><email xlink:type="simple">vesikaada@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5321-8834</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Танянский</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tanyanskiy</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Танянский Дмитрий Андреевич , д.м.н. </p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Dmitry A. Tanyanskiy, MD, PhD </p><p>Saint Petersburg</p></bio><email xlink:type="simple">dmitry.athero@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7283-079X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Василевский</surname><given-names>Д. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasilevsky</surname><given-names>D. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Василевский Дмитрий Игоревич , д.м.н., профессор</p><p>Гатчина</p></bio><bio xml:lang="en"><p>Dmitrii I. Vasilevsky, MD, PhD, Professor </p><p>Saint Petersburg</p></bio><email xlink:type="simple">vasilevsky1969@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7431-6014</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пчелина</surname><given-names>С. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Pchelina</surname><given-names>S. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пчелина Софья Николаевна , д.б.н. </p><p>Гатчина; Санкт-Петербург</p></bio><bio xml:lang="en"><p>Sofya N. Pchelina, PhD </p><p>Saint Petersburg; Gatchina</p></bio><email xlink:type="simple">sopchelina@hotmail.com</email><xref ref-type="aff" rid="aff-4"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Петербургский институт ядерной физики им. Б.П. Константинова Национального исследовательского центра «Курчатовский институт» ; Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education “Pavlov First Saint Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation ; Petersburg Nuclear Physics Institute named by B.P. Konstantinov of National Research Centre «Kurchatov Institute»</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Петербургский институт ядерной физики им. Б.П. Константинова Национального исследовательского центра «Курчатовский институт»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education “Pavlov First Saint Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное научное учреждение «Институт экспериментальной медицины»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Institution “Institute of Experimental Medicine”</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное учреждение «Петербургский институт ядерной физики им. Б.П. Константинова Национального исследовательского центра «Курчатовский институт» ; Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» Министерства здравоохранения Российской Федерации ; Федеральное государственное бюджетное научное учреждение «Институт экспериментальной медицины»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Budgetary Educational Institution of Higher Education “Pavlov First Saint Petersburg State Medical University” of the Ministry of Healthcare of Russian Federation ; Petersburg Nuclear Physics Institute named by B.P. Konstantinov of National Research Centre «Kurchatov Institute» ; Federal State Budgetary Institution “Institute of Experimental Medicine”</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>18</day><month>07</month><year>2026</year></pub-date><volume>23</volume><issue>2</issue><fpage>43</fpage><lpage>53</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мирошникова В.В., Драчева К.В., Грунина М.Н., Анисимова К.А., Изюмченко А.Д., Берулава Е.Т., Баландов С.Г., Танянский Д.А., Василевский Д.И., Пчелина С.Н., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Мирошникова В.В., Драчева К.В., Грунина М.Н., Анисимова К.А., Изюмченко А.Д., Берулава Е.Т., Баландов С.Г., Танянский Д.А., Василевский Д.И., Пчелина С.Н.</copyright-holder><copyright-holder xml:lang="en">Miroshnikova V.V., Dracheva K.V., Grunina M.N., Anisimova K.A., Izumchenko A.D., Berulava E.T., Balandov S.G., Tanyanskiy D.A., Vasilevsky D.I., Pchelina S.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.omet-endojournals.ru/jour/article/view/13288">https://www.omet-endojournals.ru/jour/article/view/13288</self-uri><abstract><sec><title>Обоснование</title><p>Обоснование. Жировая ткань (ЖТ) — активный эндокринный орган, продуцирующий биологически активные молекулы — адипокины, которые участвуют в метаболизме липидов и глюкозы. Дисбаланс секреции адипокинов при ожирении является следствием нарушения функции ЖТ, на молекулярно-генетическом уровне проявляющейся в изменении экспрессии ключевых генов, и может усугубляться при развитии метаболических нарушений, в частности сахарного диабета 2 типа (СД2).</p></sec><sec><title>Цель</title><p>Цель. Целью данного исследования являлось изучение уровня экспрессии генов PPARG, ADIPOQ, LEP, SLC2A4 в подкожной и висцеральной жировой ткани (ПЖТ и ВЖТ) у бариатрических пациентов с ожирением и СД2, а также оценка корреляции концентрации адипонектина и лептина в сыворотке крови с экспрессией указанных генов.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В одноцентровое, одномоментное, двухвыборочное, сравнительное, обсервационное исследование типа «случай-контроль» были включены пациенты с ожирением II, III, IV степени с/без СД2, а также лица без ожирения, обратившиеся в Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова с целью проведения бариатрических (пациенты) и плановых операций на брюшной полости (контрольная группа), в ходе которых были взяты образцы ПЖТ и ВЖТ, а также сыворотки крови. Для определения уровня мРНК целевых генов в ЖТ использовали полимеразную цепную реакцию в реальном времени. Концентрацию адипонектина и лептина в сыворотке крови определяли методом иммуноферментного анализа.</p></sec><sec><title>Результаты</title><p>Результаты. Группу бариатрических пациентов составили 53 пациента (средний возраст 44,1±11,2 года; индекс массы тела (ИМТ) более 35 кг/м²), из них 26 пациентов с диагнозом СД2 и 27 — без СД2. Контрольную группу составили 15 индивидуумов без ожирения, метаболических нарушений и СД2 (средний возраст 46,7±12,8 года; ИМТ менее 30 кг/м²). У пациентов с ожирением и СД2 наблюдалось снижение уровня экспрессии генов PPARG, ADIPOQ и SLC2A4 в ПЖТ по сравнению с контрольной группой. Уровень экспрессии генов PPARG и ADIPOQ был также снижен в ВЖТ у пациентов с ожирением и СД2 по сравнению с контрольной группой. Изменения уровня экспрессии генов при ожирении сопряжены со снижением концентрации адипонектина и увеличением концентрации лептина в сыворотке крови, при этом наиболее выраженное снижение концентрации адипонектина показано у пациентов с ожирением и СД2. Наблюдаются однонаправленные положительные корреляции уровней экспрессии генов PPARG, ADIPOQ, LEP, SLC2A4 в ПЖТ и ВЖТ в общей выборке.</p></sec><sec><title>Заключение</title><p>Заключение. Развитие СД2 на фоне ожирения при ИМТ более 35 кг/м² ассоциировано со снижением уровней экспрессии генов PPARG, ADIPOQ и SLC2A4 в ПЖТ, выраженным снижением концентрации адипонектина и увеличением концентрации лептина в сыворотке крови.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>BACKGROUND</title><p>BACKGROUND: Adipose tissue (AT) is an active endocrine organ that produces biologically active molecules — adipokines, which participate in lipid and glucose metabolism. The imbalance of adipokine secretion in obesity is a consequence of AT dysfunction, which at the molecular genetic level is manifested as changes in the expression of the key genes, and can be complicated by the development of metabolic disorders, in particular type 2 diabetes mellitus (T2DM).</p></sec><sec><title>AIM</title><p>AIM: The aim of this study was to investigate the expression level of PPARG, ADIPOQ, LEP, SLC2A4 genes in subcutaneous and visceral adipose tissue (SAT and VAT) in bariatric patients with obesity and T2DM, as well as to assess the correlation of adiponectin and leptin serum concentrations with the expression of corresponding genes.</p></sec><sec><title>MATERIALS AND METHODS</title><p>MATERIALS AND METHODS: The single-center, cross-sectional, two-sample, comparative, observational case-control study included patients with grade II, III, IV obesity with/without T2DM, as well as non-obese individuals who applied to the Pavlov First Saint Petersburg State Medical University for bariatric (patients) and planned abdominal surgeries (control group), SAT and VAT samples, as well as blood serum, were collected. Real-time polymerase chain reaction was used to determine the mRNA levels of target genes in AT. Adiponectin and leptin serum concentrations were assesed by enzyme immunoassay.</p></sec><sec><title>RESULTS</title><p>RESULTS: The group of bariatric patients included 53 patients (mean age 44.1±11.2 years; body mass index (BMI) over 35 kg/m2), including 26 patients with a diagnosis of T2DM and 27 without T2DM. The control group included 15 individuals without obesity, metabolic disorders and T2DM (mean age 46.7±12.8; BMI less than 30 kg/m2). In patients with obesity and T2DM, a decrease in the level of PPARG, ADIPOQ and SLC2A4 gene expression in SAT was observed compared to the control group. The level of PPARG and ADIPOQ gene expression was also reduced in VAT in patients with obesity and T2DM compared to the control group. The observed changes in gene expression in obesity were associated with a decrease in adiponectin and an increase in leptin serum concentrations, with the most pronounced decrease in adiponectin concentration in patients with obesity and T2DM. Unidirectional positive correlations were observed in the expression levels of PPARG, ADIPOQ, LEP, SLC2A4 genes in SAT and VAT in the total cohort.</p></sec><sec><title>CONCLUSION</title><p>CONCLUSION: The development of T2DM on the basis of obesity and BMI of more than 35 kg/m2 is associated with reduced expression levels of the PPARG, ADIPOQ and SLC2A4 genes in SAT, a marked decrease in the concentration of adiponectin and an increase in the concentration of leptin in the blood serum.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>ожирение</kwd><kwd>сахарный диабет 2 типа</kwd><kwd>жировая ткань</kwd><kwd>адипонектин</kwd><kwd>лептин</kwd><kwd>PPARγ (gamma)</kwd><kwd>транспортер глюкозы GLUT4</kwd><kwd>инсулинорезистентность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>оbesity</kwd><kwd>type 2 diabetes mellitus</kwd><kwd>adipose tissue</kwd><kwd>adiponectin</kwd><kwd>leptin</kwd><kwd>PPARγ (gamma)</kwd><kwd>glucose transporter GLUT4</kwd><kwd>insulin resistance</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование выполнено за счет средств: Госзадание ПСПбГМУ им. акад. И.П.Павлова на тему «Ожирение, метаболический синдром и сердечно-сосудистые заболевания: молекулярно-генетические предикторы неблагоприятного течения и оптимизация выбора персонифицированной терапии» (1022040900079-2, уникальный номер реестровой записи 720000Ф.99.1.БН62АБ13000); Госзадание ФГБНУ ИЭМ на тему «Молекулярно-клеточные механизмы участия макрофагов в регуляции функции эндотелия на разных этапах формирования атеросклеротических поражений» (шифр № FGWG-2025-0007); Госзадание Министерства науки и высшего образования Российской Федерации (тема №1024011100004-4-1.6.8;1.6.4;1.6.7;1.6.1. «Функциональная и структурная организация сложных, мультикомпонентных биологических систем и их динамика. Молекулярные и клеточные компоненты патогенеза социально-значимых заболеваний»).</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Алфёрова В.И., Мустафина С.В. 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