ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet2018153-70ometendo-9629Research ArticleСтатьиArticlesНациональные клинические рекомендации по лечению морбидного ожирения у взрослых. 3-ий пересмотр (лечение морбидного ожирения у взрослых)Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults)https://orcid.org/0000-0002-8175-7886ДедовИван ИвановичDedovIvan I.

д.м.н., профессор, академик РАН

MD, PhD, Professor, Academician of Russian Academy of Sciences

dedov@endocrincentr.ruМельниченкоГалина АфанасьевнаMel'nichenkoGalina A.

д.м.н., профессор, акад. РАН

MD, PhD, Professor, Academician of Russian Academy of Sciences

melnich@endocrincentr.ruШестаковаМарина ВладимировнаShestakovaMarina V.

д.м.н., профессор, академик РАН

Sc.D. prof., Academican of Russian Academy of Sciences

nephro@endocrincentr.ruТрошинаЕкатерина АнатольевнаTroshinaEkaterina A.

д.м.н., проф., член-корр. РАН

MD, PhD, prof., correspondence fellow of Russian Academy of Sciences

troshina@inbox.ruМазуринаНаталья ВалентиновнаMazurinaNatalya V.

к.м.н.

PhD

natalyamazurina@mail.ruhttps://orcid.org/0000-0001-6612-6851ШестаковаЕкатерина АлексеевнаShestakovaEkaterina A.

ведущий научный сотрудник КДЦ

MD, PhD, leading research associate

katiashestakova@mail.ruhttps://orcid.org/0000-0002-4798-118XЯшковЮрий ИвановичYashkovYuriy I.

д.м.н., профессор

MD, PhD, prof.

yu@yashkov.ruНеймаркАлександр ЕвгеньевичNeimarkAlexander E.

к.м.н.

PhD

sas_spb@mail.ruБирюковаЕлена ВалерьевнаBiryukovaElena V.

д.м.н., профессор

MD, PhD, prof.

lena@obsudim.ruБондаренкоИрина ЗиятовнаBondarenkoIrina Z.

д.м.н., гл.н.с.

MD, PhD

iz_bondarenko@mail.ruБорданНаталья СеменовнаBordanNatalia S.

к.м.н.

PhD

socetanie@mail.ruДзгоеваФатима ХаджимуратовнаDzgoevaFatima H.

к.м.н.

PhD

fatima.dzgoeva@gmail.ruЕршоваЕкатерина ВладимировнаErshovaEkaterina V.

к.м.н.

PhD

yu99pol06@rambler.ruКомшиловаКсения АндреевнаKomshilovaKseniya A.

к.м.н.

PhD

kom-ksusha@rambler.ruМкртумянАшот МусаеловичMkrtumyanAshot M.

д.м.н., профессор

MD, PhD, prof.

vagrashot@mail.ruПетунинаНина АлександровнаPetuninaNina A.

д.м.н., профессор

MD, PhD, prof.

napetunina@mail.ruРоманцоваТатьяна ИвановнаRomantsovaTatiana I.

д.м.н., профессор

MD, PhD, prof.

romantsovatatiana@rambler.ruСтаростинаЕлена ГеоргиевнаStarostinaElena G.

д.м.н., профессор

MD, PhD, prof.

elena.starostina@rambler.ruСтронгинЛеонид ГригорьевичStronginLeonid G.

д.м.н., профессор

MD, PhD, prof.

malstrong@mail.ruСуплотоваЛюдмила АлександровнаSuplotovaLudmila A.

д.м.н., профессор

MD, PhD, prof.

suplotovala@mail.ruФадеевВалентин ВикторовичFadeyevValentin V.

д.м.н., профессор, член-корр. РАН

MD, PhD, Professor, correspondence fellow of Russian Academy of Sciences

walfad@mail.ru<p>ФГБУ &laquo;Национальный медицинский исследовательский центр эндокринологии&raquo; Минздрава России</p>Россия<p>Endocrinology Research Centre</p>Russian Federation<p>3АО &laquo;Центр эндохирургии и литотрипсии&raquo;</p>Россия<p>The Center of Endosurgery and Lithotripsy</p>Russian Federation<p>ФГБУ &laquo;Национальный медицинский исследовательский центр имени В. А. Алмазова&raquo; Минздрава России</p>Россия<p>Almazov National Medical Research Centre</p>Russian Federation<p>ФГБОУВО &laquo;Московский государственный медико-стоматологический университет имени А.И. Евдокимова&raquo; Минздрава России</p>Россия<p>Moscow State University of Medicine and Dentistry named after A.I. Evdokimov</p>Russian Federation<p>ФГБУ &laquo;Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова&raquo; Минздрава России</p>Россия<p>Research Center for Obstetrics, Gynecology and Perinatology</p>Russian Federation<p>ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)</p>Россия<p>Sechenov First Moscow State Medical University</p>Russian Federation<p>ГБУЗ МО &laquo;Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского&raquo;</p>Россия<p>M.F. Vladimirsky Moscow Regional Research Clinical Institute (MONIKI)</p>Russian Federation<p>ФГБОУВО "Приволжский исследовательский медицинский университет" Минздрава России</p>Россия<p>Privolzhsky Research Medical University</p>Russian Federation<p>ФГБОУВО "Тюменский государственный медицинский университет" Минздрава России</p>Россия<p>Tyumen State Medical University</p>Russian Federation2018250420181515370Copyright &#x00A9; Дедов И.И., Мельниченко Г.А., Шестакова М.В., Трошина Е.А., Мазурина Н.В., Шестакова Е.А., Яшков Ю.И., Неймарк А.Е., Бирюкова Е.В., Бондаренко И.З., Бордан Н.С., Дзгоева Ф.Х., Ершова Е.В., Комшилова К.А., Мкртумян А.М., Петунина Н.А., Романцова Т.И., Старостина Е.Г., Стронгин Л.Г., Суплотова Л.А., Фадеев В.В., 20182018Дедов И.И., Мельниченко Г.А., Шестакова М.В., Трошина Е.А., Мазурина Н.В., Шестакова Е.А., Яшков Ю.И., Неймарк А.Е., Бирюкова Е.В., Бондаренко И.З., Бордан Н.С., Дзгоева Ф.Х., Ершова Е.В., Комшилова К.А., Мкртумян А.М., Петунина Н.А., Романцова Т.И., Старостина Е.Г., Стронгин Л.Г., Суплотова Л.А., Фадеев В.В.Dedov I.I., Mel'nichenko G.A., Shestakova M.V., Troshina E.A., Mazurina N.V., Shestakova E.A., Yashkov Y.I., Neimark A.E., Biryukova E.V., Bondarenko I.Z., Bordan N.S., Dzgoeva F.H., Ershova E.V., Komshilova K.A., Mkrtumyan A.M., Petunina N.A., Romantsova T.I., Starostina E.G., Strongin L.G., Suplotova L.A., Fadeyev V.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/9629

Представлен 3-ий пересмотр клинических рекомендаций по лечению морбидного ожирения у взрослых. Морбидным называется ожирение с индексом массы тела (ИМТ) ≥40 кг/м2 или с ИМТ ≥35 кг/м2 при наличии серьезных осложнений, связанных с ожирением. В рекомендациях представлены данные о распространенности ожирения, его этиологии и патогенезе, а также об ассоциированных осложнениях. Подробно описаны необходимые методы лабораторной и инструментальной диагностики ожирения. В данном пересмотре рекомендаций впервые определена стадийность назначения консервативных и хирургических методов лечения ожирения. Впервые выделена группа пациентов с ожирением и сахарным диабетом 2 типа, у которых метаболическая хирургия позволяет достичь длительного улучшения контроля гликемии или ремиссии сахарного диабета.

The presented paper is a third revision of the clinical recommendations for the treatment of morbid obesity in adults. Morbid obesity is a condition with body mass index (BMI) ≥40 kg / m2 or a BMI ≥35 kg / m2 in the presence of serious complications associated with obesity. The recommendations provide data on the prevalence of obesity, its etiology and pathogenesis, as well as on associated complications. The necessary methods for laboratory and instrumental diagnosis of obesity are described in detail. In this revision of the recommendations, the staging of prescribing conservative and surgical methods for the treatment of obesity are determined. For the first time, a group of patients with obesity and type 2 diabetes mellitus is selected, in whom metabolic surgery allows a long-term improvement in the control of glycemia or remission of diabetes mellitus.

артериальная гипертониябандажирование желудкабариатрические/метаболические операциибилиопанкреатическое шунтирование (БПШ)гипокалорийное питаниежелудочное шунтирование (гастрошунтирование)лираглутидморбидное ожирениеожирениеорлистатпродольная резекция желудкасахарный диабет 2 типасибутраминсиндром обструктивного апноэ снафизическая активностьarterial hypertensiongastric bandingbariatric / metabolic surgerybiliopancreatic diversion (BPD)hypocaloric nutritiongastric bypassliraglutidemorbid obesityobesityorlistatsleeve gastrectomytype 2 diabetessibutraminobstructive sleep apnoephysical activityReferencesWorld Health Organization. Obesity: preventing and managing the global epidemic. 1997, Geneva:WHO http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/World Health Organization. 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The authors declare that there are no conflicts of interest present.