Роль инсулина, лептина и адипонектина в формировании структурно-функциональных изменений миокарда при ожирении и их динамика на фоне снижения массы тела: литературный обзор.

Целью данной работы явилось обобщение литературных данных о возможных взаимосвязях между уровнями инсулина, лептина и адипонектина и формированием структурно-функциональных изменений миокарда при ожирении, а также их динамики на фоне снижения массы тела. Произведен анализ исследований, найденных по ключевым словам «insulin, adiponectin, leptin, left ventricular hypertrophy» в международных базах данных Pubmed, Medline и Cochrane. Результаты многих работ свидетельствуют о положительных связях гиперинсулинемии и гиперлептинемии с массой и индексом массы миокарда левого желудочка.  Инсулинорезистентность может выступать независимым предиктором субклинической диастолической дисфункции. Вклад адипонектина в развитие сердечно-сосудистых заболеваний широко исследуется: многие авторы получали результаты, указывающие на его протективное действие на миокард. При похудении наблюдается снижение уровней инсулина и лептина крови, однако снижение уровня лептина, по данным отдельных авторов, происходило только при уменьшении массы тела на величину, превышающую 7% от исходной. Результаты измерения уровня адипонектина у пациентов с ожирением на фоне снижения массы тела остаются противоречивыми: одни авторы получали увеличение концентрации данного белка в крови, другие отмечали отсутствие динамики.

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