rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2021-599-607rsp-3081Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРазвитие сахарного диабета 2-го типа при подагреType 2 diabetes mellitus and gouthttps://orcid.org/0000-0002-5394-7869ЖелябинаО. В.ZhelyabinaO. V.

Желябина Ольга Владимировна

115522, Российская Федерация, Москва, Каширское шоссе, 34а

Olga Zhelyabina

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

olga-sheliabina@mail.ruhttps://orcid.org/0000-0003-1191-5831ЕлисеевМ. С.EliseevM. S.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202131102021595599607Copyright © Желябина О.В., Елисеев М.С., 20212021Желябина О.В., Елисеев М.С.Zhelyabina O.V., Eliseev M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3081

Подагра – наиболее часто встречающийся у взрослых воспалительный артрит, распространенность которого продолжает увеличиваться в течение последних десятилетий. Подагра характеризуется гиперурикемией с обязательной кристаллизацией уратов и связанной с ней воспалительной реакцией, а также метаболическими эффектами, вызванными в том числе этими процессами. В частности, диагноз подагры ассоциируется с высоким риском нарушений углеводного обмена, превышающим популяционный в 2 раза: по разным данным, от 21 до 26% пациентов с подагрой имеют сахарный диабет 2-го типа (СД 2). Однако роль мочевой кислоты и уратснижающих препаратов в его развитии у таких больных изучена недостаточно. Обсуждается возможность влияния на риск развития СД 2 хронического воспаления, интерлейкина-1β, других провоспалительных цитокинов, гиперурикемии, ксантиоксидазы и других факторов, ассоциирующихся с подагрой. Возможно, уровень мочевой кислоты связан с СД 2 и другими метаболическими заболеваниями, вызывая патофизиологические изменения не только через воспаление, но и через окислительный стресс, повреждение эндотелия сосудов. Также предполагается, что подагра и СД 2 могут иметь общие генетические маркеры. Взаимосвязь нарушений пуринового и углеводного обменов является стимулом для поиска препаратов, обладающих положительным влиянием как на пуриновый, так и на углеводный обмен. Однако не ясно, какой уровень мочевой кислоты следует рассматривать в качестве фактора риска, а также остаются противоречивыми данные по влиянию на риск развития СД 2 препаратов, применяемых для лечения подагры.

Gout is the most common inflammatory arthritis in adults and has continued to increase in prevalence over the past decades. Gout is characterized by hyperuricemia with the obligatory crystallization of urates and an associated inflammatory reaction, as well as metabolic effects caused, among other things, by these processes. In particular, the diagnosis of gout is identified with a high risk of carbohydrate metabolism disorders, which is 2 times higher than the population risk: according to various sources, from 21 to 26% of patients with gout have type 2 diabetes mellitus (DM 2). However, the role of uric acid and urate-lowering drugs in its development in patients with gout remains controversial. The possibility of influencing the risk of developing diabetes mellitus type 2 of chronic inflammation, the activity of interleukin-1β and other pro-inflammatory cytokines, hyperuricemia, xanthioxidase and other factors associated with gout is discussed. It is possible that the level of uric acid is associated with diabetes and other metabolic diseases, causing pathophysiological changes not only through inflammation, but also oxidative stress, damage to the vascular endothelium. It is also suggested that gout and DM 2 may share genetic markers. The interrelation of violations of purine and carbohydrate metabolism prompts the search for drugs that have a simultaneous positive effect on purine and carbohydrate metabolism. However, it is not clear what the level of uric acid should be considered as a risk factor, there are conflicting data on the possibility of reducing the risk of developing diabetes with various anti-gout therapies.

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