Развитие сахарного диабета 2-го типа при подагре
https://doi.org/10.47360/1995-4484-2021-599-607
Аннотация
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.
Об авторах
О. В. Желябина
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Россия
Желябина Ольга Владимировна
115522, Российская Федерация, Москва, Каширское шоссе, 34а
М. С. Елисеев
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Россия
115522, Российская Федерация, Москва, Каширское шоссе, 34а
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Рецензия
Для цитирования:
Желябина О.В., Елисеев М.С. Развитие сахарного диабета 2-го типа при подагре. Научно-практическая ревматология. 2021;59(5):599-607. https://doi.org/10.47360/1995-4484-2021-599-607
For citation:
Zhelyabina O.V., Eliseev M.S. Type 2 diabetes mellitus and gout. Rheumatology Science and Practice. 2021;59(5):599-607. (In Russ.) https://doi.org/10.47360/1995-4484-2021-599-607
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