Современные представления о роли адипокинов в патогенезе ишемической болезни сердца

Введение. Распространенность абдоминального ожирения и его ассоциация с ишемической болезнью сердца являются предпосылкой для изучения взаимосвязей на молекулярном уровне за счет секретируемых жировой тканью адипокинов.

Цель — провести критический анализ данных, представленных в доступных источниках, индексированных в базах данных (Российский индекс научного цитирования и PubMed) за период 2018–2026 гг., посвященных патогенетической взаимосвязи абдоминального ожирения и ишемической болезни сердца посредством эффектов адипокинов.

Результаты. Широкий спектр (более 600) адипокинов может быть дифференцирован в зависимости от их участия в атерогенезе как ключевом субстрате ишемической болезни сердца на про- и антиатерогенные и адипокины с неопределенной ролью. Механизмы действия адипокинов проатерогенного влияния (лептин, хемерин, резистин, липокалин-2, IL-1β, IL-6, IL-8, IL-18, IFN-γ, TNF-α и др.) включают в себя формирование хронического воспаления с активацией синтеза провоспалительных цитокинов, С-реактивный белок, окислительного стресса, дислипидемии, опосредованных дисфункцией эндотелия, гладкомышечных клеток и внеклеточного матрикса сосудистой стенки, избыточным образованием пенистых клеток. Роль адипокинов антиатерогенного действия (адипонектин, FGF-21, програнулин и др.) реализуется за счет изменения липидного профиля плазмы, противовоспалительных, антиоксидантных свойств. Адипокины с неопределенной ролью в атерогенезе (адипсин, IL-17, оментин и др.) являются объектом пристального изучения и уточнения их роли в патогенезе ишемической болезни сердца. Представленная информация расширяет имеющиеся сведения о роли адипокинов в патогенезе ишемической болезни сердца, является предпосылкой для проведения дальнейших исследований и совершенствования диагностических, прогностических, терапевтических, профилактических синергичных стратегий у больных с ишемической болезнью сердца и абдоминальным ожирением в клинической практике, в т. ч. в контексте персонализированной биомолекулярной медицины, направленной на снижение глобального бремени атеросклероза. 

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