systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.38109/2075-082X-2022-4-5-15systhiper-640Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL ARTICLEВлияние системных и эктопических жировых депо на состояние функции почекThe influence of systemic and ectopic fat depots on the state of kidney functionhttps://orcid.org/0000-0001-5215-4894БлиноваН. B.BlinovaN. V.

Блинова Наталия Владимировна, кандидат медицинских наук, старший научный сотрудник отдела гипертонии

ул. 3-я Черепковская, 15-А, Москва 121552

Nataliya V. Blinova, Cand. of Sci. (Med.), Senior Researcher, Department of Hypertension, A.L. Myasnikov Institute of Clinical Cardiology

3rd Cherepkovskaya str., 15a, Moscow 121552

nat-cardio1@yandex.ruhttps://orcid.org/0000-0001-7895-9068ЖернаковаЮ. В.ZhernakovaYu. V.

Жернакова Юлия Валерьевна, доктор медицинских наук, ученый секретарь Института клинической кардиологии им. А.Л. Мясникова

ул. 3-я Черепковская, 15-А, Москва 121552

Yuliya V. Zhernakova, Prof., Dr. of Sci. (Med.), Scientific Secretary, A.L. Myasnikov Institute of Clinical Cardiology

3rd Cherepkovskaya str., 15a, Moscow 121552

juli001@mail.ruhttps://orcid.org/0000-0001-7092-8689АзимоваМ. О.AzimovaM. O.

Азимова Марина Олеговна, кандидат медицинских наук, врач-кардиолог

ул. Лобачевского д. 42, стр. 1, Москва 119415

Marina O. Azimova, Cand. of Sci. (Med.), Cardiologist

Moscow

 

marinaazimovaa@gmail.comhttps://orcid.org/0000-0001-5917-0205АндреевскаяМ. В.AndreevskayaM. V.

Андреевская Марина Владимировна, кандидат медицинских наук, научный сотрудник, отдела ультразвуковых методов исследования

ул. 3-я Черепковская, 15-А, Москва 121552

Marina V. Andreevskaya, Cand. of Sci. (Med.), Researcher, Department of Ultrasound Research Methods

3rd Cherepkovskaya str., 15a, Moscow 121552

marineracrim@mail.ruhttps://orcid.org/0000-0002-9822-4357ЧазоваИ. Е.ChazovaI. E.

Чазова Ирина Евгеньевна, доктор медицинских наук, академик РАН, руководитель отдела гипертонии Института клинической кардиологии им. А.Л. Мясникова

ул. 3-я Черепковская, 15-А, Москва 121552

Irina E. Chazova, Dr. of Sci. (Med.), Academician of RAS, Deputy General Director for Scientific and Expert Work, Head of Hypertension Department, A.L. Myasnikov Research Institute of Cardiology

3rd Cherepkovskaya str., 15a, Moscow 121552

 

c34h@yandex.ruФГБУ «Национальный медицинский исследовательский центр кардиологии» им. акад. Е.И. Чазова Минздрава РоссииРоссияE.I. Chazov National Medical Research Center Of CardiologyRussian FederationФГБУ «Национальный медицинский исследовательский центр кардиологии» им. акад. Е.И. Чазова Минздрава РоссииРоссияE.I. Chazov National Medical Research Center of CardiologyRussian FederationГБУЗ города Москвы «Городская клиническая больница № 31 Департамента здравоохранения города Москвы»РоссияCity Clinical Hospital No. 31Russian Federation202203012023194515Copyright © Блинова Н.B., Жернакова Ю.В., Азимова М.О., Андреевская М.В., Чазова И.Е., 20222022Блинова Н.B., Жернакова Ю.В., Азимова М.О., Андреевская М.В., Чазова И.Е.Blinova N.V., Zhernakova Y.V., Azimova M.O., Andreevskaya M.V., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/640Цель

Цель: оценка функции почек и почечной гемодинамики у лиц с ожирением на различных этапах кардиометаболического континуума, включая метаболически здоровое абдоминальное ожирение (МЗАО) без метаболического синдрома (МС), МС и сахарный диабет (СД) 2 типа.

Материалы и методы

Материалы и методы: в настоящем исследовании представлен анализ выборки (n = 156), состоящей из лиц с абдоминальным ожирением (АО) в возрасте 18-45 лет. Методы исследования включали антропометрические измерения, лабораторные (общий холестерин (ХС), триглицериды, ХСЛПВП, ХСЛПНП, мочевая кислота, креатинин, цистатин С, глюкоза, инсулин, с расчетом индекса инсулинорезистентности HOMA-IR, адипонектин, лептин, скорость клубочковой фильтрации) и инструментальные исследования (УЗИ почек и ультразвуковое допплеровское сканирование почечных артерий, МСКТ с определением жировых депо).

Результаты

Результаты: установлено, что функция почек (СКФ) и почечный кровоток тесно связаны с размерами жировых депо, как системных (интраабдоминальный жир), так и локальных (периренальный жир и жир почечного синуса). У лиц с МЗАО наблюдается некоторое снижение СКФ по сравнению со здоровыми лицами и повышение пульсационного индекса (PI), что свидетельствует о повышении периферического сосудистого сопротивления кровотоку. У лиц с МС и СД 2 типа эти изменения выражены в еще большей степени.

Выводы

Выводы: таким образом, выявление нарушений почечной гемодинамики на самых ранних этапах кардиометаболического континуума позволит выделить лиц с высоким почечным и сердечно-сосудистым риском.

Objective

Objective: To assess renal function and renal hemodynamics in obese individuals at various stages of the cardiometabolic continuum, including metabolically healthy abdominal obesity (MНАО) without metabolic syndrome (MS), MS, and type 2 diabetes mellitus (DM).

Materials and methods

Materials and methods: The sample (n = 156) consisting of individuals with abdominal obesity (AO) aged 18-45 years. Study methods included anthropometric measurements, laboratory (total cholesterol, triglycerides, HDL, LDL, uric acid, creatinine, cystatin C, glucose, insulin, with calculation of HOMA-IR, adiponectin, leptin, glomerular filtration rate) and instrumental examinations (renal ultrasound and renal artery duplex scaning, CT with determination of fat depots).

Results

Results: Renal function (GFR) and renal blood flow were to be strongly related to fat depot sizes, both systemic (intraabdominal fat) and local (perirenal fat and renal sinus fat) depot. In persons with MHAO, there is a slight decrease in GFR compared to healthy persons and an increase in the pulse index (PI), which indicates an increase in peripheral vascular resistance to blood flow. In individuals with MS and type 2 DM, these changes are even more pronounced.

Conclusions

Conclusions: Thus, the identification of renal hemodynamic disorders at the early stages of the cardiometabolic continuum will allow highlighting persons with high renal and cardiovascular risk

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