aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАНateroskleroz-666Research ArticleОБЗОРЫREVIEWSТолщина интимы-медии сонных артерий у женщин: связь с факторами риска сердечно-сосудистых заболеванийThe thickness of the intime-media of the carotid arteries in women: relationship to risk factors of cardiovascular diseasesРябиковА. Н.RyabikovA. N.

Андрей Николаевич Рябиков, д-р мед. наук, проф., ведущий научный сотрудник, проф.

СО РАМН

ФГБУ «НИИ терапии»

лаборатория клиники и этиопатогенеза терапевтических заболеваний

630089

ул. Бориса Богаткова, 175/1

ГБОУ ВПО «Новосибирский государственный медицинский университет»

кафедра терапии, гематологии и трансфузиологии

630049

Красный просп., 52

Новосибирск

SB RAMS

Federal State Budgetary Institution "Research Institute of Therapy"

630089

st. Boris Bogatkov, 175/1

State Budgetary Educational Institution of Higher Professional Education "Novosibirsk State Medical University"

630049

Red Avenue, 52

Novosibirsk

andrew_ryabikov@mail.comУколоваЮ. Ю.UkolovaYu. Yu.

Юлия Юрьевна Уколова, аспирантка

ГБОУ ВПО «Новосибирский государственный медицинский университет»

кафедра терапии, гематологии и трансфузиологии

630049

Красный просп., 52

630049

State Budgetary Educational Institution of Higher Professional Education "Novosibirsk State Medical University"

630049

Red Avenue, 52

Novosibirsk

ukolova@hotmail.comМалютинаС. К.MalyutinaS. K.

Софья Константиновна Малютина, д-р мед. наук, проф., главный научный сотрудник, проф.

СО РАМН; Минздрав России

ФГБУ «НИИ терапии»

лаборатория клиники и этиопатогенеза терапевтических заболеваний

630089

ул. Бориса Богаткова, 175/1

ГБОУ ВПО «Новосибирский государственный медицинский университет»

кафедра терапии, гематологии и трансфузиологии

630049

Красный просп., 52

Новосибирск

SB RAMS; Russian Ministry of Health

Federal State Budgetary Institution "Research Institute of Therapy"

630089

st. Boris Bogatkov, 175/1

State Budgetary Educational Institution of Higher Professional Education "Novosibirsk State Medical University"

630049

Red Avenue, 52

Novosibirsk

smalyutina@hotmail.comРАМН; Минздрав РоссииRAMS; Russian Ministry of HealthМинздрав РоссииRussian Ministry of HealthРАМНRAMS201306042022915464Copyright © Рябиков А.Н., Уколова Ю.Ю., Малютина С.К., 20222022Рябиков А.Н., Уколова Ю.Ю., Малютина С.К.Ryabikov A.N., Ukolova Y.Y., Malyutina S.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/666

   Особенности развития женского атеросклероза менее изучены, чем у мужчин, в том числе и факторы риска субклинических изменений стенки сонных артерий у женщин. C целью обобщения литературных данных о связи толщины интимо-медиального комплекса (ТИМК) сонных артерий с факторами риска сердечно-сосудистых заболеваний (ССЗ) у женщин проведен поиск литературных данных по теме за 20 лет (1993–2012) с использованием интернет-ресурса Pub Med (http://www.ncbi.nlm.nih.gov/pubmed). Обзор дополнен ранее опубликованными крупными исследованиями. Анализ литературных данных показал особенности ассоциаций ТИМК с факторами риска ССЗ у женщин. Выявлены более слабая связь ТИМК с возрастом у женщин до 50 лет и опережающий ежегодный прирост ТИМК в более старшем возрасте по сравнению с мужчинами. Артериальная гипертония и уровни (преимущественно) систолического артериального давления ассоциируются с увеличением ТИМК одинаково у мужчин и у женщин. Показана прямая связь ТИМК с ожирением у лиц обоего пола. Описана более высокая частота ожирения и метаболического синдрома у женщин в постменопаузе, но в доступной литературе существенных различий в их ассоциациях с ТИМК у мужчин и женщин не обнаружено. Показаны специфические связи с дислипидемией, а именно: различный вклад уровня триглицеридов в увеличение ТИМК у женщин в зависимости от менструального статуса и возраста. Курение ассоциировалось с увеличением ТИМК и у женщин старше 45 лет являлось самым сильным предиктором атеросклероза независимо от возраста и сроков менопаузы. Отмечен поло-специфический вклад генетических факторов и новых биомаркеров в развитие субклинических признаков атеросклероза. Понимание женских особенностей детерминации увеличения ТИМК сонных артерий может повысить эффективность профилактики атеросклероза на ранней стадии.

   The specific features of the development of atherosclerosis in women and determinants of subclinical changes of carotid artery are less investigated than in men. The purpose of review is to summarize the findings from published studies of the association between carotid intima-media thickness (CIMT) and risk factors of cardiovascular diseases (CVD) in women. We performed a systematic PubMed literature search for 20 years (1993–2012) on this subject (http://www.ncbi.nlm.nih.gov/pubmed). In addition, some early published major studies were included in the review. Despite heterogeneity of the results presented in literature, their analysis showed specific features of the associations between CIMT and CVD risk factors in women. For instance, weak association was revealed between CIMT and age in women under 50 years old and the faster annual progression of CIMT was shown at older age compared to men. Hypertension and blood pressure (predominantly systolic) are associated with CIMT increase similarly in men and women. Direct association between CIMT and obesity was also shown in both sexes. The higher prevalence of obesity and metabolic syndrome was reported among women in menopausal age than in men, but we failed to find out the evidence of different associations between these factors and CIMT in men and women in available literature. Specific associations was found with dyslipidemia, namely, the different impact of triglycerides level on CIMT in women depending on menstrual status and age. The smoking was associated with CIMT, and in women above 45 years old smoking was the most powerful predictor of atherosclerosis independently from menstrual status and age. Sex-specific effect of genetic factors and new biomarkers on the development of subclinical atherosclerosis was observed although the data accumulated in this area are controversial and require further research. The understanding of female peculiarities in the determination of carotid intima-media thickening might improve the efficiency of atherosclerosis prevention at early stage.

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