aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.52727/2078-256X-2022-18-3-236-246ateroskleroz-807Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSКардиоваскулярные эффекты метформина: в центре внимания метаболизм жировой тканиCardiovascular effects of metformin: focus on adipose tissue metabolismhttps://orcid.org/0000-0002-7780-829XГруздеваО. В.GruzdevaO. V.

Ольга Викторовна Груздева - доктор медицинских наук, доцент, профессор РАН, зав. лабораторией исследований гомеостаза ОЭМ.

650002, Кемерово, Сосновый бульвар, 6

Olga V. Gruzdeva - doctor of medical sciences, professor, head of the laboratory for homeostasis research.

6, Sosnovy Blvd, Kemerovo, 65000

o_gruzdeva@mail.ruhttps://orcid.org/0000-0002-0500-2449БычковаЕ. Е.BychkovaE. E.

Евгения Евгеньевна Бычкова - лаборант-исследователь, лаборатория исследований гомеостаза ОЭМ

650002, Кемерово, Сосновый бульвар, 6, 8-923-472-18-72

Evgeniya Е. Bychkova - research assistant, laboratory for homeostasis research.

6, Sosnovy Blvd, Kemerovo, 650002

eugenia.tarasowa@yandex.ruhttps://orcid.org/0000-0002-6890-3287ДылеваЮ. А.DylevaJ. A.

Юлия Александровна Дылева - кандидат медицинских наук, старший научный сотрудник, лаборатория исследований гомеостаза.

650002, Кемерово, Сосновый бульвар, 6

Julia A. Dyleva - candidate of medical sciences, senior researcher, laboratory for homeostasis research.

6, Sosnovy Blvd, Kemerovo, 650002

dyleva87@yandex.ruНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation202230092022183236246Copyright © Груздева О.В., Бычкова Е.Е., Дылева Ю.А., 20222022Груздева О.В., Бычкова Е.Е., Дылева Ю.А.Gruzdeva O.V., Bychkova E.E., Dyleva J.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/807

Настоящий обзор посвящен анализу данных по изучению возможного влияния метформина на эндокринную функцию жировой ткани: синтез и секрецию гормонов адипоцитов – адипокинов (лептина, адипонектина, резистина) – и гастроинтестинальной системы (грелина). Метформин – сахароснижающее лекарственное средство класса бигуанидов, используемое в качестве терапии первой линии для коррекции нарушений углеводного обмена. В настоящее время существенно возрос интерес к плейотропным кардиопротективным и антиатерогенным свойствам метформина. Показаны молекулярные механизмы его влияния на углеводный и липидный обмен в жировой ткани на примере изолированных адипоцитов (in vitro) и в живом организме (in vivo). Ключевым ферментом регуляции в действии метформина является АМФ-активируемая протеинкиназа (AMPK), активация которой блокирует синтез жирных кислот и способствует липолизу и окислению жирных кислот, ингибирует продукцию глюкозы в печени, снижая экспрессию АМФ-стимулированных генов ферментов глюконеогенеза, повышает чувствительность к инсулину, что в конечном итоге потенцирует снижение содержания глюкозы. Вместе с тем недостаточно изучены дозозависимые эффекты метформина, нет данных о его долгосрочном влиянии на метаболизм жировой ткани, что требует пристального внимания к изучению данного вопроса. В целом, метформин не только представляется перспективным препаратом для борьбы с гипергликемией, но и, возможно, способствует коррекции дислипидемии при сахарном диабете 2 типа и снижает сердечно-сосудистые риски, связанные с этим заболеванием.

This review is devoted to the analysis of data on the study of the possible effect of metformin on the endocrine function of adipose tissue: the synthesis and secretion of adipocyte hormones – adipokines (leptin, adiponectin, resistin) and the gastrointestinal system (ghrelin). metformin is a biguanide class of hypoglycemic drugs used as a first-line therapy for the correction of carbohydrate metabolism. Currently, there has been a significant increase in interest in the pleiotropic cardioprotective and antiatherogenic properties of metformin. The molecular mechanisms of action of metformin on carbohydrate and lipid metabolism in adipose tissue are shown in the example of isolated adipocytes (in vitro) and in a living organism (in vivo). The key enzyme regulation in metformin action is с-AMPactivated protein kinase (AMPK). Activation of this enzyme blocks fatty acid synthesis, activates lipolysis and fatty acid oxidation; inhibits glucose production in the liver, reducing the expression of AMP-stimulated genes of enzymes of gluconeogenesis, increases insulin sensitivity, which ultimately contributes to the reduction of glucose. However, the dose-dependent effects of metformin are not well understood, there is no data on the long-term effects of the drug on the metabolism of adipose tissue, which requires careful attention to the study of this issue. Overall, metformin seems to be a promising drug to combat hyperglycemia, and dyslipidemia in diabetes mellitus type 2 and obesity, and for the prevention of cardiovascular risks associated with these diseases.

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