aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.52727/2078-256X-2023-19-2-154-161ateroskleroz-910Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSКлинико-метаболические аспекты неалкогольной жировой болезни печени в зависимости от индекса массы телаClinical and metabolic aspects of non-alcoholic fatty liver disease depending on BMIГерасименкоО. Н.GerasimenkoO. N.

Оксана Николаевна Герасименко, д-р мед. наук, проф., зав. кафедрой факультетской терапии им. проф. Г. Д. Залесского

630091, г. Новосибирск, Красный просп., 52

Oksana N. Gerasimenko, doctor of medical sciences, professor, head of the department of faculty therapy named after prof. G. D. Zalessky

52, Krasny ave, Novosibirsk, 630091

profgerasimenko@inbox.ruЗнахаренкоЕ. А.ZnakharenkoE. A.

Елена Александровна Знахаренко, аспирант кафедры факультетской терапии им. проф. Г. Д. Залесского

630091, г. Новосибирск, Красный просп., 52

Elena A. Znakharenko, postgraduate student of the department of faculty therapy named after prof. G. D. Zalessky

52, Krasny ave, Novosibirsk, 630091

znaxarenko85@bk.ruГорбуноваА. М.GorbunovaA. M.

Алена Михайловна Горбунова, аспирант кафедры факультетской терапии им. проф. Г. Д. Залесского

630091, г. Новосибирск, Красный просп., 52

Alyona M. Gorbunova, postgraduate student of the department of faculty therapy named after prof. G. D. Zalessky

52, Krasny ave, Novosibirsk, 630091

gvv3@nso.ruТолмачеваА. А.TolmachevaA. A.

Анастасия Александровна Толмачева, канд. мед. наук, ассистент кафедры факультетской терапии им. проф.Г. Д. Залесского

630091, г. Новосибирск, Красный просп., 52

Anastasiia A. Tolmacheva, candidate of medical sciences, assistant of the department of faculty therapy named after prof. G. D. Zalessky

52, Krasny ave, Novosibirsk, 630091

gvv3@nso.ruБазуеваА. С.BazuevaА. S.

Анастасия Сергеевна Базуева, студент лечебного факультета

630091, г. Новосибирск, Красный просп., 52

Anastasiia S. Bazueva, student of the medical department

52, Krasny ave, Novosibirsk, 630091

koroleva.o89137917685@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииNovosibirsk State Medical University202311072023192154161Copyright © Герасименко О.Н., Знахаренко Е.А., Горбунова А.М., Толмачева А.А., Базуева А.С., 20232023Герасименко О.Н., Знахаренко Е.А., Горбунова А.М., Толмачева А.А., Базуева А.С.Gerasimenko O.N., Znakharenko E.A., Gorbunova A.M., Tolmacheva A.A., Bazueva А.S.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/910

В настоящее время достаточно хорошо изучены вопросы взаимосвязи неалкогольной жировой болезни печени (НАЖБП) с ожирением, особенно абдоминальным, а также метаболическим синдромом, который, в свою очередь, значительно повышает кардиометаболический риск и отражается на заболеваемости, прогнозе и продолжительности жизни больных. И хотя у больных ожирением распространенность различных клинических форм НАЖБП значительно выше, чем в общей популяции, 7–20 % людей с НАЖБП имеют пониженный трофологический статус или индекс массы тела (ИМТ). При этом темпы прогрессирования заболевания, ассоциированные состояния, а также диагностические и лечебные подходы различаются для пациентов с НАЖБП в зависимости от ИМТ, что выявляет потребность в четких указаниях клиницистам относительно терапии НАЖБП в зависимости от нутритивного статуса. Нами выполнен систематический обзор с целью обобщить клинико-метаболические аспекты НАЖБП в зависимости от нутритивного статуса, а также подходы к немедикаментозному лечению посредством изменения образа жизни. Обсуждаются фундаментальные клинико-функциональные, метаболические, гормональные и другие факторы патологического процесса, определяющие механизмы и прогноз заболевания у пациентов с НАЖБП с различным ИМТ и нутритивным статусом. Использованы сведения по теме из публикаций на основе баз данных PubMed и РИНЦ.

At present, the issues of the relationship between non-alcoholic fatty liver disease (NAFLD) and obesity, especially abdominal, as well as metabolic syndrome, which, in turn, significantly increases the cardiometabolic risk and affects the incidence, prognosis and life expectancy of patients, are quite well studied. And although the prevalence of various clinical forms of NAFLD is significantly higher in obese patients than in the general population, 7–20 % of people with NAFLD are estimated to have a lean body habit. At the same time, the rate of disease progression, associated conditions, anddiagnostic and management approaches differ for patients with NAFLD depending on body mass index (BMI), which reveals the need for clear guidance to clinicians regarding the NAFLD treatment depending on nutritional status. We performed a systematic review to summarize the clinical and metabolic aspects of NAFLD depending on nutritional status, as well as approaches to non-drug treatment through lifestyle changes. The fundamental clinical and functional, metabolic, hormonal and other factors of the pathological process that determine the mechanisms and prognosis of the disease in patients with NAFLD with different BMI are discussed. Information on the topic from publications based on the PubMed and RSCI databases was used.

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