Д.В. Лапицкий, А.Н. Ряполов, В.А. Пупкевич, Т.В. Чирикова, И.Б. Бутяновская, Р.Ф. Ермолкевич, А.А. Арабей, А.В. Гончарик, Ж.А. Ибрагимова, Н.П. Митьковская
ГУ «432 Главный военный клинический медицинский центр МО ВС Республики Беларусь», г. Минск, УО «Белорусский государственный медицинский университет»
В статье отражены результаты изучения динамики гормонов жировой ткани лептина и адипонектина в зависимости от выраженности неспецифического воспаления, а также дан анализ взаимосвязей адипокинов с показателями, отражающими нарушения обмена глюкозы, липидов, содержание жировой ткани в организме пациентов с ХОБЛ при различных уровнях маркеров неспецифического воспаления (высокочувствительного С-реактивного белка, интерлейкина–8). При высоком уровне маркеров воспаления отмечено снижение уровня лептина и повышение уровня адипонектина. Обратное соотношение уровней адипокинов выявлено при уменьшении маркеров воспалительной реакции. Низкий уровень лептина в условиях воспаления, а также высокий уровень лептина при уменьшении выраженности воспаления способствуют нарушениям обмена глюкозы, повышению содержания жировой ткани в организме. Снижение уровня адипонектина при уменьшении маркеров воспалительной реакции сопровождается уменьшением его протективных свойств относительно нарушений обмена глюкозы. Применение селективного блокатора небиволола ассоциировано с повышением уровня адипонектина. Использование розувастатина ассоциировано с повышением уровня лептина, снижением уровня адипонектина, вероятно, за счет подавления воспалительной реакции (плейотропное действие лекарственного средства).
ключевые слова: лептин, адипонектин, неспецифическое воспаление, нарушение обмена глюкозы, повышение содержания жировой ткани, небиволол, статины

для цитирования: Д.В. Лапицкий, А.Н. Ряполов, В.А. Пупкевич, Т.В. Чирикова, И.Б. Бутяновская, Р.Ф. Ермолкевич, А.А. Арабей, А.В. Гончарик, Ж.А. Ибрагимова, Н.П. Митьковская. Метаболическая активность жировой ткани у пациентов с хронической обструктивной болезнью легких в условиях хронического неспецифического воспаления. Неотложная кардиология и кардиооваскулярные риски, 2019, Т. 3, № 2, С. 698–708

Adipose tissue metabolic activity in chronic obstructive pulmonary disease patients in case of chronic nonspecific inflammation
D.V. Lapitski, A.N. Ryapolov, V.A. Pupkevich, T.V. Chirikova, I.B. Butyanovskaya, R.F. Ermolkevch, A.A. Arabey, A.V. Goncharik, G.A. Ibragimova, N.P. Mitkovskaya
The article addresses the dynamics of adipose tissue hormones leptin (LN) and adiponectin (AN) depending on nonspecific inflammation (NI) degree, as well as relations between adipokin and glucose/lipids metabolic disorders, adipose tissue capacity with different NI degrees in patients with chronic obstructive pulmonary disease (COPD). NI is associated with a high AN degree and a low LN degree which promotes the increase in metabolic substrata intake for immunity caloric supply. NI decrease is associated with a low AN degree and a highLN degree which promotes increase in adipose tissue capacity and worsening of glucose/lipids metabolic disorders. Nebivolol administration is associated with increase in AN level. Statins administration results in decrease in AN level and increase in LN level, due to reduced NI. Thus, treatment strategy in COPD patients should include some measures to prevent adipose tissue capacity increase and glucose/lipids metabolic disorders when NI is reduced.
keywords: leptin, adiponectin, nonspecific inflammation, glucose metabolic disorders, adipose tissue capacity increase, nebivolol, statins

for references: D.V. Lapitski, A.N. Ryapolov, V.A. Pupkevich, T.V. Chirikova, I.B. Butyanovskaya, R.F. Ermolkevch1, A.A. Arabey, A.V. Goncharik, G.A. Ibragimova, N.P. Mitkovskaya. AAdipose tissue metabolic activity in chronic obstructive pulmonary disease patients in case of chronic nonspecific inflammation. Neotlozhnaya kardiologiyai kardioovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2019, vol. 3, no. 2, pp. 698–708.

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