emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2025.9.1.2390emcardio-114Research ArticleОригинальные научные публикацииOriginal Scientific ResearchСаркопеническое ожирение у пациентов с артериальной гипертензией и метаболически ассоциированной жировой болезнью печени: фокус на воспаление. Часть 1Sarcopenic obesity in patients with arterial hypertension and metabolic dysfunction-associated steatotic liver disease: focus on inflammation. Part 1АнтюхК. Ю.AntyukhK. Yu.

Минск

Minsk

gladun-karina@mail.ruГригоренкоЕ. А.GrigorenkoE. A.

Минск

Minsk

ВасильеваН. А.VasilyevaN. A.

Минск

Minsk

СеменоваН. В.SemenovaN. V.

Минск

Minsk

КолядкоМ. Г.KolyadkoM. G.

Минск

Minsk

ГеворкянТ. Т.GevorkyanT. T.

Минск

Minsk

КурушкоТ. В.KurushkoT. V.

Минск

Minsk

ШептулинаА. Ф.SheptulinaA. F.

Москва

Moscow

ДрапкинаО. М.DrapkinaO. M.

Москва

Moscow

МитьковскаяН. П.MitkovskayaN. P.

Минск

Minsk

Республиканский научно-практический центр «Кардиология»Republican Scientific and Practical Center "Cardiology"Республиканский научно-практический центр «Кардиология»; Белорусский государственный медицинский университетRepublican Scientific and Practical Center "Cardiology"; Belarusian State Medical UniversityРеспубликанский центр медицинской реабилитации и бальнеолеченияRepublican Medical Rehabilitation and BalneotherapyНациональный медицинский исследовательский центр терапии и профилактической медицины Министерства здравоохранения Российской ФедерацииNational Medical Research Center for Therapy and Preventive MedicineБелорусский государственный медицинский университетBelarusian State Medical University2025110920259123902403Copyright © Антюх К.Ю., Григоренко Е.А., Васильева Н.А., Семенова Н.В., Колядко М.Г., Геворкян Т.Т., Курушко Т.В., Шептулина А.Ф., Драпкина О.М., Митьковская Н.П., 20252025Антюх К.Ю., Григоренко Е.А., Васильева Н.А., Семенова Н.В., Колядко М.Г., Геворкян Т.Т., Курушко Т.В., Шептулина А.Ф., Драпкина О.М., Митьковская Н.П.Antyukh K.Y., Grigorenko E.A., Vasilyeva N.A., Semenova N.V., Kolyadko M.G., Gevorkyan T.T., Kurushko T.V., Sheptulina A.F., Drapkina O.M., Mitkovskaya N.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/114

Цель исследования – оценить показатели неспецифического воспаления у пациентов с артериальной гипертензией (АГ) и метаболически ассоциированной жировой болезнью печени (МАЖБП) в зависимости от наличия саркопенического ожирения.

Материал и методы

Материал и методы. В исследование включены 133 пациента обоего пола с АГ I-II степени и МАЖБП, разделенные на две группы в зависимости от наличия / отсутствия саркопенического ожирения: 1-я группа (основная) – пациенты с АГ, МАЖБП и саркопеническим ожирением (n = 34, 25,6%), средний возраст 51,8 ± 6,88 лет; 2-я группа (контрольная) – пациенты с АГ, МАЖБП без саркопенического ожирения (n = 99, 74,4%), средний возраст 46,4 ± 8,13 лет. Диагностика саркопенического ожирения проводилась на основе критериев European Society for Clinical Nutrition and Metabolism и European Association for the Study of Obesity. Концентрацию маркеров воспаления в сыворотке крови (интерлейкина-6 (ИЛ-6), фактора некроза опухоли-α (ФНО-α)) оценивали методом иммуноферментного анализа, высокочувствительного С-реактивного белка (hs-СРБ) методом биохимического анализа. Анализ результатов исследования осуществлялся с помощью пакета статистической программы SPSS 27.0 (IBM, USA). Полученные данные интерпретировали как достоверные, а различия между показателями считали значимыми при p < 0,05.

Результаты

Результаты. У пациентов с саркопеническим ожирением в сравнении с лицами без ожирения были установлены более высокие значения hs-СРБ (2,64 (1,37 – 4,18) мг/л против 1,76 (0,90 – 2,87) мг/л, р = 0,033). Показатели ИЛ-6 (2,56 (1,46 – 3,64) пг/мл против 2,07 (1,26 – 3,62) пг/мл, р = 0,142) и ФНО-α (1,13 (0,75 – 3,09) пг/мл против 0,50 (0,07 – 3,77) пг/мл, р = 0,227) между группами достоверно не различались. Корреляционный анализ выявил множественные связи между маркерами воспаления, показателями состава тела, мышечной силы и функции, при этом наибольшая степень сцепления была установлена с уровнем hs-СРБ.

Заключение

Заключение.   Результаты  исследования  свидетельствуют о том, что наличие саркопенического ожирения у пациентов с АГ и МАЖБП ассоциировано с повышением содержания в сыворотке кровиhs-СРБ.

Во второй части статьи будут представлены данные о влиянии уровня маркеров воспаления и провоспалительных цитокинов на кардиометаболические риски пациентов с саркопеническим ожирением, АГ и МАЖБП, изложены механизмы увеличения риска развития метаболической дисфункции, связанной со стеатозом печени и АГ, как ключевого звена патофизиологии коморбидности у представленной категории пациентов.

Purpose

Purpose. The purpose of the study was to evaluate the nonspecific inflammatory markers in patients with arterial hypertension (AH) and metabolic dysfunction-associated steatotic liver disease (MASLD) depending on the presence of sarcopenic obesity.

Materials and methods

Materials and methods. The study included 133 patients of both sexes with AH grade I-II and MASLD, divided into two groups depending on the presence/absence of sarcopenic obesity: group 1 (main) – patients with AH, MASLD, and sarcopenic obesity (n = 34, 25.6%), average age 51.8 ± 6.88 years; group 2 (control) – patients with AH, MASLD without sarcopenic obesity (n = 99, 74.4%), average age 46.4 ± 8.13 years.

Sarcopenic obesity was diagnosed based on the criteria of the European Society for Clinical Nutrition and Metabolism and the European Association for the Study of Obesity. The concentration of inflammatory markers (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)) in the blood serum was assessed by enzyme immunoassay, and high-sensitivity C-reactive protein (hs-CRP) by biochemical analysis. Statistical analysis of the obtained data was performed using the SPSS 27.0 statistical software package (IBM, USA). The obtained data were interpreted as reliable, and differences between the indicators were considered significant at p < 0.05.

Results

Results. Patients with sarcopenic obesity had higher hs-CRP values (2.64 (1.37 – 4.18) mg/L vs. 1.76 (0.90–2.87) mg/L, p = 0.033) compared to individuals without obesity. The IL-6 values (2.56 (1.46–3.64) pg/mL vs. 2.07 (1.26 – 3.62) pg/mL, p = 0.142) and TNF-α (1.13 (0.75 – 3.09) pg/mL vs. 0.50 (0.07 – 3.77) pg/mL, p = 0.227) did not differ significantly between the groups. Correlation analysis revealed multiple associations between inflammatory markers, body composition, muscle strength, and function, with the highest degree of association found with hs-CRP levels.

Conclusion

Conclusion. The results of the study indicate that the presence of sarcopenic obesity in patients with AH and MASLD is associated with an increased level of hs-CRP in the blood serum.

The second part of the article will present data on the influence of inflammation markers and pro-inflammatory cytokines on cardiometabolic risks in patients with sarcopenic obesity, AH, and MASLD, and will describe the mechanisms of increasing the risk of metabolic dysfunction associated with liver steatosis and AH, as a key link in the pathophysiology of comorbidity in this category of patients.

артериальная гипертензияметаболически ассоциированная жировая болезнь печениожирениемаркеры воспаленияцитокиныarterial hypertensionmetabolically associated fatty liver diseaseobesityinflammation markerscytokinesНастоящее исследование выполнено при финансовой поддержке Белорусского республиканского фонда фундаментальных исследований в рамках научного проекта М23РНФ-231 «Распространенность и факторы, ассоциированные с нарушениями костно-мышечного статуса, у пациентов молодого и среднего возраста с артериальной гипертензией и неалкогольной жировой болезнью печени в российской и белорусской популяциях» совместно с ФГБУ «НМИЦ ТПМ» Минздрава России, № гос. регистрации 20221914 от 27.12.2022This study was carried out with the financial support of the Belarusian Republican Foundation for Basic Research within the framework of the scientific project M23RNF-231 «Prevalence and factors, associated with the musculoskeletal disorders in young and middle-aged patients with arterial hypertension and non-alcoholic fatty liver disease in Russian and Belarusian populations» in cooperation with the Federal State Budgetary Institution "National Medical Research Center for Therapy and Preventive Medicine» of the Ministry of Healthсare of the Russian Federation, registration no. 20221914 dated 12.27.2022ReferencesCruz-Jentoft A.J., Bahat G., Bauer J. et al. 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The authors declare that there are no conflicts of interest present.