nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-183-11-20-24nogr-1469Research ArticleПЕРЕДОВАЯ СТАТЬЯLEADING ARTICLEРоль желчных кислот в многообразии механизмов формирования печеночных проявлений метаболического синдромаThe role of bile acids in the variety of mechanisms of the formation of hepatic manifestations of metabolic syndromehttps://orcid.org/0000-0002-1095-8787ГриневичВ. Б.GrinevichV. B.

Гриневич Владимир Борисович, заведующий 2 кафедрой (терапии усовершенствования врачей), д. м. н., профессор

194044, Санкт-Петербург, улица Академика Лебедева, д. 6

Vladimir B. Grinevich, Head of 2nd Therapy department of postgraduate education, DSci, professor; Scopus Author ID: 7005167197

194044, St. Petersburg, Akademika Lebedev street, 6

https://orcid.org/0000-0001-8347-0531КравчукЮ. А.KravchukYu. A.

Кравчук Юрий Алексеевич, д. м. н., профессор 2 кафедры (терапии усовершенствования врачей)

194044, Санкт-Петербург, улица Академика Лебедева, д. 6

Yuri A. Kravchuk, M.D., D. Sc. (Medicine), Professor of 2nd Therapy department of postgraduate education

194044, St. Petersburg, Akademika Lebedev street, 6

kravchuk2003@mail.ruАрапхановаМ. М.ArapkhanovаM. M.

Арапханова Марина Магомедовна, врач-гастроэнтеролог клиники 2 кафедры (терапии усовершенствования врачей)

194044, Санкт-Петербург, улица Академика Лебедева, д. 6

Marina M. Arapkhanova, gastroenterologist of 2nd Therapy department of postgraduate education

194044, St. Petersburg, Akademika Lebedev street, 6

КонВ. Е.KonV. E.

Кон Виктория Ефимовна, к. м. н., заведующая кардиологическим отделением с восстановительным лечением № 1

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Viktoria E. Kon, MD, PhD, Head of the Cardiology Department with Rehabilitation Treatment No. 1

197341, St. Petersburg, st. Akkuratova, 2

МихайловаЛ. В.MikhailovaL. V.

Михайлова Любовь Вячеславовна, врач-кардиолог

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Lyubov V. Mikhailova, cardiologist

197341, St. Petersburg, st. Akkuratova, 2

https://orcid.org/0000-0003-3279-6448РатниковаА. К.RatnikovaA. K.

Ратникова Анна Константиновна, врач УЗД, врач-кардиолог

194044, Санкт-Петербург, улица Академика Лебедева, д. 6194291, Санкт-Петербург, пр. Культуры, д. 4 

Anna K. Ratnikova, sonologist, cardiologist

194044, St. Petersburg, Akademika Lebedev street, 6194291, St. Petersburg, Kultury Ave., 4 

ФГБВОУ ВО «Военно-медицинская академия имени С. М. Кирова» МО РФРоссияMilitary Medical Academy named after S. M. KirovRussian FederationФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian FederationФГБВОУ ВО «Военно-медицинская академия имени С. М. Кирова» МО РФ; ФГБУ «Северо-Западный окружной научно-клинический центр имени Л. Г. Соколова Федерального медико-биологического агентства»РоссияMilitary Medical Academy named after S. M. Kirov; Federal state budgetary institution “North-West District Scientific and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency”Russian Federation202013112020183112024Copyright © Гриневич В.Б., Кравчук Ю.А., Арапханова М.М., Кон В.Е., Михайлова Л.В., Ратникова А.К., 20202020Гриневич В.Б., Кравчук Ю.А., Арапханова М.М., Кон В.Е., Михайлова Л.В., Ратникова А.К.Grinevich V.B., Kravchuk Y.A., Arapkhanovа M.M., Kon V.E., Mikhailova L.V., Ratnikova A.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1469

Метаболический синдром и неалкогольная жировая болезнь печени, как его печеночное проявление, сегодня являются крайне актуальными и социально значимыми проблемами здравоохранения. В статье представлены новые данные по проблеме патогенеза неалкогольной жировой болезни печени с позиции влияния желчных кислот на состояние углеводного и липидного обмена, функционирование жировой ткани, состав и функции микробно-тканевого комплекса кишечника. Желчные кислоты являются лиганд-связывающими доменами, участвующими в активации многих рецепторов. Освещена роль эндогенной фруктозы, мочевой кислоты, хронической болезни почек, дисфункции тромбоцитарного звена в развитии заболевания, определены направления терапевтического воздействия. Увеличение окислительного стресса, нарушение микробно-тканевого комплекса кишечника, дислипидемия, избыточная активация тромбоцитов формируют «порочный круг», способствующий прогрессированию заболеваний печени и почек.

Metabolic syndrome and non-alcoholic fatty liver disease, as its hepatic manifestation, are extremely relevant and socially significant health problems today. The article presents new data on the problem of the pathogenesis of non-alcoholic fatty liver disease from the perspective of the influence of bile acids on the state of carbohydrate and lipid metabolism, the functioning of adipose tissue, the composition and function of the intestinal microbial-tissue complex. Bile acids are ligand-binding domains involved in the activation of many receptors. The role of endogenous fructose, uric acid, chronic kidney disease, platelet dysfunction in the development of the disease is highlighted, the directions of therapeutic action are determined. An increase in oxidative stress, a violation of the intestinal microbial-tissue complex, dyslipidemia, and excessive platelet activation form a “vicious circle” that promotes the progression of liver and kidney diseases.

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