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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nogr</journal-id><journal-title-group><journal-title xml:lang="ru">Экспериментальная и клиническая гастроэнтерология</journal-title><trans-title-group xml:lang="en"><trans-title>Experimental and Clinical Gastroenterology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-8658</issn><publisher><publisher-name>«Global Media Technologies»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31146/1682-8658-ecg-235-3-55-65</article-id><article-id custom-type="elpub" pub-id-type="custom">nogr-3134</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МЕТАБОЛИЧЕСКИЙ СИНДРОМ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>METABOLIC SYNDROME</subject></subj-group></article-categories><title-group><article-title>Метаболически ассоциированная жировая болезнь печени при метаболическом синдроме</article-title><trans-title-group xml:lang="en"><trans-title>Metabolic dysfunctionassociated steatotic liver disease in the setting of metabolic syndrome</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0207-7063</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Цыганкова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tsygankova</surname><given-names>O. V.</given-names></name></name-alternatives><email xlink:type="simple">oksana_c.nsk@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1530-3106</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Веретюк</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Veretyuk</surname><given-names>V. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6584-2060</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тимощенко</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Timoshchenko</surname><given-names>O. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский государственный медицинский университет» Минздрава России; Научно-исследовательский институт терапии и профилактической медицины - филиал ФГБНУ «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novosibirsk State Medical University; Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Novosibirsk State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Научно-исследовательский институт терапии и профилактической медицины - филиал ФГБНУ «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>29</day><month>10</month><year>2025</year></pub-date><volume>0</volume><issue>3</issue><fpage>55</fpage><lpage>65</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Цыганкова О.В., Веретюк В.В., Тимощенко О.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Цыганкова О.В., Веретюк В.В., Тимощенко О.В.</copyright-holder><copyright-holder xml:lang="en">Tsygankova O.V., Veretyuk V.V., Timoshchenko O.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nogr.org/jour/article/view/3134">https://www.nogr.org/jour/article/view/3134</self-uri><abstract><p>Неалкогольная жировая болезнь печени (НАЖБП) является наиболее распространенной патологией печени, поражая глобально около 38% населения, и представляет собой спектр состояний, начиная от накопления жира в гепатоцитах и прогрессируя до воспаления печени (стеатогепатита) с различной степенью фиброза, а также риском развития цирроза и гепатоцеллюлярной карциномы. С накоплением научных данных, усовершенствованием методов диагностики сформировалось понимание того, что метаболическая дисфункция является ключевой в патогенезе и последствиях НАЖБП. В 2020 году было предложено пересмотреть номенклатуру и классификацию НАЖБП в метаболически ассоциированную жировую болезнь печени (МАЖБП), акцентируя внимание на метаболической дисфункции в основе данной нозологии. В данном обзоре обсуждаются различия в дефинициях и классификации НАЖБП и МАЖБП, клиническое бремя и последствия МАЖБП как мультисистемного заболевания с акцентом на патогенетических взаимосвязях МАЖБП и метаболического синдрома.</p></abstract><trans-abstract xml:lang="en"><p>Nonalcoholic fatty liver disease (NAFLD) is the most common liver pathology, affecting about 38% of the global population. It represents a spectrum of conditions, starting from the fat accumulation in hepatocytes (steatosis) and progressing to liver inflammation (steatohepatitis) with varying degrees of fibrosis, as well as a risk of developing cirrhosis and hepatocellular carcinoma. With the accumulation of scientific data and improvements in diagnostic methods, an understanding has emerged that metabolic dysfunction is central to the pathogenesis and consequences of NAFLD. In 2020 a proposal was made to revise the nomenclature and classification of NAFLD to metabolic dysfunction-associated steatotic liver disease (MASLD), emphasizing the underlying metabolic dysfunction of this condition. This review discusses the differences in the definitions and classification of NAFLD and MASLD, the clinical burden and consequences of MASLD as a multisystem disease, with a focus on the pathogenetic interrelationships between MASLD and metabolic syndrome.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>НАЖБП</kwd><kwd>МАЖБП</kwd><kwd>НАСГ</kwd><kwd>стеатоз</kwd><kwd>стеатогепатит</kwd><kwd>метаболическая дисфункция</kwd><kwd>метаболический синдром</kwd><kwd>диабет</kwd></kwd-group><kwd-group xml:lang="en"><kwd>NAFLD</kwd><kwd>MASLD</kwd><kwd>NASH</kwd><kwd>steatosis</kwd><kwd>steatohepatitis</kwd><kwd>metabolic dysfunction</kwd><kwd>metabolic syndrome</kwd><kwd>diabetes</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Lim S., Kim J.W., Targher G. Links between metabolic syndrome and metabolic dysfunction-associated fatty liver disease. Trends Endocrinol Metab. 2021 Jul;32(7):500-514. doi: 10.1016/j.tem.2021.04.008.</mixed-citation><mixed-citation xml:lang="en">Lim S., Kim J.W., Targher G. Links between metabolic syndrome and metabolic dysfunction-associated fatty liver disease. Trends Endocrinol Metab. 2021 Jul;32(7):500-514. doi: 10.1016/j.tem.2021.04.008.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Eslam M., Newsome P.N., Sarin S.K. et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020 Jul;73(1):202-209. doi: 10.1016/j.jhep.2020.03.039.</mixed-citation><mixed-citation xml:lang="en">Eslam M., Newsome P.N., Sarin S.K. et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020 Jul;73(1):202-209. doi: 10.1016/j.jhep.2020.03.039.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Li Y.Y., Zheng T.L., Xiao S.Y. et al. Hepatocytic ballooning in non-alcoholic steatohepatitis: Dilemmas and future directions. Liver Int. 2023 Jun;43(6):1170-1182. doi: 10.1111/liv.15571.</mixed-citation><mixed-citation xml:lang="en">Li Y.Y., Zheng T.L., Xiao S.Y. et al. Hepatocytic ballooning in non-alcoholic steatohepatitis: Dilemmas and future directions. Liver Int. 2023 Jun;43(6):1170-1182. doi: 10.1111/liv.15571.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024 Sep;81(3):492-542. doi: 10.1016/j.jhep.2024.04.031.</mixed-citation><mixed-citation xml:lang="en">European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J Hepatol. 2024 Sep;81(3):492-542. doi: 10.1016/j.jhep.2024.04.031.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Lemieux I., Després J.P. Metabolic Syndrome: Past, Present and Future. Nutrients. 2020 Nov 14;12(11):3501. doi: 10.3390/nu12113501.</mixed-citation><mixed-citation xml:lang="en">Lemieux I., Després J.P. Metabolic Syndrome: Past, Present and Future. Nutrients. 2020 Nov 14;12(11):3501. doi: 10.3390/nu12113501.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Cornier M.A., Dabelea D., Hernandez T.L. et al. The metabolic syndrome. Endocr Rev. 2008 Dec;29(7):777-822. doi: 10.1210/er.2008-0024.</mixed-citation><mixed-citation xml:lang="en">Cornier M.A., Dabelea D., Hernandez T.L. et al. The metabolic syndrome. Endocr Rev. 2008 Dec;29(7):777-822. doi: 10.1210/er.2008-0024.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Alberti K.G., Eckel R.H., Grundy S.M. et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20;120(16):1640-5. doi: 10.1161/CIRCULATIONAHA.109.192644.</mixed-citation><mixed-citation xml:lang="en">Alberti K.G., Eckel R.H., Grundy S.M. et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20;120(16):1640-5. doi: 10.1161/CIRCULATIONAHA.109.192644.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Mychka V.B., Zhernakova Yu.V., Chazova I.E. The recommendations of the experts of allRussian scientific society of cardiology for the diagnosis and treatment of metabolic syndrome (second revision). Doctor.Ru. 2010;(3):15-8. (in Russ.)@@ Мычка В.Б., Жернакова Ю.В., Чазова И.Е. Рекомендации экспертов Всероссийского научного общества кардиологов по диагностике и лечению метаболического синдрома (второй пересмотр). Доктор.ру. 2010;(3): 15-8.</mixed-citation><mixed-citation xml:lang="en">Mychka V.B., Zhernakova Yu.V., Chazova I.E. The recommendations of the experts of allRussian scientific society of cardiology for the diagnosis and treatment of metabolic syndrome (second revision). Doctor.Ru. 2010;(3):15-8. (in Russ.)@@ Мычка В.Б., Жернакова Ю.В., Чазова И.Е. Рекомендации экспертов Всероссийского научного общества кардиологов по диагностике и лечению метаболического синдрома (второй пересмотр). Доктор.ру. 2010;(3): 15-8.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Tang S.Y., Tan J.S., Pang X.Z., Lee G.H. Metabolic dysfunction associated fatty liver disease: The new nomenclature and its impact. World J Gastroenterol. 2023 Jan 21;29(3):549-560. doi: 10.3748/wjg.v29.i3.549.</mixed-citation><mixed-citation xml:lang="en">Tang S.Y., Tan J.S., Pang X.Z., Lee G.H. Metabolic dysfunction associated fatty liver disease: The new nomenclature and its impact. World J Gastroenterol. 2023 Jan 21;29(3):549-560. doi: 10.3748/wjg.v29.i3.549.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Chan K.E., Koh T.J.L., Tang A.S.P. et al. Global Prevalence and Clinical Characteristics of Metabolic-associated Fatty Liver Disease: A Meta-Analysis and Systematic Review of 10 739 607 Individuals. J Clin Endocrinol Metab. 2022 Aug 18;107(9):2691-2700. doi: 10.1210/clinem/dgac321.</mixed-citation><mixed-citation xml:lang="en">Chan K.E., Koh T.J.L., Tang A.S.P. et al. Global Prevalence and Clinical Characteristics of Metabolic-associated Fatty Liver Disease: A Meta-Analysis and Systematic Review of 10 739 607 Individuals. J Clin Endocrinol Metab. 2022 Aug 18;107(9):2691-2700. doi: 10.1210/clinem/dgac321.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Maev I.V., Andreev D.N., Kucheryavyy Yu.A. Prevalence of non-alcoholic fat disease liver in Russian Federation: meta-analysis. Consilium Medicum. 2023;25(5):313-319. (In Russ.) doi: 10.26442/20751753.2023.5.202155.@@ Маев И.В., Андреев Д.Н., Кучерявый Ю.А. Распространенность неалкогольной жировой болезни печени в России: метаанализ. Consilium Medicum. 2023;25(5):313-319. doi: 10.26442/20751753.2023.5.202155.</mixed-citation><mixed-citation xml:lang="en">Maev I.V., Andreev D.N., Kucheryavyy Yu.A. Prevalence of non-alcoholic fat disease liver in Russian Federation: meta-analysis. Consilium Medicum. 2023;25(5):313-319. (In Russ.) doi: 10.26442/20751753.2023.5.202155.@@ Маев И.В., Андреев Д.Н., Кучерявый Ю.А. Распространенность неалкогольной жировой болезни печени в России: метаанализ. Consilium Medicum. 2023;25(5):313-319. doi: 10.26442/20751753.2023.5.202155.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Melnichenko G.A., Yeliseyeva A. Yu., Mayevskaya M.V. Prevalence of non-alcoholic fatty liver disease at obesity and its interrelation with cardio-vascular disease and 2nd type diabetes mellitus risk factors.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012;22(2):45-53. (In Russ.)@@ Мельниченко Г.А., Елисеева А.Ю., Маевская М.В. Распространенность неалкогольной жировой болезни печени при ожирении и ее взаимосвязь с факторами риска сердечно-сосудистых заболеваний и сахарного диабета 2-го типа. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2012;22(2):45-53.</mixed-citation><mixed-citation xml:lang="en">Melnichenko G.A., Yeliseyeva A. Yu., Mayevskaya M.V. Prevalence of non-alcoholic fatty liver disease at obesity and its interrelation with cardio-vascular disease and 2nd type diabetes mellitus risk factors.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012;22(2):45-53. (In Russ.)@@ Мельниченко Г.А., Елисеева А.Ю., Маевская М.В. Распространенность неалкогольной жировой болезни печени при ожирении и ее взаимосвязь с факторами риска сердечно-сосудистых заболеваний и сахарного диабета 2-го типа. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2012;22(2):45-53.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Ivashkin V.T., Drapkina O.M., Mayev I.V. et al. Prevalence of non-alcoholic fatty liver disease in out-patients of the Russian Federation: DIREG 2 study results.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2015;25(6):31-41. (In Russ.)@@ Ивашкин В.Т., Драпкина О.М., Маев И.В. и соавт. Распространенность неалкогольной жировой болезни печени у пациентов амбулаторно-поликлинической практики в Российской Федерации: результаты исследования DIREG 2. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2015;25(6):31-41.</mixed-citation><mixed-citation xml:lang="en">Ivashkin V.T., Drapkina O.M., Mayev I.V. et al. Prevalence of non-alcoholic fatty liver disease in out-patients of the Russian Federation: DIREG 2 study results.Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2015;25(6):31-41. (In Russ.)@@ Ивашкин В.Т., Драпкина О.М., Маев И.В. и соавт. Распространенность неалкогольной жировой болезни печени у пациентов амбулаторно-поликлинической практики в Российской Федерации: результаты исследования DIREG 2. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2015;25(6):31-41.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Liu J., Ayada I., Zhang X. et al. Estimating Global Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease in Overweight or Obese Adults. Clin Gastroenterol Hepatol. 2022 Mar;20(3): e573-e582. doi: 10.1016/j.cgh.2021.02.030.</mixed-citation><mixed-citation xml:lang="en">Liu J., Ayada I., Zhang X. et al. Estimating Global Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease in Overweight or Obese Adults. Clin Gastroenterol Hepatol. 2022 Mar;20(3): e573-e582. doi: 10.1016/j.cgh.2021.02.030.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Fu C.E., Ng C.H., Yong J.N. et al. A Meta-analysis on Associated Risk of Mortality in Nonalcoholic Fatty Liver Disease. Endocr Pract. 2023 Jan;29(1):33-39. doi: 10.1016/j.eprac.2022.10.007.</mixed-citation><mixed-citation xml:lang="en">Fu C.E., Ng C.H., Yong J.N. et al. A Meta-analysis on Associated Risk of Mortality in Nonalcoholic Fatty Liver Disease. Endocr Pract. 2023 Jan;29(1):33-39. doi: 10.1016/j.eprac.2022.10.007.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Xiao J., Ng C.H., Chan K.E. et al. Hepatic, Extra-hepatic Outcomes and Causes of Mortality in NAFLD - An Umbrella Overview of Systematic Review of Meta-Analysis. J Clin Exp Hepatol. 2023 Jul-Aug;13(4):656-665. doi: 10.1016/j.jceh.2022.11.006.</mixed-citation><mixed-citation xml:lang="en">Xiao J., Ng C.H., Chan K.E. et al. Hepatic, Extra-hepatic Outcomes and Causes of Mortality in NAFLD - An Umbrella Overview of Systematic Review of Meta-Analysis. J Clin Exp Hepatol. 2023 Jul-Aug;13(4):656-665. doi: 10.1016/j.jceh.2022.11.006.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Ford E.S. The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the National Health and Nutrition Examination Survey II Mortality Study. Atherosclerosis. 2004 Apr;173(2):309-14. doi: 10.1016/j.atherosclerosis.2003.12.022.</mixed-citation><mixed-citation xml:lang="en">Ford E.S. The metabolic syndrome and mortality from cardiovascular disease and all-causes: findings from the National Health and Nutrition Examination Survey II Mortality Study. Atherosclerosis. 2004 Apr;173(2):309-14. doi: 10.1016/j.atherosclerosis.2003.12.022.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Wu S.H., Liu Z., Ho S.C. Metabolic syndrome and all-cause mortality: a meta-analysis of prospective cohort studies. Eur J Epidemiol. 2010 Jun;25(6):375-84. doi: 10.1007/s10654-010-9459-z.</mixed-citation><mixed-citation xml:lang="en">Wu S.H., Liu Z., Ho S.C. Metabolic syndrome and all-cause mortality: a meta-analysis of prospective cohort studies. Eur J Epidemiol. 2010 Jun;25(6):375-84. doi: 10.1007/s10654-010-9459-z.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Gathirua-Mwangi W.G., Monahan P.O., Murage M.J., Zhang J. Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey. Cancer Causes Control. 2017 Feb;28(2):127-136. doi: 10.1007/s10552-016-0843-1.</mixed-citation><mixed-citation xml:lang="en">Gathirua-Mwangi W.G., Monahan P.O., Murage M.J., Zhang J. Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey. Cancer Causes Control. 2017 Feb;28(2):127-136. doi: 10.1007/s10552-016-0843-1.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Bruno G., Merletti F., Biggeri A. et al. Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study. Diabetes Care. 2004 Nov;27(11):2689-94. doi: 10.2337/diacare.27.11.2689.</mixed-citation><mixed-citation xml:lang="en">Bruno G., Merletti F., Biggeri A. et al. Metabolic syndrome as a predictor of all-cause and cardiovascular mortality in type 2 diabetes: the Casale Monferrato Study. Diabetes Care. 2004 Nov;27(11):2689-94. doi: 10.2337/diacare.27.11.2689.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Fu C.E., Yong J.N., Ng C.H. et al. The prognostic value of including non-alcoholic fatty liver disease in the definition of metabolic syndrome. Aliment Pharmacol Ther. 2023 May;57(9):979-987. doi: 10.1111/apt.17397.</mixed-citation><mixed-citation xml:lang="en">Fu C.E., Yong J.N., Ng C.H. et al. The prognostic value of including non-alcoholic fatty liver disease in the definition of metabolic syndrome. Aliment Pharmacol Ther. 2023 May;57(9):979-987. doi: 10.1111/apt.17397.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Nguyen V.H., Le M.H., Cheung R.C., Nguyen M.H. Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD. Clin Gastroenterol Hepatol. 2021 Oct;19(10):2172-2181.e6. doi: 10.1016/j.cgh.2021.05.029.</mixed-citation><mixed-citation xml:lang="en">Nguyen V.H., Le M.H., Cheung R.C., Nguyen M.H. Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD. Clin Gastroenterol Hepatol. 2021 Oct;19(10):2172-2181.e6. doi: 10.1016/j.cgh.2021.05.029.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Moretti V., Romeo S., Valenti L. The contribution of genetics and epigenetics to MAFLD susceptibility. Hepatol Int. 2024 Apr 25. doi: 10.1007/s12072-024-10667-5.</mixed-citation><mixed-citation xml:lang="en">Moretti V., Romeo S., Valenti L. The contribution of genetics and epigenetics to MAFLD susceptibility. Hepatol Int. 2024 Apr 25. doi: 10.1007/s12072-024-10667-5.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Chitturi S., Abeygunasekera S., Farrell G.C. et al. NASH and insulin resistance: Insulin hypersecretion and specific association with the insulin resistance syndrome. Hepatology. 2002 Feb;35(2):373-9. doi: 10.1053/jhep.2002.30692.</mixed-citation><mixed-citation xml:lang="en">Chitturi S., Abeygunasekera S., Farrell G.C. et al. NASH and insulin resistance: Insulin hypersecretion and specific association with the insulin resistance syndrome. Hepatology. 2002 Feb;35(2):373-9. doi: 10.1053/jhep.2002.30692.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Samuel V.T., Shulman G.I. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest. 2016 Jan;126(1):12-22. doi: 10.1172/JCI77812.</mixed-citation><mixed-citation xml:lang="en">Samuel V.T., Shulman G.I. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. J Clin Invest. 2016 Jan;126(1):12-22. doi: 10.1172/JCI77812.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Kuchay M.S., Choudhary N.S., Mishra S.K. Pathophysiological mechanisms underlying MAFLD. Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1875-1887. doi: 10.1016/j.dsx.2020.09.026.</mixed-citation><mixed-citation xml:lang="en">Kuchay M.S., Choudhary N.S., Mishra S.K. Pathophysiological mechanisms underlying MAFLD. Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1875-1887. doi: 10.1016/j.dsx.2020.09.026.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Ametov A.S., Tsygankova O.V.Complex metabolic protection as a modern strategy for the management of type 2 diabetes mellitus. Endocrinology: News, Opinions, Training. 2021; 10(2):93-104. (In Russ.) doi: 10.33029/2304-9529-2021-10-2-93-104.@@ Аметов А.С., Цыганкова О.В. Комплексная метаболическая протекция как современная стратегия управления сахарным диабетом 2 типа. Эндокринология: новости, мнения, обучение. 2021; 10(2):93-104. doi: 10.33029/2304-9529-2021-10-2-93-104.</mixed-citation><mixed-citation xml:lang="en">Ametov A.S., Tsygankova O.V.Complex metabolic protection as a modern strategy for the management of type 2 diabetes mellitus. Endocrinology: News, Opinions, Training. 2021; 10(2):93-104. (In Russ.) doi: 10.33029/2304-9529-2021-10-2-93-104.@@ Аметов А.С., Цыганкова О.В. Комплексная метаболическая протекция как современная стратегия управления сахарным диабетом 2 типа. Эндокринология: новости, мнения, обучение. 2021; 10(2):93-104. doi: 10.33029/2304-9529-2021-10-2-93-104.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Tsygankova O.V., Veretyuk V.V., Mareev V.Yu. Modification of the of the cardiometabolic profile using combined therapy of the angiotensin receptor-neprilysin inhibitor and empagliflozin in comorbid patients with Chronic Heart Failure and type 2 Diabetes Mellitus. Kardiologiia. 2020;60(5):146-152. (In Russ.) doi: 10.18087/cardio.2020.5.n840.@@ Цыганкова О.В., Веретюк В.В., Мареев В.Ю. Возможности положительной модификации кардиометаболического профиля при совместном назначении ангиотензиновых рецепторов-неприлизина ингибитора и эмпаглифлозина у коморбидных пациентов с хронической сердечной недостаточностью и сахарным диабетом 2 типа. Кардиология. 2020;60(5):146-152. doi: 10.18087/cardio.2020.5.n840.</mixed-citation><mixed-citation xml:lang="en">Tsygankova O.V., Veretyuk V.V., Mareev V.Yu. Modification of the of the cardiometabolic profile using combined therapy of the angiotensin receptor-neprilysin inhibitor and empagliflozin in comorbid patients with Chronic Heart Failure and type 2 Diabetes Mellitus. Kardiologiia. 2020;60(5):146-152. (In Russ.) doi: 10.18087/cardio.2020.5.n840.@@ Цыганкова О.В., Веретюк В.В., Мареев В.Ю. Возможности положительной модификации кардиометаболического профиля при совместном назначении ангиотензиновых рецепторов-неприлизина ингибитора и эмпаглифлозина у коморбидных пациентов с хронической сердечной недостаточностью и сахарным диабетом 2 типа. Кардиология. 2020;60(5):146-152. doi: 10.18087/cardio.2020.5.n840.</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Mouzaki M., Comelli E.M., Arendt B.M. et al.Intestinal microbiota in patients with nonalcoholic fatty liver disease. Hepatology. 2013 Jul;58(1):120-7. doi: 10.1002/hep.26319.</mixed-citation><mixed-citation xml:lang="en">Mouzaki M., Comelli E.M., Arendt B.M. et al.Intestinal microbiota in patients with nonalcoholic fatty liver disease. Hepatology. 2013 Jul;58(1):120-7. doi: 10.1002/hep.26319.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Wong V.W., Tse C.H., Lam T.T. et al. Molecular characterization of the fecal microbiota in patients with nonalcoholic steatohepatitis - a longitudinal study. PLoS One. 2013 Apr 25;8(4): e62885. doi: 10.1371/journal.pone.0062885.</mixed-citation><mixed-citation xml:lang="en">Wong V.W., Tse C.H., Lam T.T. et al. Molecular characterization of the fecal microbiota in patients with nonalcoholic steatohepatitis - a longitudinal study. PLoS One. 2013 Apr 25;8(4): e62885. doi: 10.1371/journal.pone.0062885.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Ferrara C.M., Goldberg A.P., Ortmeyer H.K., Ryan A.S. Effects of aerobic and resistive exercise training on glucose disposal and skeletal muscle metabolism in older men. J Gerontol A Biol Sci Med Sci. 2006 May;61(5):480-7. doi: 10.1093/gerona/61.5.480.</mixed-citation><mixed-citation xml:lang="en">Ferrara C.M., Goldberg A.P., Ortmeyer H.K., Ryan A.S. Effects of aerobic and resistive exercise training on glucose disposal and skeletal muscle metabolism in older men. J Gerontol A Biol Sci Med Sci. 2006 May;61(5):480-7. doi: 10.1093/gerona/61.5.480.</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Stangl M.K., Böcker W., Chubanov V. et al. Sarcopenia - Endocrinological and Neurological Aspects. Exp Clin Endocrinol Diabetes. 2019 Jan;127(1):8-22. doi: 10.1055/a-0672-1007.</mixed-citation><mixed-citation xml:lang="en">Stangl M.K., Böcker W., Chubanov V. et al. Sarcopenia - Endocrinological and Neurological Aspects. Exp Clin Endocrinol Diabetes. 2019 Jan;127(1):8-22. doi: 10.1055/a-0672-1007.</mixed-citation></citation-alternatives></ref><ref id="cit33"><label>33</label><citation-alternatives><mixed-citation xml:lang="ru">Wijarnpreecha K., Kim D., Raymond P., Scribani M., Ahmed A. Associations between sarcopenia and nonalcoholic fatty liver disease and advanced fibrosis in the USA. Eur J Gastroenterol Hepatol. 2019 Sep;31(9):1121-1128. doi: 10.1097/MEG.0000000000001397.</mixed-citation><mixed-citation xml:lang="en">Wijarnpreecha K., Kim D., Raymond P., Scribani M., Ahmed A. Associations between sarcopenia and nonalcoholic fatty liver disease and advanced fibrosis in the USA. Eur J Gastroenterol Hepatol. 2019 Sep;31(9):1121-1128. doi: 10.1097/MEG.0000000000001397.</mixed-citation></citation-alternatives></ref><ref id="cit34"><label>34</label><citation-alternatives><mixed-citation xml:lang="ru">Pedersen B.K., Febbraio M.A. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012 Apr 3;8(8):457-65. doi: 10.1038/nrendo.2012.49.</mixed-citation><mixed-citation xml:lang="en">Pedersen B.K., Febbraio M.A. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012 Apr 3;8(8):457-65. doi: 10.1038/nrendo.2012.49.</mixed-citation></citation-alternatives></ref><ref id="cit35"><label>35</label><citation-alternatives><mixed-citation xml:lang="ru">Collino M., Mastrocola R., Nigro D. et al. Variability in myosteatosis and insulin resistance induced by high-fat diet in mouse skeletal muscles. Biomed Res Int. 2014;2014:569623. doi: 10.1155/2014/569623.</mixed-citation><mixed-citation xml:lang="en">Collino M., Mastrocola R., Nigro D. et al. Variability in myosteatosis and insulin resistance induced by high-fat diet in mouse skeletal muscles. Biomed Res Int. 2014;2014:569623. doi: 10.1155/2014/569623.</mixed-citation></citation-alternatives></ref><ref id="cit36"><label>36</label><citation-alternatives><mixed-citation xml:lang="ru">Zhang H.J., Zhang X.F., Ma Z.M. et al. Irisin is inversely associated with intrahepatic triglyceride contents in obese adults. J Hepatol. 2013 Sep;59(3):557-62. doi: 10.1016/j.jhep.2013.04.030.</mixed-citation><mixed-citation xml:lang="en">Zhang H.J., Zhang X.F., Ma Z.M. et al. Irisin is inversely associated with intrahepatic triglyceride contents in obese adults. J Hepatol. 2013 Sep;59(3):557-62. doi: 10.1016/j.jhep.2013.04.030.</mixed-citation></citation-alternatives></ref><ref id="cit37"><label>37</label><citation-alternatives><mixed-citation xml:lang="ru">Wang X., Hu Z., Hu J., Du J., Mitch W.E. Insulin resistance accelerates muscle protein degradation: Activation of the ubiquitin-proteasome pathway by defects in muscle cell signaling. Endocrinology. 2006 Sep;147(9):4160-8. doi: 10.1210/en.2006-0251.</mixed-citation><mixed-citation xml:lang="en">Wang X., Hu Z., Hu J., Du J., Mitch W.E. Insulin resistance accelerates muscle protein degradation: Activation of the ubiquitin-proteasome pathway by defects in muscle cell signaling. Endocrinology. 2006 Sep;147(9):4160-8. doi: 10.1210/en.2006-0251.</mixed-citation></citation-alternatives></ref><ref id="cit38"><label>38</label><citation-alternatives><mixed-citation xml:lang="ru">Koo B.K., Kim D., Joo S.K. et al. Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis. J Hepatol. 2017 Jan;66(1):123-131. doi: 10.1016/j.jhep.2016.08.019.</mixed-citation><mixed-citation xml:lang="en">Koo B.K., Kim D., Joo S.K. et al. Sarcopenia is an independent risk factor for non-alcoholic steatohepatitis and significant fibrosis. J Hepatol. 2017 Jan;66(1):123-131. doi: 10.1016/j.jhep.2016.08.019.</mixed-citation></citation-alternatives></ref><ref id="cit39"><label>39</label><citation-alternatives><mixed-citation xml:lang="ru">Targher G., Valenti L., Byrne C.D. Metabolic Dysfunction-Associated Steatotic Liver Disease. N Engl J Med. 2025 Aug 14;393(7):683-698. doi: 10.1056/NEJMra2412865.</mixed-citation><mixed-citation xml:lang="en">Targher G., Valenti L., Byrne C.D. Metabolic Dysfunction-Associated Steatotic Liver Disease. N Engl J Med. 2025 Aug 14;393(7):683-698. doi: 10.1056/NEJMra2412865.</mixed-citation></citation-alternatives></ref><ref id="cit40"><label>40</label><citation-alternatives><mixed-citation xml:lang="ru">Radu F., Potcovaru C.G., Salmen T. et al. The Link between NAFLD and Metabolic Syndrome. Diagnostics (Basel). 2023 Feb 7;13(4):614. doi: 10.3390/diagnostics13040614.</mixed-citation><mixed-citation xml:lang="en">Radu F., Potcovaru C.G., Salmen T. et al. The Link between NAFLD and Metabolic Syndrome. Diagnostics (Basel). 2023 Feb 7;13(4):614. doi: 10.3390/diagnostics13040614.</mixed-citation></citation-alternatives></ref><ref id="cit41"><label>41</label><citation-alternatives><mixed-citation xml:lang="ru">Cotter T.G., Rinella M. Nonalcoholic Fatty Liver Disease 2020: The State of the Disease. Gastroenterology. 2020 May;158(7):1851-1864. doi: 10.1053/j.gastro.2020.01.052.</mixed-citation><mixed-citation xml:lang="en">Cotter T.G., Rinella M. Nonalcoholic Fatty Liver Disease 2020: The State of the Disease. Gastroenterology. 2020 May;158(7):1851-1864. doi: 10.1053/j.gastro.2020.01.052.</mixed-citation></citation-alternatives></ref><ref id="cit42"><label>42</label><citation-alternatives><mixed-citation xml:lang="ru">Marchesini G., Bugianesi E., Forlani G. et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003 Apr;37(4):917-23. doi: 10.1053/jhep.2003.50161.</mixed-citation><mixed-citation xml:lang="en">Marchesini G., Bugianesi E., Forlani G. et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology. 2003 Apr;37(4):917-23. doi: 10.1053/jhep.2003.50161.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
