Общность патогенетических механизмов неалкогольной жировой болезни печени и синдрома поликистозных яичников

Распространенность СПЯ и НАБЖП имеет четкую ассоциацию друг с другом, и наличие одного заболевания повышает риски формирования другого, что необходимо учитывать при комплексной оценке состояния пациентки. Оба заболевания повышают риски развития социально значимых заболеваний, ассоциированных с уменьшением продолжительности жизни - таких как сахарный диабет 2 типа и кардиоваскулярные заболевания. Целью данного обзора было суммирование актуальных данных по распространенности и патофизиологии НАЖБП при СПКЯ. Были проанализированы статьи по СПЯ и НАЖБП с помощью поиска РИНЦ, MEDLINE и Pub Med за последние 10 лет, использовались ключевые слова: «СПЯ», «НАЖБП», «инсулинорезистентность», «гиперандрогенемия». В обзор были включены наиболее интересные работы с точки зрения автора, широко и разносторонне охватывающие проблему. Проведенный анализ литературы показал, что в патогенезе как СПЯ, так и НАБЖП участвуют такие факторы как гиперандрогенемия, инсулинорезистентность с компенсаторной гиперинсулинемией (с вовлечением в процесс метаболической дисрегуляции всех «классических» органов-мишеней инсулина, в том числе скелетной мускулатуры), митохондриальная дисфункция и кишечный дисбиоз. Для патофизиологического процесса формирования СПЯ и НАБЖП характерно формирование «порочных» кругов, когда нарушение одного звена патогенеза активизирует другие звенья, усугубляя и поддерживая первичные отклонения. Это свидетельствует о том, что необходим поиск комплексных нетривиальных подходов к диагностике и терапии этих заболеваний, с применением препаратов различных групп, включая инсулинсензетайзеры, метабиотики, антиоксиданты и гепатопротекторы. Роль каждого из препаратов должна быть оценена в клинических исследованиях.

НАЖБП, СПЯ, патогенез, гиперандрогенемия, инсулинорезистентность

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