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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">kpccz</journal-id><journal-title-group><journal-title xml:lang="ru">Комплексные проблемы сердечно-сосудистых заболеваний</journal-title><trans-title-group xml:lang="en"><trans-title>Complex Issues of Cardiovascular Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2306-1278</issn><issn pub-type="epub">2587-9537</issn><publisher><publisher-name>Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17802/2306-1278-2026-15-1-41-50</article-id><article-id custom-type="elpub" pub-id-type="custom">kpccz-1867</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>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ. Патологическая физиология</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL STUDIES. Pathological physiology</subject></subj-group></article-categories><title-group><article-title>ОСОБЕННОСТИ МЕЖГЕННЫХ ВЗАИМОДЕЙСТВИЙ ПОЛИМОРФНЫХ ЛОКУСОВ ГЕНОВ ЛИПИДНОГО И УГЛЕВОДНОГО ОБМЕНА, АССОЦИИРОВАННЫХ С РАЗВИТИЕМ ИНФАРКТА МИОКАРДА У ПАЦИЕНТОВ С ОЖИРЕНИЕМ</article-title><trans-title-group xml:lang="en"><trans-title>GENE-GENE INTERACTIONS OF POLYMORPHIC LOCUSES OF LIPID AND CARBOHYDRATE METABOLISM GENES ASSOCIATED WITH THE MYOCARDIAL INFARCTION RISK IN PATIENTS WITH OBESITY</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9714-4080</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хуторная</surname><given-names>Мария Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Khutornaya</surname><given-names>Mariya V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук научный сотрудник лаборатории геномной медицины отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>PhD, Researcher at the Laboratory of Genomic Medicine, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">masha_hut@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/0000-0002-6620-5960</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хрячкова</surname><given-names>Оксана Николаевна</given-names></name><name name-style="western" xml:lang="en"><surname>Hryachkova</surname><given-names>Oksana N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук научный сотрудник лаборатории геномной медицины отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>PhD, Researcher at the Laboratory of Genomic Medicine, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">oksana_hryachkova@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/0000-0002-4467-8732</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Синицкая</surname><given-names>Анна Викторовна</given-names></name><name name-style="western" xml:lang="en"><surname>Sinitskaya</surname><given-names>Anna V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук старший научный сотрудник лаборатории геномной медицины отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>PhD, Senior Researcher at the Laboratory of Genomic Medicine, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">annacepokina@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/0000-0002-0747-2495</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Асанов</surname><given-names>Максим Айдарович</given-names></name><name name-style="western" xml:lang="en"><surname>Asanov</surname><given-names>Maxim A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>младший научный сотрудник лаборатории геномной медицины отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>Junior Researcher at the Laboratory of Genomic Medicine, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">asmaks988@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7388-356X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Поддубняк</surname><given-names>Алена Олеговна</given-names></name><name name-style="western" xml:lang="en"><surname>Poddubnyak</surname><given-names>Alena O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>лаборант-исследователь лаборатории геномной медицины отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>Laboratory Research Assistant at the Laboratory of Genomic Medicine, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">alyona.poddubnyak@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4824-2418</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Синицкий</surname><given-names>Максим Юрьевич</given-names></name><name name-style="western" xml:lang="en"><surname>Sinitsky</surname><given-names>Maxim Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>кандидат биологических наук заведующий лабораторией геномной медицины отдела экспериментальной медицины федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>PhD, Head of the Laboratory of Genomic Medicine, Department of Experimental Medicine, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">max-sinitsky@rambler.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/0000-0003-3729-616X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильевич</surname><given-names>Кашталап Василий</given-names></name><name name-style="western" xml:lang="en"><surname>Kashtalap</surname><given-names>Vasiliy V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>профессор РАН, доктор медицинских наук, профессор, заведующий отделом клинической кардиологии федерального государственного бюджетного научного учреждения «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний», Кемерово, Российская Федерация</p></bio><bio xml:lang="en"><p>PhD, MD, Professor, Professor of the Russian Academy of Sciences, Head of the Department of clinical Cardiology Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russian Federation</p></bio><email xlink:type="simple">v_kash@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Федеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»<country>Россия</country></aff><aff xml:lang="en">Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>28</day><month>02</month><year>2026</year></pub-date><volume>15</volume><issue>1</issue><fpage>41</fpage><lpage>50</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Хуторная М.В., Хрячкова О.Н., Синицкая А.В., Асанов М.А., Поддубняк А.О., Синицкий М.Ю., Васильевич К.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Хуторная М.В., Хрячкова О.Н., Синицкая А.В., Асанов М.А., Поддубняк А.О., Синицкий М.Ю., Васильевич К.В.</copyright-holder><copyright-holder xml:lang="en">Khutornaya M.V., Hryachkova O.N., Sinitskaya A.V., Asanov M.A., Poddubnyak A.O., Sinitsky M.Y., Kashtalap V.V.</copyright-holder><license 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.nii-kpssz.com/jour/article/view/1867">https://www.nii-kpssz.com/jour/article/view/1867</self-uri><abstract><sec><title>Основные положения</title><p>Основные положения</p><p>В данной работе изучено комбинированное взаимодействие полиморфных локусов генов липидного и углеводного обмена у пациентов с инфарктом миокарда на фоне ожирения. Предполагается, что эти взаимодействия могут усиливать или ослаблять проявление метаболических нарушений, объясняя индивидуальные различия в кардиометаболической предрасположенности к развитию данной патологии.</p></sec><sec><title> </title><p> </p></sec><sec><title>Цель</title><p>Цель. Изучить модели межгенных взаимодействий полиморфных локусов генов-кандидатов липидного и углеводного обмена у пациентов с инфарктом миокарда в зависимости от наличия сопутствующего ожирения.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В исследование включено 146 пациентов с острым инфарктом миокарда, распределённых на группы с ожирением и без него. Контрольная выборка состояла из 300 условно здоровых жителей региона. ДНК выделяли из периферической крови методом фенол-хлороформной экстракции. Генотипирование 12 полиморфных вариантов 8 генов, участвующих в регуляции липидного и углеводного обмена, выполняли методом TaqMan на анализаторе ViiA™ 7. Анализ межгенных взаимодействий осуществляли в программе MDR v.3.0.2.</p></sec><sec><title>Результаты</title><p>Результаты. В ходе исследования у пациентов с инфарктом миокарда выявлены значимые ассоциации полиморфных локусов rs2229765 гена IGF1R и rs7412 гена APOE, ассоциированные с повышенным риском ожирения. С помощью метода MDR определены ключевые модели межгенных взаимодействий: четырёхлокусная рисковая в отношении инфаркта миокарда модель (rs1137101 LEPR – rs1137100 LEPR – rs1042031 APOB – rs6725189 APOB) и двенадцатилокусная рисковая в отношении ожирения модель, включающая все анализируемые полиморфные локусы. Установлено, что наибольший энтропийный вклад в риск инфаркта миокарда вносят гены APOB (rs6725189), LEPR (rs1137100) и LIPC (rs1800588), а ярко выраженный синергичный эффект выявлен для пары rs6725189-rs1042031 гена APOB. В модели риска ожирения максимальные индивидуальные вклады отмечены у rs7412 гена APOE и rs2229765 гена IGF1R, а сильные синергичные взаимодействия – у пар, включающих rs1137100 гена LEPR.</p></sec><sec><title>Заключение</title><p>Заключение. Оценка межгенных взаимодействий позволила заключить, что суммарный патогенетический эффект полиморфных локусов генов липидного и углеводного обмена превосходит их вклад при независимом влиянии, что может быть использовано для оценки генетического риска развития инфаркта миокарда и разработки персонализированных подходов к профилактике и ведению пациентов с кардиометаболической коморбидностью.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Highlights</title><p>Highlights</p><p>Combined interactions of polymorphic loci in lipid and carbohydrate metabolism genes in patients with myocardial infarction) and obesity were studied in the presented research. It was hypothesized that these interactions can explain the individual differences in the risk of cardiometabolic disorders due to modulation of their manifestation.</p></sec><sec><title> </title><p> </p></sec><sec><title>Aim</title><p>Aim. To investigate the patterns of gene-gene interactions of polymorphic loci in lipid and carbohydrate metabolism genes in patients with myocardial infarction depending on the presence of comorbid obesity.</p></sec><sec><title>Methods</title><p>Methods. 146 patients with acute myocardial infarction, divided into groups with and without obesity were examined. The control cohort consisted of 300 apparently healthy residents of the region. DNA was isolated from peripheral blood using phenol-chloroform extraction. Genotyping of 12 polymorphic variants in 8 genes involved in the regulation of lipid and carbohydrate metabolism was performed using the TaqMan assay on a ViiA™ 7 analyzer. Gene-gene interaction analysis was performed using MDR v.3.0.2.</p></sec><sec><title>Results</title><p>Results. In this study, significant associations between the IGF1R gene rs2229765 polymorphism and APOE gene rs7412 polymorphism associated with an increased obesity risk in myocardial infarction patients were identified. Using the MDR assay, key gene-gene interaction models were identified: a four-locus model associated with myocardial infarction risk (rs1137101 LEPR – rs1137100 LEPR – rs1042031 APOB – rs6725189 APOB) and a twelve-locus model associated with obesity risk including all analyzed polymorphic loci. The greatest entropic contributions to myocardial infarction risk were found to be made by APOB gene rs6725189 polymorphism, LEPR gene rs1137100 polymorphism, and LIPC gene rs1800588 polymorphism, while a pronounced synergistic effect was detected for the rs6725189-rs1042031 (APOB) pair. In the obesity risk model, the greatest individual contributions were observed for APOE gene rs7412 polymorphism and IGF1R gene rs2229765 polymorphism, while strong synergistic interactions were observed for pairs including LEPR gene rs1137100 polymorphism.</p></sec><sec><title>Conclusion</title><p>Conclusion. Assessment of gene-gene interactions revealed that the combined pathogenetic effects of polymorphic loci of lipid and carbohydrate metabolism genes exceed their independent contributions. This finding can be used to assess the genetic risk of myocardial infarction and develop personalized approaches to the prevention and management of patients with cardiometabolic comorbidity.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>Ген</kwd><kwd>Полиморфный локус</kwd><kwd>Межгенные взаимодействия</kwd><kwd>Инфаркт миокарда</kwd><kwd>Ожирение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Gene</kwd><kwd>Polymorphic locus</kwd><kwd>Gene-gene interactions</kwd><kwd>Myocardial infarction</kwd><kwd>Obesity</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">Хрячкова О.Н., Хуторная М.В., Синицкая А.В., Асанов М.А., Поддубняк А.О., Синицкий М.Ю., Кашталап В.В. Связь полиморфных вариантов ряда генов-кандидатов метаболизма липидов и углеводов с риском развития инфаркта миокарда: результаты одноцентрового одномоментного исследования. 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