КАРДИОМЕТАБОЛИЧЕСКИЙ РИСК ПРИ ОЖИРЕНИИ И МЕТАБОЛИЧЕСКОМ СИНДРОМЕ: СОВРЕМЕННЫЕ АЛГОРИТМЫ СТРАТИФИКАЦИИ

Основные положения

Современные алгоритмы стратификации, опирающиеся на фенотипирование ожирения (учёт висцерального жира и состава тела) и новые биомаркеры, позволяют точнее прогнозировать кардиометаболический риск по сравнению с классическими шкалами, основанными только на индексе массы тела и окружности талии. НАЖБП и индексы инсулинорезистентности (включая TyG и комбинированные индексы) выступают важными независимыми компонентами риска и должны быть включены в клинические алгоритмы ранней стратификации.

Резюме

Ожирение и метаболический синдром являются ключевыми факторами развития сердечно-сосудистых заболеваний и сахарного диабета 2 типа. Современные исследования выявляют различные фенотипы ожирения, включая метаболически здоровое ожирение и ожирение при нормальной массе тела, что требует совершенствования подходов к стратификации кардиометаболического риска. Цель исследования – систематизация современных данных о кардиометаболическом риске при ожирении и метаболическом синдроме и анализ современных алгоритмов стратификации риска. Проведен систематический обзор литературы согласно рекомендациям PRISMA. Поиск осуществлялся в базах данных PubMed, Google Scholar, eLibrary за период с 2020 по 2024 г. После скрининга 1099 публикаций в окончательный анализ включено 10 исследований, соответствующих критериям отбора. Современные методы стратификации кардиометаболического риска, основанные на фенотипировании ожирения, оценке висцерального жира и новых биомаркерах, существенно превосходят традиционные подходы. Индексы инсулинорезистентности демонстрируют высокую прогностическую ценность для сердечно-сосудистой смертности. Установлена важная роль неалкогольной жировой болезни печени как компонента кардиометаболического риска. Современные методы стратификации кардиометаболического риска, учитывающие различные фенотипы ожирения и новые биомаркеры, обеспечивают более точное прогнозирование сердечно-сосудистых осложнений по сравнению с традиционными методиками. Перспективными направлениями являются внедрение персонализированных стратегий профилактики и более широкое использование новых шкал стратификации риска в клинической практике.

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