cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2019-34-4-39-48cardiotomsk-861Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESИнсулинорезистентность: нерешенные вопросы вреда и пользыInsulin resistance: Unsolved issues of harm and usehttps://orcid.org/0000-0003-3996-3325БеликЕ. В.BelikE. V.

Белик Екатерина Владимировна - младший научный сотрудник, лаборатория исследований гомеостаза.

650002, Кемерово, Сосновый бульвар, 6

Ekaterina V. Belik - Junior Research Scientist, Homeostasis Research Laboratory.

6, Sosnoviy blvd, Kemerovo, 650002

sionina.ev@mail.ruhttps://orcid.org/0000-0002-7780-829XГруздеваО. В.GruzdevaO. V.

Груздева Ольга Викторовна - доктор медицинских наук, заведующий лабораторией исследований гомеостаза, отдел диагностики сердечно-сосудистых заболеваний, НИИКПССЗ; доцент кафедры патологической физиологии, медицинской и клинической биохимии, КГМУ.

650002, Кемерово, Сосновый бульвар, 6; 650056, Кемерово, ул. Ворошилова, 22а

Olga V. Gruzdeva - Dr. Sci. (Med.), Head of the Homeostasis Research Laboratory, RICICD; Associate Professor, Department of Pathophysiology, KSMU.

6, Sosnoviy blvd, Kemerovo, 650002; 22А, Voroshilov str., Kemerovo, 650056

ogruzdeva@mail.ruНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian FederationНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний; Кемеровский государственный медицинский университет Министерства здравоохранения Российской ФедерацииРоссияResearch Institute for Complex Issues of Cardiovascular Diseases; Kemerovo State Medical UniversityRussian Federation2019230120203443948Copyright © Белик Е.В., Груздева О.В., 20202020Белик Е.В., Груздева О.В.Belik E.V., Gruzdeva O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/861

Развитие инсулинорезистентности (ИР), диагностируемой более чем у половины пациентов кардиологического профиля, принято считать негативным фактором, способствующим дальнейшему усугублению имеющихся метаболических нарушений и прогрессированию сердечно-сосудистых заболеваний (ССЗ). Однако в последнее время появляются немногочисленные данные, свидетельствующие о том, что около четверти лиц с ожирением имеют благоприятный прогноз ССЗ. Эти данные позволили предположить, что для пациентов высокого риска ИР является своеобразным защитным механизмом, препятствующим повреждению органов и тканей сердечнососудистой системы. В настоящем обзоре отражены потенциальные защитные механизмы ИР и возможности их клинического применения при выборе тактики лечения пациентов с ожирением, сахарным диабетом (СД) 2-го типа и трудно контролируемой гипергликемией.

Insulin resistance, diagnosed in more than half of cardiac patients, is considered to be a negative factor contributing to further exacerbation of existing metabolic disorders and the progression of cardiovascular diseases (CVD). However, recently, scarce data emerged suggesting that about a quarter of obese people have a favorable prognosis of CVD. These data allowed us to make an assumption that insulin resistance in high-risk patients may represent some kind of a protective mechanism that prevents damage to the organs and tissues of the cardiovascular system. This review discusses the potential protective mechanisms of insulin resistance and the possibilities of their clinical use in choosing the treatment tactics in patients with obesity, type 2 diabetes mellitus, and poorly controlled glycemia.

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