Kazan medical journalKazan medical journalКазанский медицинский журнал0368-48142587-9359Eco-Vector62481310.17816/KMJ624813ReviewsОбзорыReview ArticleHepatocardial relationships in non-alcoholic fatty liver disease: issues of epidemiology, diagnosis, prognosisГепатокардиальные взаимоотношения при неалкогольной жировой болезни печени: вопросы эпидемиологии, диагностики, прогнозаhttps://orcid.org/0009-0008-5906-74761658-9382SavzikhanovaRenata R.СавзихановаРената Рашидовна
Russian Federation

student

студент

renatasavzihanova@mail.ruhttps://orcid.org/0000-0002-0147-85038176-0595SubkhangulovaDinara OlegovnaСубхангуловаДинара Олеговна
Russian Federation

student

студент

dinara.subkhangulova0404@yandex.ruhttps://orcid.org/0000-0001-8050-289257205153574O-2336-20167013-4320KhazovaElena V.ХазоваЕлена Владимировна
Russian Federation

MD, Cand. Sci. (Med.), Assoc. Prof., Depart. of Propaedeutics of Internal Diseases Named after Professor SS. Zimnitsky; Research, UNIL “New Professional Competences in Health Preservation”, Institute of Fundamental Medicine and Biology

канд. мед. наук, доц., каф. пропедевтики внутренних болезней имени профессора С.С. Зимницкого; науч. сотр., УНИЛ «Новые профессиональные компетенции по здоровьесбережению», Институт фундаментальной медицины и биологи

hazova_elena@mail.ruKazan State Medical UniversityКазанский государственный медицинский университетKazan (Volga Region) Federal UniversityКазанский (Приволжский) федеральный университет26062024271120241056100310141912202312062024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttp://creativecommons.org/licenses/by-nc-sa/4.0https://kazanmedjournal.ru/kazanmedj/article/view/624813

World statistics indicate a steady increase in the prevalence of non-alcoholic fatty liver disease, which correlates with the pandemics of obesity and diabetes, which are quite common in Russia. The commonality of cardiometabolic risk factors, the high global prevalence of non-alcoholic fatty liver disease and atherosclerotic cardiovascular diseases generates the interest of researchers in studying hepatocardial relationships. Currently, non-alcoholic fatty liver disease is positioned as a hepatic manifestation of a multisystem disorder, heterogeneous in underlying causes, manifestations, course and outcomes. The purpose of this review was to analyze hepatocardial relationships based on publications. 76 sources on the epidemiology of non-alcoholic fatty liver disease, published from 2011–2023 in journals indexed in Pubmed and eLibrary, were analyzed. Age and gender aspects of the development of non-alcoholic fatty liver disease were considered. The pathogenetic mechanisms of hepatocardial relationships, which were closely related to systemic inflammation, insulin resistance, metabolic syndrome and its components, were highlighted. The criteria and methods for diagnosing non-alcoholic fatty liver disease and metabolic-associated liver disease were outlined. Recent studies demonstrated the presence of hepatocardial connections, characterized by an increased risk of developing atherosclerosis, cardiomyopathy and rhythm disturbances, changes in the structural and functional parameters and geometry of the heart, as well as diastolic dysfunction, which may precede and/or contribute to the development of chronic heart failure in patients with non-alcoholic fatty liver disease. The article presents data on non-alcoholic fatty liver disease as a new factor associated with the development of adverse cardiovascular events to a greater extent than the outcome of liver diseases themselves, which confirms the need for primary and secondary prevention of cardiovascular diseases in this cohort of patients.

Мировая статистика свидетельствует о неуклонном росте распространённости неалкогольной жировой болезни печени, коррелирующей с пандемиями ожирения и сахарного диабета, достаточно распространёнными в России. Общность факторов кардиометаболического риска, высокая глобальная распространённость неалкогольной жировой болезни печени и атеросклеротических сердечно-сосудистых заболеваний формирует интерес исследователей к изучению гепатокардиальных взаимоотношений. В настоящее время неалкогольную жировую болезнь печени позиционируют как печёночное проявление мультисистемного расстройства, неоднородного по основным причинам, проявлениям, течению и исходам. Целью настоящего обзора был анализ гепатокардиальных взаимоотношений на основе публикаций. Проанализировано 76 источников, посвящённых эпидемиологии неалкогольной жировой болезни печени, опубликованных в 2011–2023 гг. в журналах, индексируемых в Pubmed и eLibrary. Рассмотрены возрастные и половые аспекты развития неалкогольной жировой болезни печени. Освещены патогенетические механизмы гепатокардиальных взаимоотношений, находящихся в тесной связи с системным воспалением, инсулинорезистентностью, метаболическим синдромом и его компонентами. Изложены критерии и методы диагностики неалкогольной жировой болезни печени и метаболически-ассоциированной болезни печени. Исследования последних лет демонстрируют наличие гепатокардиальных связей, характеризующихся повышением риска развития атеросклероза, кардиомиопатии и нарушением ритма, изменением структурно-функциональных параметров и геометрии сердца, а также диастолической дисфункцией, которые могут предшествовать и/или способствовать развитию хронической сердечной недостаточности у пациентов с неалкогольной жировой болезнью печени. В статье приведены данные о неалкогольной жировой болезни печени как новом факторе, ассоциированном с развитием неблагоприятных кардиоваскулярных событий в большей степени, чем исход самих заболеваний печени, что подтверждает необходимость первичной и вторичной профилактики сердечно-сосудистых заболеваний у данной когорты пациентов.

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