Вплив інфекції Helicobacter pylori на компоненти метаболічного синдрому. Огляд літератури

О. Є. Гріднєв; С. В. Гріднєва

doi:10.30978/UTJ2024-1-77

Автор(и)

О. Є. Гріднєв ДУ «Національний інститут терапії імені Л. Т. Малої НАМН України», Харків, Ukraine https://orcid.org/0000-0003-4716-3520
С. В. Гріднєва ДУ «Національний інститут терапії імені Л. Т. Малої НАМН України», Харків; Харківський національний університет імені В. Н. Каразіна, Ukraine http://orcid.org/0000-0002-7498-9574

DOI:

https://doi.org/10.30978/UTJ2024-1-77

Ключові слова:

метаболічний синдром, Helicobacter pylori, антигелікобактерна терапія, дисліпідемії, гіперглікемія

Анотація

Наголошено на здатності Helicobacter pylori впливати на метаболічні процеси. Розглянуто можливі механізми такого впливу. Наведено дані, що інфікування H. pylori підвищує частоту метаболічного синдрому та його компонентів. Зазначено, що системні хронічні запальні процеси (одна з основних ланок патогенезу метаболічно‑асоційованих захворювань) можуть ініціюватися H. pylori за рахунок «класичних» механізмів, притаманних метаболічним захворюванням: активації прозапальних цитокінів (фактора некрозу пухлини α, інтерлейкінів‑1, ‑6,) і адипоцитарних гормонів. Насамперед це зумовлено здатністю H. pylori продукувати цитотоксини (CagА/VacA) і наявністю ліпополісахариду в їхній клітинній стінці (ендотоксину), що може як безпосередньо, так і опосередковано індукувати прозапальну відповідь, зокрема системну. Доказом цього є дані про те, що ерадикація H. pylori запобігає повторному стенозу коронарних артерій після встановлення стенту, поліпшує перебіг артеріальної гіпертензії, сприяє значному зниженню концентрації С‑реактивного білка. Крім того, вплив H. pylori на прозапальні цитокіни й адипоцитарні гормони може спричинити формування аномального проатерогенного ліпідного профілю. Про це свідчать дані щодо зменшення концентрації загального холестерину, тригліцеридів, холестерину ліпопротеїнів низької густини на тлі збільшення вмісту холестерину ліпопротеїнів високої густини після успішної ерадикації H. pylori. Зазначено, що інфекція H. pylori є чинником, що спричиняє інсулінорезистентність та хронічну гіперглікемію. Це також переважно пов’язано зі здатністю H. pylori продукувати цитотоксини. Деякі дослідники не встановили зв’язку між H. pylori та рівнем глікозильованого гемоглобіну, що можна пояснити використанням серологічних методів діагностики гелікобактерій. Відмінності в результатах досліджень можуть бути пов’язані з методологічними помилками, тому необхідно провести додаткові дослідження в цьому напрямі, що сприятиме розробці профілактичних і лікувальних стратегій.

Біографії авторів

О. Є. Гріднєв, ДУ «Національний інститут терапії імені Л. Т. Малої НАМН України», Харків

MD, Doctor of Medical Science, Senior Researcher, Leading Researcher of the Department of Study of Digestive System Diseases and their Comorbidity with Non-Communicable Diseases

С. В. Гріднєва, ДУ «Національний інститут терапії імені Л. Т. Малої НАМН України», Харків; Харківський національний університет імені В. Н. Каразіна

к. мед. н., доцент, доцент кафедри загальної практики — сімейної медицини, лікар-гастроентеролог

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