clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2024-102-11-12-800-811clinmed-979Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESМеханизмы формирования и прогрессирования кардиоваскулярной патологии при ожиренииMechanisms of formation and progression of cardiovascular pathology in obesityhttps://orcid.org/0000-0002-7220-4745ПановаЕ. И.PanovaE. I.

Панова Елена Ивановна — д-р мед. наук, доцент, профессор кафедры эндокринологии и внутренних болезней

Нижний Новгород

Elena I. Panova — Doctor of Medical Sciences, Associate Professor, Professor of the Department of Endocrinology and Internal Diseases

Nizhny Novgorod

lpanova2005@yandex.ruhttps://orcid.org/0000-0002-8302-2218МорозоваЕ. П.MorozovaE. P.

Морозова Елена Павловна — канд. мед. наук, доцент кафедры эндокринологии и внутренних болезней

Нижний Новгород

Elena P. Morozova — Candidate of Medical Sciences, Associate Professor of the Department of Endocrinology and Internal Diseases

Nizhny Novgorod

https://orcid.org/0000-0002-8280-2669КонышеваМ. С.KonyshevaM. S.

Конышева Мария Сергеевна — канд. мед. наук, доцент кафедры эндокринологии и внутренних болезней

Нижний Новгород

Marya S. Konysheva — Candidate of Medical Sciences, Associate Professor of the Department of Endocrinology and Internal Diseases

Nizhny Novgorod

ФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияPrivolzhsky Research Medical University of the Ministry of Healthcare of RussiaRussian Federation20240703202510211-12800811Copyright © Панова Е.И., Морозова Е.П., Конышева М.С., 20252025Панова Е.И., Морозова Е.П., Конышева М.С.Panova E.I., Morozova E.P., Konysheva M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/979

Ожирение в настоящее время признано пандемией современности и серьезной медико-социальной проблемой, приносящей существенный экономический ущерб обществу. Это в значительной мере обусловлено ростом и омоложением заболеваемости, сопутствующей ожирению кардиоваскулярной патологией, ухудшающей качество жизни, ведущей к ранней временной и стойкой утрате трудоспособности и преждевременной смерти. В настоящем обзоре дан анализ современных представлений о рисках и механизмах поражения сердечно-сосудистой системы при ожирении, роли инсулинорезистентности, гормональной активности жировой ткани, прогностической сущности разных типов ожирения. Наряду с традиционными факторами кардиоваскулярного риска ожирение сопровождается целым рядом метаболических, гормональных расстройств, развитием системного воспаления, оксидативного стресса, приводящих к специфическому поражению миокарда — липотоксической кардиомиопатии. Это патологическое состояние вносит существенный вклад в развитие миокардиальной дисфункции (сердечной недостаточности, ургентных аритмий с риском внезапной сердечной смерти) даже в отсутствие ишемической болезни сердца. В обзоре приводятся современные данные об особенностях ремоделирования миокарда при ожирении, механизмах его развития и прогрессирования, способах диагностики. Акцентируется внимание на факте, что проблема диагностики миокардиальной дисфункции, а также адекватного лечения данной патологии, включающего немедикаментозные воздействия, хирургические вмешательства и использование препаратов для снижения массы тела, далека от разрешения. Это диктует необходимость углубленных исследований данной патологии и поиска новых, оптимальных, эффективных и безопасных методов профилактики и лечения.

Obesity is currently recognized as a pandemic of modernity and a serious medical and social problem that brings significant economic damage to society. This is largely due to the increase and younger onset of obesity-related morbidity, accompanied by cardiovascular pathology, which worsens quality of life, leading to early temporary and permanent loss of working capacity and premature death. This review presents an analysis of current understanding of the risks and mechanisms of cardiovascular system damage in obesity, the role of insulin resistance, the hormonal activity of adipose tissue, and the prognostic significance of different types of obesity. Along with traditional cardiovascular risk factors, obesity is associated with a range of metabolic and hormonal disorders, the development of systemic inflammation, and oxidative stress, leading to specific myocardial damage—lipotoxic cardiomyopathy. This pathological condition significantly contributes to the development of myocardial dysfunction (heart failure, urgent arrhythmias with the risk of sudden cardiac death) even in the absence of ischemic heart disease. The review provides current data on the features of myocardial remodeling in obesity, the mechanisms of its development and progression, and methods of diagnosis. It emphasizes that the problem of diagnosing myocardial dysfunction, as well as adequate treatment of this pathology—including non-drug interventions, surgical procedures, and the use of weightloss medications—is far from being resolved. This necessitates in-depth research into this pathology and the search for new, optimal, effective, and safe methods for prevention and treatment.

ожирениелипотоксическая кардиомиопатияинсулинорезистентностьсистемное воспалениеоксидативный стрессремоделирование миокардависцеральная жировая тканьлечение ожиренияobesitylipotoxic cardiomyopathyinsulin resistancesystemic infl ammationoxidative stressmyocardial remodelingvisceral adipose tissueobesity treatmentReferencesАлферова В.И., Мустафина С.В. Распространенность ожирения во взрослой популяции Российской Федерации (обзор литературы). Ожирение и метаболизм. 2022;19(1):96–105. DOI: 10.14341/omet12809Alferova V.I., Mustafina S.V. The prevalence of obesity in the adult population of the Russian Federation (literature review). Obesity and metabolism. 2022;19(1):96–105. (In Russian). DOI: 10.14341/omet12809Raeisi T., Mozaffari H., Sepehri N. et al. The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and metaanalysis. Eat. Weight Disord. 2022;27(3):893–911. DOI: 10.1007/s40519-021-01269-3Raeisi T., Mozaffari H., Sepehri N. et al. The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and metaanalysis. Eat. Weight Disord. 2022;27(3):893–911. DOI: 10.1007/s40519-021-01269-3Здравоохранение в России. 2023: Статистический сборник. Росстат. М: З-46; 2023:179. [Healthcare in Russia. 2023: Statistical collection. Rosstat. M: Z-46; 2023:179. (In Russian)]. [Electronic resource]. URL: rosstat.gov.ru/storage/mediabank/ Zdravoohran-2023.pdfHealthcare in Russia. 2023: Statistical collection. Rosstat. M: Z-46; 2023:179. (In Russian). [Electronic resource]. URL: rosstat.gov.ru/storage/mediabank/Zdravoohran-2023.pdfKontsevaya A., Shalnova S., Deev A., J., Jewell J., Rakovac I. et al. Overweight and Obesity in the Russian Population: Prevalence in Adults and Association with Socioeconomic Parameters and Cardiovascular Risk Factors. Obes. Facts. 2019;12(1):103–14. DOI: 10.1159/000493885Kontsevaya A., Shalnova S., Deev A., J., Jewell J., Rakovac I. et al. Overweight and Obesity in the Russian Population: Prevalence in Adults and Association with Socioeconomic Parameters and Cardiovascular Risk Factors. Obes. Facts. 2019;12(1):103–14. DOI: 10.1159/000493885Драпкина О.М., Елиашевич С.О., Шепель Р.Н. Ожирение как фактор риска хронических неинфекционных заболеваний. Российский кардиологический журнал. 2016;(6):73–9. DOI: 10.15829/1560-4071-2016-6-73-79Drapkina O.M., Eliashevich S.O., Shepel R.N. Obesity as a risk factor for chronic non-communicable diseases. Russ. J. Cardiol. 2016;(6):73–9. (In Russian). DOI: 10.15829/1560-4071-2016-6-73-79Дедов И.И., Шестакова М.В., Галстян Г.P. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет. 2016;19(2):104–12. DOI: 10.14341/DM2004116-17Dedov I.I., Shestakova M.V., Galstyan G.R. Prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes mellitus. 2016;19(2):104–12. (In Russian). DOI: 10.14341/DM2004116-17Концевая А.В., Шальнова С.А., Драпкина О.М. Исследование ЭССЕ-РФ: эпидемиология и укрепление общественного здоровья Кардиоваскулярная терапия и профилактика. 2021;20(5):2987. DOI: 10.15829/1728-8800-2021-2987Kontsevaya A.V., Shalnova S.A., Drapkina O.M. ESSE-RF study: epidemiology and public health promotion. Cardiovascular therapy and prevention. 2021;20(5):2987. (In Russian). DOI: 10.15829/1728-8800-2021-2987Оганов Р.Г. Демографические тенденции в Российской Федерации: вклад болезней системы кровообращения. Кардиоваскулярная терапия и профилактика. 2012;11(1)5–10. DOI: 10.15829/1728-8800-2012-1-5-10Oganov R.G., Maslennikova G.Ya. Demographic trends in the Russian Federation: the impact of cardiovascular disease. Cardiovascular therapy and prevention. 2012;11(1):5–10. (In Russian). DOI: 10.15829/1728-8800-2012-1-5-10Lubrano C., Saponara M., Barbaro G. et al. Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One. 2012;7(10):e47059. DOI: 10.1371/journal.pone.0047059.Lubrano C., Saponara M., Barbaro G. et al. Relationships between body fat distribution, epicardial fat and obstructive sleep apnea in obese patients with and without metabolic syndrome. PLoS One. 2012;7(10):e47059. DOI: 10.1371/journal.pone.0047059.Whaley-Connell, A., Sowers J. Indices of obesity and cardiometabolic risk. Hypertension. 2011;58(6):91–3. DOI: 10.1161/HYPERTENSIONAHA.111.180406Whaley-Connell, A., Sowers J. Indices of obesity and cardiometabolic risk. Hypertension. 2011;58(6):91–3. DOI: 10.1161/HYPERTENSIONAHA.111.180406Драпкина О.М., Концевая А.В., Калинина А.М., Авдеев С.Н., Агальцов М.В., Александрова Л.М. и др. Профилактика хронических неинфекционных заболеваний в Российской Федерации. Национальное руководство 2022. Кардиоваскулярная терапия и профилактика. 2022;21(4):3235. DOI: 10.15829/1728-8800-2022-3235Drapkina O.M., Kontsevaya A.V., Kalinina A.M., Avdeev S.M., Agaltsov M.V., Alexandrova L.M. et al. Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines 2022. Cardiovascular therapy and prevention. 2022;21(4):3235. (In Russian). DOI: 10.15829/1728-8800-2022-3235Усачева Е.В., Нелидова А.В., Куликова О.М., Флянку И.П. Смертность трудоспособного населения России от сердечно-сосудистых заболеваний. Гигиена и санитария. 2021;100(2):159– 165. DOI: 10.47470/0016-9900-2021-100-2-159-165Usacheva E.V., Nelidova A.V., Kulikova O.M., Flyanku I.P. Mortality of Russian able-bodied population from cardiovascular diseases. Hygiene and sanitation. 2021;100(2):159–165. (In Russian). DOI: 10.47470/0016-9900-2021-100-2-159-165Goldberg, I.J., Trent, C.M., Schulze, P.C. Lipid metabolism and toxicity in the. Cell metabolism. 2012;15(6):805–812. DOI: 10.1016/j.cmet.2012.04.006Goldberg, I.J., Trent, C.M., Schulze, P.C. Lipid metabolism and toxicity in the. Cell metabolism. 2012;15(6):805–812. DOI: 10.1016/j.cmet.2012.04.006Mozaffarian D., Benjamin E.J., Go A.S., Arnett D.K. et al. Heart disease and stroke statistics — 2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–e322. DOI:10.1161/CIR.0000000000000152Mozaffarian D., Benjamin E.J., Go A.S., Arnett D.K. et al. Heart disease and stroke statistics — 2015 update: a report from the American Heart Association. Circulation. 2015;131(4):e29–e322. DOI:10.1161/CIR.0000000000000152Li Chuanbao, Liu Huiruo, Xu Feng, Chen Yuguo. The role of lipotoxicity in cardiovascular disease. Emergency and Critical Care Medicine. 2022; 2(4):214–218. DOI: 10.1097/EC9.0000000000000024Li Chuanbao, Liu Huiruo, Xu Feng, Chen Yuguo. The role of lipotoxicity in cardiovascular disease. Emergency and Critical Care Medicine. 2022; 2(4):214–218. DOI: 10.1097/EC9.0000000000000024Pinto Y.M., Elliott P.M., Arbustini E., Adler Y., Anastasakis A., Böhm M., Denis Duboc D. et al. Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: aposition statement of the ESC working group on myocardial and pericardial diseases. European Heart Journal. 2016;37(23):1850–1858. DOI: 10.1093/eurheartj/ehv727Pinto Y.M., Elliott P.M., Arbustini E., Adler Y., Anastasakis A., Böhm M., Denis Duboc D. et al. Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice: aposition statement of the ESC working group on myocardial and pericardial diseases. European Heart Journal. 2016;37(23):1850–1858. DOI: 10.1093/eurheartj/ehv727Bozkurt B., Colvin M., Cook J., Cooper L., Deswal A., Fonarow G., Francis G., Lenihan D. et al. Current diagnostic and treatment strategies for specific dilated cardiomyopathies: a scientific statement from the American Heart Association. Circulation. 2016;134:e579– e646. DOI: 10.1161/CIR.0000000000000455Bozkurt B., Colvin M., Cook J., Cooper L., Deswal A., Fonarow G., Francis G., Lenihan D. et al. Current diagnostic and treatment strategies for specific dilated cardiomyopathies: a scientific statement from the American Heart Association. Circulation. 2016;134:e579– e646. DOI: 10.1161/CIR.0000000000000455Zhang Y., Jun Ren . Role of cardiac steatosis and lipotoxicity in obesity cardiomyopathy. Hypertension. 2011;57(2):148–150. DOI:10.1161/HYPERTENSIONAHA.110.164178Zhang Y., Jun Ren . Role of cardiac steatosis and lipotoxicity in obesity cardiomyopathy. Hypertension. 2011;57(2):148–150. DOI:10.1161/HYPERTENSIONAHA.110.164178Nishida K., Kinya Otsu. Inflammation and metabolic cardiomyopathy. Cardiovasc. Res. 2017;113(4):389–398. DOI: 10.1093/cvr/cvx012Nishida K., Kinya Otsu. Inflammation and metabolic cardiomyopathy. Cardiovasc. Res. 2017;113(4):389–398. DOI: 10.1093/cvr/cvx012Drosatos K., Schulze P. Cardiac Lipotoxicity: Molecular Pathways and Therapeutic Implications. Curr. Heart Fail. Rep. 2013;10(2):109– 121. DOI: 10.1007/s11897-013-0133-0Drosatos K., Schulze P. Cardiac Lipotoxicity: Molecular Pathways and Therapeutic Implications. Curr. Heart Fail. Rep. 2013;10(2):109– 121. DOI: 10.1007/s11897-013-0133-0Čolak E., Pap D. The Role of Oxidative Stress in the Development of Obesity and Obesity-Related Metabolic Disorders. J. Med. Biochem. 2021,40,1–9. DOI: 10.5937/jomb0-24652Čolak E., Pap D. The Role of Oxidative Stress in the Development of Obesity and Obesity-Related Metabolic Disorders. J. Med. Biochem. 2021,40,1–9. DOI: 10.5937/jomb0-24652Haffar T., Bérubé-Simard F., Bousette N. Impaired fatty acid oxidation as a cause for lipotoxicity in cardiomyocytes. Biochem. Biophys. Res. Commun. 2015;468(1–2):73–78. DOI: 10.1016/j.bbrc.2015.10.162Haffar T., Bérubé-Simard F., Bousette N. Impaired fatty acid oxidation as a cause for lipotoxicity in cardiomyocytes. Biochem. Biophys. Res. Commun. 2015;468(1–2):73–78. DOI: 10.1016/j.bbrc.2015.10.162Shu H., Peng Y., Hang W., Li N., Zhou N., Wang D.W.. Emerging Roles of Ceramide in Cardiovascular Diseases. Aging Dis. 2022;13(1):232–245. DOI: 10.14336/AD.2021.0710Shu H., Peng Y., Hang W., Li N., Zhou N., Wang D.W.. Emerging Roles of Ceramide in Cardiovascular Diseases. Aging Dis. 2022;13(1):232–245. DOI: 10.14336/AD.2021.0710Wang X., Pu H., Ma C., Jiang T., Wei Q., Zhang C., et al. Adiponectin abates atherosclerosis by reducing oxidative stress. Med. Sci. Monit. 2014;2(20):1792–800. DOI: 10.12659/MSM.892299Wang X., Pu H., Ma C., Jiang T., Wei Q., Zhang C., et al. Adiponectin abates atherosclerosis by reducing oxidative stress. Med. Sci. Monit. 2014;2(20):1792–800. DOI: 10.12659/MSM.892299Masenga S.K., Kabwe L.S., Chakulya M., Kirabo A. Mechanisms of Oxidative Stress in Metabolic Syndrome. Int. J. Mol. Sci. 2023;24(9):7898. DOI: 10.3390/ijms24097898Masenga S.K., Kabwe L.S., Chakulya M., Kirabo A. Mechanisms of Oxidative Stress in Metabolic Syndrome. Int. J. Mol. Sci. 2023;24(9):7898. DOI: 10.3390/ijms24097898Poletto A.C., David-Silva A., Yamamoto A.P. d.M., Machado U.F., Furuya D.T. Reduced Slc2a4/GLUT4 expression in subcutaneous adipose tissue of monosodium glutamate obese mice is recovered after atorvastatin treatment. Diabetol. Metab. Syndr. 2015;7:18. DOI: 10.1186/s13098-015-0015-6Poletto A.C., David-Silva A., Yamamoto A.P. d.M., Machado U.F., Furuya D.T. Reduced Slc2a4/GLUT4 expression in subcutaneous adipose tissue of monosodium glutamate obese mice is recovered after atorvastatin treatment. Diabetol. Metab. Syndr. 2015;7:18. DOI: 10.1186/s13098-015-0015-6Venditti P., Stefano L., Meo S. Mitochondrial metabolism of reactive oxygen species. Mitochondrion. 2013;13(2):71—82. DOI: 10.1016/j. mito.2013.01.008Venditti P., Stefano L., Meo S. Mitochondrial metabolism of reactive oxygen species. Mitochondrion. 2013;13(2):71—82. DOI: 10.1016/j.mito.2013.01.008Груздева О.А., Бородкина Д.А., Акбашева О.Е., Дылева Ю.А., Антонова Л.В., Матвеева В.Г., Иванов С.В. и др. Адипокино-цитокиновый профиль адипоцитов эпикардиальной жировой ткани при ишемической болезни сердца на фоне висцерального ожирения. Ожирение и метаболизм. 2017;4:38–45. DOI: 10.14341/OMET2017438-45Gruzdeva O.V., Borodkina D.A., Akbasheva O.E., Dyleva Yu.A., Antonova L.V., Matveeva V.G., Ivanov S.V. et al. Adipocine-cytokine profile of adipocytes epicardial adipose tissue with coronary heart disease on the background of visceral obesity. Obesity and metabolism. 2017;14(4):38–45. (In Russian). DOI: 10.14341/OMET2017438-45Деева Т.А. Клиническое значение неинвазивных маркеров фиброза у пациентов с метаболическим синдромом: дис. канд. мед. наук. Москва. 2015:145. URL: https://www.sechenov.ru/upload/medialibrary/c72/dissertatsiya_deeva_03.12.15_ispravlen_.pdfDeeva T.A. Clinical significance of noninvasive fibrosis markers in patients with metabolic syndrome: dis. сand. med. sciences. Moscow. 2015:145. (In Russian). [Electronic resource]. URL: https://www.sechenov.ru/upload/medialibrary/c72/dissertatsiya_deeva_03.12.15_ispravlen_.pdfВавилова Т.П., Плетень А.П., Михеев Р.К. Биологическая роль адипокинов как маркеров патологического состояния. Вопросы питания. 2017;86(2);5–13.Vavilova T.P., Pleten’ A.P., Mikheev R.K. Biological role of adipokines and their association with morbid conditions. Voprosy pitaniia [Problems of Nutrition]. 2017;86(2):5–13. (In Russian).Wu Z.J., Cheng Y.J., Gu W.J., Aung H.L. Adiponectin is associated with increased mortality in patients with already established cardiovascular disease: A systematic review and metaanalysis. Metabolism. 2014;63(9):1157–66. DOI: 10.1016/j.metabol.2014.05.001Wu Z.J., Cheng Y.J., Gu W.J., Aung H.L. Adiponectin is associated with increased mortality in patients with already established cardiovascular disease: A systematic review and metaanalysis. Metabolism. 2014;63(9):1157–66. DOI: 10.1016/j.metabol.2014.05.001Shibata R., Ouchi N., Takahashi R., Terakura Y., Ohashi K., Ikeda N. et al. Omentin as a novel biomarker of metabolic risk factors. Diabetol. Metab. Syndr. 2012;4(1):37. DOI: 10.1186/1758-5996-4-37Shibata R., Ouchi N., Takahashi R., Terakura Y., Ohashi K., Ikeda N. et al. Omentin as a novel biomarker of metabolic risk factors. Diabetol. Metab. Syndr. 2012;4(1):37. DOI: 10.1186/1758-5996-4-37Alpert M.A, Omran J., Bostick B.P. Effects of obesity on cardiovascular hemodynamics, cardiac morphology, and ventricular function. Curr. Obes. Rep. 2016;5(4):424–34. DOI: 10.1007/s13679-016-0235-6Alpert M.A, Omran J., Bostick B.P. Effects of obesity on cardiovascular hemodynamics, cardiac morphology, and ventricular function. Curr. Obes. Rep. 2016;5(4):424–34. DOI: 10.1007/s13679-016-0235-6Бубнова М.Г. Роль ожирения и висцерального жира сердца в запуске сердечно-сосудистого континуума. Клинические эффекты орлистата. Регулярные выпуски «РМЖ». 2014;2:116–124.Bubnova M.G. The role of obesity and visceral heart fat in triggering the cardiovascular continuum. Clinical effects of orlistat. Regular issues of “RMJ”. 2014;2:116–124. (In Russian).Азимова М.О., Блинова Н.В., Жернакова Ю.В., Чазова И.Е. Ожирение как предиктор сердечно-сосудистых заболеваний: роль локальных жировых депо. Системные гипертензии. 2018;15(3):39–43. [Azimova M.O., Blinova N.V., Zhernakova Yu.V., Chazova I.E. Obesity as a predictor for disease development: role of localized fat depot. Systemic hypertension. 2018;15(3):39–43. (In Russian)]. DOI: 10.26442/2075-082X_2018.3.39-43Azimova M.O., Blinova N.V., Zhernakova Yu.V., Chazova I.E. Obesity as a predictor for disease development: role of localized fat depot. Systemic hypertension. 2018;15(3):39–43. (In Russian). DOI: 10.26442/2075-082X_2018.3.39-43Dela Cruz C.S., Matthay, R.A. Role of obesity in cardiomyopathy and pulmonary hypertensio. Clinics in Chest Medicine. 2009;30(3):509– 523. DOI: 10.1016/j.ccm.2009.06.001Dela Cruz C.S., Matthay, R.A. Role of obesity in cardiomyopathy and pulmonary hypertensio. Clinics in Chest Medicine. 2009;30(3):509– 523. DOI: 10.1016/j.ccm.2009.06.001Park J-S., Lee Y-H., Seo K-W., Choi B-J., Choi S-Y., Yoon M-H. et al. Echocardiographic epicardial fat thickness is a predictor for target vessel revascularization in patients with ST-elevation myocardial infarction. Lipids in Health and Disease. 2016;15(1):194. DOI: 10.1186/s12944-016-0371-8Park J-S., Lee Y-H., Seo K-W., Choi B-J., Choi S-Y., Yoon M-H. et al. Echocardiographic epicardial fat thickness is a predictor for target vessel revascularization in patients with ST-elevation myocardial infarction. Lipids in Health and Disease. 2016;15(1):194. DOI: 10.1186/s12944-016-0371-8Britton K.A, Pedley A., Massaro J.M, Corsini E.M., Murabito J.M., Hoffmann U., Fox C.S. Prevalence, Distribution, and Risk Factor Correlates of High Thoracic Periaortic Fat in the Framingham Heart Study. Journal of the American Heart Association. 2012;1(6):e004200. DOI: 10.1161/JAHA.112.004200Britton K.A, Pedley A., Massaro J.M, Corsini E.M., Murabito J.M., Hoffmann U., Fox C.S. Prevalence, Distribution, and Risk Factor Correlates of High Thoracic Periaortic Fat in the Framingham Heart Study. Journal of the American Heart Association. 2012;1(6):e004200. DOI: 10.1161/JAHA.112.004200Martinelli I., Tomassoni D., Moruzzi M., Roy P., Cifani C., Amenta F., Tayebati S.K. Cardiovascular Changes Related to Metabolic Syndrome: Evidence in Obese Zucker Rats. Int. J. Mol. Sci. 2020;21(6):2035. DOI: 10.3390/ijms21062035Martinelli I., Tomassoni D., Moruzzi M., Roy P., Cifani C., Amenta F., Tayebati S.K. Cardiovascular Changes Related to Metabolic Syndrome: Evidence in Obese Zucker Rats. Int. J. Mol. Sci. 2020;21(6):2035. DOI: 10.3390/ijms21062035Романцова, Т.И., Овсянникова А.В. Периваскулярная жировая ткань: роль в патогенезе ожирения, сахарного диабета 2 типа и сердечно-сосудистой патологии. Ожирение и метаболизм. 2015;12(4):5–13. DOI: 10.14341/omet201545-13Romantsova T.I., Ovsyannikovna A.V. Perivascular adipose tissue: role in the pathogenesis of obesity, type 2 diabetes mellitus and cardiovascular pathology. Obesity and metabolism. 2015;12(4):5–13. (In Russian). DOI: 10.14341/omet201545-13Гриценко О.В., Чумакова Г.А., Ельчанинова С.А., Веселовская Н.Г., Шевляков И.В., Калугина О.А. Липотоксическое поражение миокарда при ожирении. CardioСоматика. 2017;04:36–40. DOI: 10.26442/CS45386Gritsenko O.V., Chumakova G.A., Elchaninova S.A. et al. Lipotoxicity damage of myocardium in obesity. Cardiosomatics. 2017;8(4):36–40. (In Russian). DOI: 10.26442/CS45386Wang J., Xiang Bo, Hung-Yu Lin, Freed D., Arora R.C., Tian G.. Pathological mechanism for delayed hyperenhancement of chronic scarred myocardium in contrast agent enhanced magnetic resonance imaging. PloS One. 2014;9(5):e96463. DOI: 10.1371/journal.pone.0096463Wang J., Xiang Bo, Hung-Yu Lin, Freed D., Arora R.C., Tian G.. Pathological mechanism for delayed hyperenhancement of chronic scarred myocardium in contrast agent enhanced magnetic resonance imaging. PloS One. 2014;9(5):e96463. DOI: 10.1371/journal.pone.0096463Языева Д.Ш., Федотова Д.А. Морфогистологические изменения миокарда при ожирении. Бюллетень медицинских Интернет-конференций (ISSN 2224-6150).2017;7(1) [© Бюллетень медицинских Интернет-конференций, 2017]. URL: www.medconfer.com265. ID: 2017-01-6-T-10658.Yazyeva D.S., Fedotova D.A. Morphohistological changes of the myocardium in obesity. Bulletin of Medical Internet conferences. 2017;7(1).(In Russian). [Electronic resource]. URL: www.medconfer.com 265. ID: 2017-01-6-T-10658.López B., González A., Ravassa S., Beaumont J., Moreno M.U., San José G., Querejeta R., Díez J. Circulating biomarkers of myocardial fibrosis. J. Am. Coll. Cardiol. 2015;65(22):2449–2456. DOI: 10.1016/j.jacc.2015.04.026López B., González A., Ravassa S., Beaumont J., Moreno M.U., San José G., Querejeta R., Díez J. Circulating biomarkers of myocardial fibrosis. J. Am. Coll. Cardiol. 2015;65(22):2449–2456. DOI: 10.1016/j.jacc.2015.04.026Morelli M., Gaggini M., Daniele G., Marraccini P., Sicari R., Gastaldelli A. Ectopic fat: the true culprit linking obesity and cardiovascular disease? Thromb. Haemost. 2013;110(4):651–60. DOI: 10.1160/TH13-04-0285Morelli M., Gaggini M., Daniele G., Marraccini P., Sicari R., Gastaldelli A. Ectopic fat: the true culprit linking obesity and cardiovascular disease? Thromb. Haemost. 2013;110(4):651–60. DOI: 10.1160/TH13-04-0285Гиоева З. М., Богданов А.Р., Залетова Т.С., Богданова А.А. Ожирение как фактор риска развития хронической сердечной недостаточности (литературный обзор). Доктор.Ру. 2017;10(139):21–25.Gioeva Z.M., Bogdanov A.R., Zaletova T.S., Bogdanova A.A. Obesity as a Risk Factor for Chronic Heart Failure: a Review of the Literature. Doctor.Ru. 2017;10(139):21–25. (In Russian).Логачева И.В., Рязанова Т.А., Макарова В.Р., Авзалова Ф.Р., Максимов Н.И. Ремоделирование сердца у больных с избыточной массой тела и ожирением при коморбидной кардиальной патологии. Российский кардиологический журнал. 2017;4(144):40–46. DOI: 15829/1560-4071-2017-4-40-46Logacheva I.V., Ryazanova T.A., Makarova V.R., Avzalova F.R., Maksimov N.I. Heart remodeling in overweight and odesity with cardiac comorbidities. Russ. J. Cardiol. 2017;(4):40–46. (In Russian). DOI: 15829/1560-4071-2017-4-40-46Vecchié A., Dallegri F., Carbone F., Bonaventura A., Liberale L., Portincasa P., Gema Frühbeck G., Montecucco F. Obesity phenotypes and their paradoxical association with cardiovascular diseases. Eur. J. Intern. Med. 2018.48:6–17. DOI: 10.1016/j.ejim.2017.10.020Vecchié A., Dallegri F., Carbone F., Bonaventura A., Liberale L., Portincasa P., Gema Frühbeck G., Montecucco F. Obesity phenotypes and their paradoxical association with cardiovascular diseases. Eur. J. Intern. Med. 2018.48:6–17. DOI: 10.1016/j.ejim.2017.10.020Чумакова Г.А., Веселовская Н.Г. Клиническое значение висцерального ожирения. М. ГЭОТАР-Медиа, 2016:160.Chumakova G.A., Veselovskaya N.G. Clinical significance of visceral obesity. M. GEOTAR-Media. 2016:160. (In Russian)].Dudenbostel T., Ghazi L., Liu M., Li P., Oparil S, Calhoun D.A. Body mass index predicts 24-hour urinary aldosterone levels in patients with resistant hypertension. Hypertension. 2016;68(4):995–1003. DOI: 10.1161/HYPERTENSIONAHA.116.07806Dudenbostel T., Ghazi L., Liu M., Li P., Oparil S, Calhoun D.A. Body mass index predicts 24-hour urinary aldosterone levels in patients with resistant hypertension. Hypertension. 2016;68(4):995–1003. DOI: 10.1161/HYPERTENSIONAHA.116.07806Pilitsi E.E., O.M. Farr J.M., Polyzos S.A., Perakakis N, Nolen-Doerr E., Papathanasiou A.E., Mantzoros C.S. Pharmacotherapy of obesity: available medications and drugs under investigation. Metabolism. 2018;31:S0026–0495(18)30228–2. DOI: 10.1016/j.metabol.2018.10.010Pilitsi E.E., O.M. Farr J.M., Polyzos S.A., Perakakis N, Nolen-Doerr E., Papathanasiou A.E., Mantzoros C.S. Pharmacotherapy of obesity: available medications and drugs under investigation. Metabolism. 2018;31:S0026–0495(18)30228–2. DOI: 10.1016/j.metabol.2018.10.010Heinzel F.R., Hohendanner F., Jin G., Sedej S., Edelmann F. Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. J. Appl. Physiol .2015;119(10):1233–42. DOI: 10.1152/japplphysiol.00374.2015Heinzel F.R., Hohendanner F., Jin G., Sedej S., Edelmann F. Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. J. Appl. Physiol .2015;119(10):1233–42. DOI: 10.1152/japplphysiol.00374.2015Гриценко О., Чумакова Г.А., Шевляков И.В., Трубина Е.В. Механизмы развития сердечной недостаточности при ожирении. Российский кардиологический журнал. 2018;23(5):81–86. DOI: 10.15829/1560-4071-2018-5-81-86Gritsenko O.V., Chumakova G.A., Shevlyakov I.V., Trubina E.V. The mechanisms of heart failure development in obesity. Russian journal of cardiology. 2018;23(5):81–86. (In Russian). DOI: 10.15829/1560-4071-2018-5-81-86Matloch Z., Kotulák T., Haluzík M. The role of epicardial adipose tissue in heart disease. Physiol. Res.2016;65(1):23–32. DOI: 10.33549/physiolres.933036Matloch Z., Kotulák T., Haluzík M. The role of epicardial adipose tissue in heart disease. Physiol. Res.2016;65(1):23–32. DOI: 10.33549/physiolres.933036Дружилов М.А., Бетелева Ю.Е., Дружилова О.Ю. и др. Роль эпикардиального ожирения в развитии структурно-функционального ремоделирования сердц. Российский кардиологический журнал. 2017;4:35–9. DOI: 10.15829/1560-4071-2017-4-35-39Druzhilov M.A., Beteleva Yu.E., Druzhilo va O.Yu., Andreeva E.S., Kuznetsova T.Yu. The role of epicardial obesity in the development of structural and functional remodeling of the heart. Russian journal of cardiology. 2017;(4):35–39. (In Russian). DOI: 10.15829/1560-4071-2017-4-35-39Travers J.G., Kamal F.A., Robbins J. et al. Cardiac Fibrosis: The Fibroblast Awakens. Circ. Res. 2016;118(6):1021–40. DOI: 10.1161/CIRCRESAHA.115.306565.Travers J.G., Kamal F.A., Robbins J. et al. Cardiac Fibrosis: The Fibroblast Awakens. Circ. Res. 2016;118(6):1021–40. DOI: 10.1161/CIRCRESAHA.115.306565.Finicelli M., Squillaro T., Di Cristo F., Di Salle A., Melone M.A.B., Galderisi U., Peluso G. Metabolic syndrome, Mediterranean diet, and polyphenols: Evidence and perspectives. J. Cell. Physiol. 2019;234(5):5807–5826. DOI: 10.1002/jcp.27506.Finicelli M., Squillaro T., Di Cristo F., Di Salle A., Melone M.A.B., Galderisi U., Peluso G. Metabolic syndrome, Mediterranean diet, and polyphenols: Evidence and perspectives. J. Cell. Physiol. 2019;234(5):5807–5826. DOI: 10.1002/jcp.27506.López B., González A., Ravassa S., Beaumont J., Moreno M. U., San José G., Querejeta R., Díez J. Circulating biomarkers of myocardial fibrosis. J. Am. Coll. Cardiol. 2015;65(22):2449–2456. DOI: 10.1016/j.jacc.2015.04.026López B., González A., Ravassa S., Beaumont J., Moreno M. U., San José G., Querejeta R., Díez J. Circulating biomarkers of myocardial fibrosis. J. Am. Coll. Cardiol. 2015;65(22):2449–2456. DOI: 10.1016/j.jacc.2015.04.026Руденко Т.Е., Камышова Е.С Соломахина Н.И., Швецов М.Ю. Факторы риска развития., Васильева М.П., Бобкова И.Н., диастолической дисфункции миокарда левого желудочка у пациентов с хронической болезнью почек. Терапевтический архив. 2018;09:60–67. DOI: 10.26442/terarkh201890960-67Rudenko T.E., Kamyshova E.S., Vasilyeva M.P., Bobkova I.N., Solomatina N.I., Shvetsova M.Yu. Risk factors for diastolic left ventricular myocardial dysfunction in patients with chronic kidney disease. Therapeutic archive. 2018;09:60–67. (In Russian). DOI: 10.26442/terarkh201890960-67Мартыненко Т. И., Параева О.С., Дронов С.В., Шойхет Я.Н. Новые подходы к первичной дифференциации одышки при легочной и сердечной патологии. Клиническая медицина. 2014;92(9):45–51. УДК 616.24-008.47-079.4Martynenko T.I., Paraeva O.S., Dronov S.V., Shoikhet Ya.N. New approaches to primary differentiation of dyspnea in patient with pulmonary and cardiac pathology. Clinical medicine (Russian journal). 2014;92(9):45–51. (In Russian). УДК 616.24-008.47-079.4Poddar M., Chetty Y., Chetty V.T. How does obesity affect the endocrine system? A narrative review. Clin. Obes. 2017;7(3):136–44. DOI: 10.1111/cob.12184Poddar M., Chetty Y., Chetty V.T. How does obesity affect the endocrine system? A narrative review. Clin. Obes. 2017;7(3):136–44. DOI: 10.1111/cob.12184McQuillan C., Gray A., Kearney A, Menown I.B.A. Advances in clinical cardiology 2017: a summary of key clinical trials. Advances in Therapy. 2018;35(7):899–927. DOI: 10.1007/s12325-018-0716-yMcQuillan C., Gray A., Kearney A, Menown I.B.A. Advances in clinical cardiology 2017: a summary of key clinical trials. Advances in Therapy. 2018;35(7):899–927. DOI: 10.1007/s12325-018-0716-yPathak R.K., Mahajan R., Lau D.H. et al. The implications of obesity for cardiac arrhythmia mechanisms and management. Canadian Journal of Cardiology. 2015;31(2):203–210. DOI: 10.1016/j.cjca.2014.10.027Pathak R.K., Mahajan R., Lau D.H. et al. The implications of obesity for cardiac arrhythmia mechanisms and management. Canadian Journal of Cardiology. 2015;31(2):203–210. DOI: 10.1016/j.cjca.2014.10.027Праскурничий Е.А., Морозова О.И. Анализ клинико-патогенетических взаимоотношений динамики изменения массы тела и фибрилляции предсердий у пациентов с первичным ожирением. Архивъ внутренней медицины. 2021;11(5):389–400. DOI: 10.20514/2226-6704-2021-11-5-389-400Praskurnichiy E.A., Morozova O.I. Clinical and Pathogenetic Assessment of Relationships Between the Dynamics of Body Weight Changes and Atrial Fibrillation in Patients with Primary Obesity. The Russian archives of internal medicine. 2021;11(5):389–400. (In Russian). DOI: 10.20514/2226-6704-2021-11-5-389-400Nalliah C.J., Sanders P., Kottkamp H., Kalman J.M. The role of obesity in atrial fibrillation. European Heart Journal. 2016;37(20):1565–72. DOI:10.1093/eurheartj/ehv486.Nalliah C.J., Sanders P., Kottkamp H., Kalman J.M. The role of obesity in atrial fibrillation. European Heart Journal. 2016;37(20):1565–72. DOI:10.1093/eurheartj/ehv486.Huang H., Amin M., Gurin E., Wan E., Thorp S., Homma J.P. Dietinduced obesity causes long QT and reduces transcription of voltagegated potassium channels. J. Mol. Cell. Cardiol. 2013;59:151–158. DOI: 10.1016/j.yjmcc.2013.03.007Huang H., Amin M., Gurin E., Wan E., Thorp S., Homma J.P. Dietinduced obesity causes long QT and reduces transcription of voltagegated potassium channels. J. Mol. Cell. Cardiol. 2013;59:151–158. DOI: 10.1016/j.yjmcc.2013.03.007Kovesdy C.P., Furth S.L., Zoccali C. World Kidney Day Steering Committee. Obesity and kidney disease: hidden consequences of the epidemic. Blood Purif. 2017;43(4):346–54. DOI: 10.1159/000458481Kovesdy C.P., Furth S.L., Zoccali C. World Kidney Day Steering Committee. Obesity and kidney disease: hidden consequences of the epidemic. Blood Purif. 2017;43(4):346–54. DOI: 10.1159/000458481Мареев В.Ю., Агеев Ф.Т., Арутюнов Г.П., Коротеев А.В., Овчинников А.Г., Беленков Ю.Н. и соавт. Национальные рекомендации ОССН, РКО и РНМОТ по диагностике и лечению ХСН (четвертый пересмотр). Сердечная недостаточность. 2013;14(7):379– 472. УДК 616.12–008.46–036.12 (083.13)Mareev V.Yu., Ageev F.T., Arutyunov G.P., Koroteev A.V., Ovchinnikov A.G., Belenkov Yu.N. et al. National guidelines for the diagnosis and treatment of CHF (fourth revision). Heart failure. 2013; 14(7):379–472. (In Russian). УДК 616.12–008.46–036.12 (083.13)Миклишанская С.В., Соломасова Л.В., Мазур Н.А. Ожирение и механизм его отрицательного влияния на структуру и функцию сердца. Рациональная Фармакотерапия в Кардиологии. 2020;16(1):108–117. DOI: 10.20996/1819-6446-2020-02-09Miklishanskaya S.V., Solomasova L.V., Mazur M.A. Obesity and Mechanisms of its Negative Impact on the Cardiovascular System. Rational pharmacotherapy in cardiology. 2020;16(1):108–117. (In Russian). DOI: 10.20996/1819-6446-2020-02-09Alpert M. A., Omran J., Mehra A., Ardhanari S. Impact of obesity and weight loss on cardiac performance and morphology in adults. Progress in Cardiovascular Diseases. 2014;56(4):391–400. DOI: 10.1016/j.pcad.2013.09.003Alpert M. A., Omran J., Mehra A., Ardhanari S. Impact of obesity and weight loss on cardiac performance and morphology in adults. Progress in Cardiovascular Diseases. 2014;56(4):391–400. DOI: 10.1016/j.pcad.2013.09.003Гаврюшина С.В., Агеев Ф.Т. Сердечная недостаточность с сохраненной ФВ ЛЖ: эпидемиология, «портрет» больного, клиника, диагностика. Кардиология. 2018;58(S4):55–64. DOI: 10.18087/cardio.2467Gavryushina S.V., Ageev F. T. Heart failure with preserved left ventricular ejection fraction: epidemiology, patient «portrait», clinic and diagnostics. Cardiology. 2018;58(S4):55–64. (In Russian). DOI: 10.18087/cardio.2467Иванов С.И., Алехин М.Н. Неинвазивные показатели работы миокарда в оценке систолической функции левого желудочка. Кардиология. 2020; 60(3):80–88. DOI: 10.18087/cardio.2020.3.n925Ivanov S.I., Alekhin M.N. Myocardial work in assessment of left ventricular systolic function. Cardiologiia. 2020;60(3):80–88. (In Russian). DOI: 10.18087/cardio.2020.3.n925Пономаренко И.В., Сукманова И.А., Санаева А.К., Трубина Е.В., Наренкова С.О. Возможности speckle-tracking-эхокардиографии в диагностике субклинической дисфункции левого желудочка. Кардиология: новости, мнения, обучение. 2023;11(2):22–29. DOI: 10.33029/2309-1908-2023-11-2-22-29Ponomarenko I.V., Sukmanova I.A., Sanaeva A.K., Trubina E.V., Narenkova S.O. The possibilities of speckle-tracking echocardiography in the diagnosis of subclinical left ventricular dysfunction. Cardiology: news, opinions, training. 2023;11(2):22–29. (In Russian). DOI: 10.33029/2309-1908-2023-11-2-22-29Doğduş M., Kılıç S., Vuruşkan E. Evaluation of subclinical left ventricular dysfunction in overweight people with 3D speckle tracking echocardiography. Anatol. J. Cardiol 2019;21(4):180–6. DOI: 10.14744/AnatolJCardiol.2018.40456Doğduş M., Kılıç S., Vuruşkan E. Evaluation of subclinical left ventricular dysfunction in overweight people with 3D speckle tracking echocardiography. Anatol. J. Cardiol 2019;21(4):180–6. DOI: 10.14744/AnatolJCardiol.2018.40456Гриценко О.В., Чумакова Г.А., Трубина Е.В. Возможности speckle tracking-эхокардиографии для диагностики дисфункции миокарда. CardioСоматика. 2021;12(1):5–10. DOI: 10.26442/22217185.2021.1.200756Gritsenko O.V., Chumakova G.A., Trubina E.V. Features of speckle tracking echocardiography for diagnosis of myocardial dysfunction. Cardiosomatics. 2021;12(1):5–10. (In Russian). DOI: 10.26442/22217185.2021.1.200756Цыпленкова Н.С., Панова Е.И. Особенности сердечного ритма у мужчин трудоспособного возраста с ожирением и артериальной гипертензией. Ожирение и метаболизм. 2016;13(1):30–35. DOI: 10.14341/omet2016130-35Tsyplenkova N.S., Panova E.I. Heart rate features among men of working age with obesity and hypertension. Obesity and metabolism. 2016;13(1):30–35. (In Russian). DOI: 10.14341/omet2016130-35Соловьева А.В., Черданцева Т.М., Ческидов А.В., Шукис К.А. Клинико-морфологические особенности липоматозной гипертрофии межпредсердной перегородки у пациентов с заболеваниями сердечно-сосудистой системы. Наука молодых (Eruditio Juvenium). 2022;10(2):157–164. DOI: 10.23888/HMJ2022102157-164Solov’yeva A.V., Cherdantseva T.M., Cheskidov A.V., Shukis K.A. Clinical and Morphological Features of Lipomatous Hypertrophy of Interatrial Septum in Patients with Diseases of Cardiovascular System. Science of the young (Eruditio Juvenium). 2022;10(2):157–164. (In Russian). DOI: 10.23888/HMJ2022102157-164Van Veldhuisen, D.J., Linssen G.C., Jaarsma T., van Gilst W.H., Hoes A.W., Tijssen J.G., et al. B-type natriuretic peptide and prognosis in heart failure patients with preserved and reduced ejection fraction. J. Am. Coll. Cardiol. 2013;61(14):1498–506. DOI: 10.1016/j.jacc.2012.12.044Van Veldhuisen, D.J., Linssen G.C., Jaarsma T., van Gilst W.H., Hoes A.W., Tijssen J.G., et al. B-type natriuretic peptide and prognosis in heart failure patients with preserved and reduced ejection fraction. J. Am. Coll. Cardiol. 2013;61(14):1498–506. DOI: 10.1016/j.jacc.2012.12.044Mauad F., Chagas-Neto F., Benedeti A. et al. Reproducibility of abdominal fat assessment by ultrasound and computed tomography. Radiol. Bras. 2017;50(3):141–7. DOI:10.1590/0100-3984.2016.0023Mauad F., Chagas-Neto F., Benedeti A. et al. Reproducibility of abdominal fat assessment by ultrasound and computed tomography. Radiol. Bras. 2017;50(3):141–7. DOI:10.1590/0100-3984.2016.0023Шляхто Е.В., Недогода С.В., Конради А.О. и соавт. Диагностика, лечение, профилактика ожирения и ассоциированных с ним заболеваний (национальные клинические рекомендации). Санкт-Петербург. 2017:164.Shlyahto E.V., Nedogoda S.V., Conrady A.O. et al. Diagnosis, treatment, and prevention of obesity and related diseases (national clinical guidelines). Saint Petersburg. 2017:164. (In Russian).Кузнецова Т.Ю., Чумакова Г.А., Дружилов М.А. и др. Роль количественной эхокардиографической оценки эпикардиальной жировой ткани у пациентов с ожирением в клинической практике. Российский кардиологический журнал. 2017;4:81–7. DOI: 10.15829/1560-4071-2017-4-81-87Kuznetsova T.Yu., Chumakova G.A., Druzhilov M.A., Veselovskaya N.G. Clinical application of quantitative echocardiographic assessment fat tissue in obesity. Russian Journal of Cardiology. 2017;(4):81–87. (In Russian). DOI: 10.15829/1560-4071-2017-4-81-87Zhangt T., Q. Xue Q., Zhu R., Jiang Y. Diagnostic Value of PICP and PIIINP in Myocardial Fibrosis: A Systematic Review and Metaanalysis. Clin. Cardiol. 2022 Dec 5. DOI: 10.1002/clc.23901Zhangt T., Q. Xue Q., Zhu R., Jiang Y. Diagnostic Value of PICP and PIIINP in Myocardial Fibrosis: A Systematic Review and Metaanalysis. Clin. Cardiol. 2022 Dec 5. DOI: 10.1002/clc.23901Драпкина О.М., Зятенкова Е.В. Маркеры фиброза у пациентов с метаболическим синдромом. Русский медицинский журнал. 2016.26:1727–1731.Drapkina O.M., Zyatenkova T.V. Markers of fibrosis in patients with metabolic syndrome. Russian Medical Journal. 2016.26:1727–1731. (In Russian).Castro A.I., Gomez-Arbelaez D., Crujeiras A.B., Granero R., Aguera Z., Jimenez-Murcia S. et al. Effect of A Very Low-Calorie Ketogenic Diet on Food and Alcohol Cravings, Physical and Sexual Activity, Sleep Disturbances, and Quality of Life in Obese Patients. Nutrients. 2018;21;10(10):E1348. DOI: 10.3390/nu10101348Castro A.I., Gomez-Arbelaez D., Crujeiras A.B., Granero R., Aguera Z., Jimenez-Murcia S. et al. Effect of A Very Low-Calorie Ketogenic Diet on Food and Alcohol Cravings, Physical and Sexual Activity, Sleep Disturbances, and Quality of Life in Obese Patients. Nutrients. 2018;21;10(10):E1348. DOI: 10.3390/nu10101348Millard H.R., Musani S.K., Dibaba D.T., Talegawkar S.A., Taylor H.A.,Tucker K.L., Bidulescu A. Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study. Eur. J. Nutr. 2018;57(1):51–60. DOI: 10.1007/s00394-016-1296-8Millard H.R., Musani S.K., Dibaba D.T., Talegawkar S.A., Taylor H.A.,Tucker K.L., Bidulescu A. Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study. Eur. J. Nutr. 2018;57(1):51–60. DOI: 10.1007/s00394-016-1296-8Hanafy A.S., Elkatawy H.A. Beneficial effects of vitamin D on insulin sensitivity, blood pressure, abdominal subcutaneous fat thickness, and weight loss in refractory obesity. Clin Diabetes. 2018;36(3):217–225. DOI: 10.2337/cd17-0099Hanafy A.S., Elkatawy H.A. Beneficial effects of vitamin D on insulin sensitivity, blood pressure, abdominal subcutaneous fat thickness, and weight loss in refractory obesity. Clin Diabetes. 2018;36(3):217–225. DOI: 10.2337/cd17-0099Скворцов В.В., Малякина Э.А., Малякин Г.И. К вопросу о фармакологической коррекции показателей углеводного и липидного обменов у пациентов с метаболическим синдромом. Лечащий врач. 2022;12(25):44–50. DOI: 10.51793/OS.2022.25.12.008Skvortsov V.V., Malyakina E.A., Malyakin G.I. An addition to pharmacological correction of carbohydrate and lipid metabolism in patients with metabolic syndrome. Lechaschi Vrach. 2022;12(25):44–50. (In Russian). DOI: 10.51793/OS.2022.25.12.008Huwiler V.V., Schönenberger K.A., Segesser von Brunegg A. et al. Prolonged Isolated Soluble Dietary Fibre Supplementation in Overweight and Obese Patients: A Systematic Review with Meta-Analysis of Randomised Controlled Trials. Nutrients. 2022;14(13):2627. DOI: 10.3390/nu14132627Huwiler V.V., Schönenberger K.A., Segesser von Brunegg A. et al. Prolonged Isolated Soluble Dietary Fibre Supplementation in Overweight and Obese Patients: A Systematic Review with Meta-Analysis of Randomised Controlled Trials. Nutrients. 2022;14(13):2627. DOI: 10.3390/nu14132627Kränkel N., Bahls M., Van Craenenbroeck E.M., Adams V., Serratosa L., Solberg E.E., D.D. Hansen D.D., Dörr M., Kemps H. Exercise training to reduce cardiovascular risk in patients with metabolic syndrome and type 2 diabetes mellitus: How does it work? Eur. J. Prev. Cardiol. 2019;26(7):701–708. DOI: 10.1177/2047487318805158Kränkel N., Bahls M., Van Craenenbroeck E.M., Adams V., Serratosa L., Solberg E.E., D.D. Hansen D.D., Dörr M., Kemps H. Exercise training to reduce cardiovascular risk in patients with metabolic syndrome and type 2 diabetes mellitus: How does it work? Eur. J. Prev. Cardiol. 2019;26(7):701–708. DOI: 10.1177/2047487318805158Hruby A., Sahni S., Bolster D., Jacques P.F. Protein intake and functional integrity in aging: the Framingham Heart Study Offspring. J. Gerontol. A Biol. Sci. med. Sci. 2020;75(1):123–130. DOI: 10.1093/gerona/gly201Hruby A., Sahni S., Bolster D., Jacques P.F. Protein intake and functional integrity in aging: the Framingham Heart Study Offspring. J. Gerontol. A Biol. Sci. med. Sci. 2020;75(1):123–130. DOI: 10.1093/gerona/gly201Kashtanova D.A., Tkacheva J.N., Doudinskaya E.N., Strazhesko I.D., Kotovskaya Y.V., Popenko A.S., Tyakht A.V., Alexeev D.R. Gut microbiota in patients with different metabolic statuses: Moscow Study. Microorganisms. 2018;6(4):E98. DOI: 10.3390/microorganisms6040098.Kashtanova D.A., Tkacheva J.N., Doudinskaya E.N., Strazhesko I.D., Kotovskaya Y.V., Popenko A.S., Tyakht A.V., Alexeev D.R. Gut microbiota in patients with different metabolic statuses: Moscow Study. Microorganisms. 2018;6(4):E98. DOI: 10.3390/microorganisms6040098.Kobyliak N., Falalyeyeva T., Boyko N., Tsyryuk O., Beregova T., Ostapchenko L. Probiotics and nutraceuticals as a new frontier in obesity prevention and management. Diabetes Res Clin. Pract. 2018;141:190–199. DOI: 10.1016/j.diabres.2018.05.005Kobyliak N., Falalyeyeva T., Boyko N., Tsyryuk O., Beregova T., Ostapchenko L. Probiotics and nutraceuticals as a new frontier in obesity prevention and management. Diabetes Res Clin. Pract. 2018;141:190–199. DOI: 10.1016/j.diabres.2018.05.005Hayes J.F, Bhaskaran K., Batterham R., Smeeth L., Douglas I. The effect of sibutramine prescribing in routine clinical practice on cardiovascular outcomes: a cohort study in the United Kingdom. International Journal of Obesity. 2015;39(9);1359–64. DOI: 10.1038/ijo.2015.86Hayes J.F, Bhaskaran K., Batterham R., Smeeth L., Douglas I. The effect of sibutramine prescribing in routine clinical practice on cardiovascular outcomes: a cohort study in the United Kingdom. International Journal of Obesity. 2015;39(9);1359–64. DOI: 10.1038/ijo.2015.86Khera R., Murad M.H., Chandar A.K., Dulai P.S., Wang Z, Prokop J., Loomba R., Camilleri M., Singh S. Association of Pharmacological Treatments for Obesity with Weight Loss and Adverse Events: A Systematic Review and Meta-analysis. JAMA. 2016; Jun 14; 315(22):2424–34. DOI: 10.1001/jama.2016.7602Khera R., Murad M.H., Chandar A.K., Dulai P.S., Wang Z, Prokop J., Loomba R., Camilleri M., Singh S. Association of Pharmacological Treatments for Obesity with Weight Loss and Adverse Events: A Systematic Review and Meta-analysis. JAMA. 2016; Jun 14; 315(22):2424–34. DOI: 10.1001/jama.2016.7602McQuillan C., Gray A., Kearney A., Menown I.B.A. Advances in Clinical Cardiology 2017: A Summary of Key Clinical Trials. Advances in Therapy. 2018;35(7):899–927. DOI: 10.1007/s12325-018-0716-y.McQuillan C., Gray A., Kearney A., Menown I.B.A. Advances in Clinical Cardiology 2017: A Summary of Key Clinical Trials. Advances in Therapy. 2018;35(7):899–927. DOI: 10.1007/s12325-018-0716-y.Bohula E.A., Scirica S.E., Inzucchi D.K. et al. Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): a randomised, placebo-controlled trial. Lancet. 2018;392(10161):2269–2279. DOI: 10.1016/S0140-6736(18)32328-6Bohula E.A., Scirica S.E., Inzucchi D.K. et al. Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): a randomised, placebo-controlled trial. Lancet. 2018;392(10161):2269–2279. DOI: 10.1016/S0140-6736(18)32328-6Alfaris N., Minnick A.M., Hopkins C.M., Berkowitz R.I., Wadden T.A. Combination phentermine and topiramate extended release in the management of obesity. Expert. Opin Pharmacother. 2015;16(8):1263–74. DOI: 10.1517/14656566.2015.1041505Alfaris N., Minnick A.M., Hopkins C.M., Berkowitz R.I., Wadden T.A. Combination phentermine and topiramate extended release in the management of obesity. Expert. Opin Pharmacother. 2015;16(8):1263–74. DOI: 10.1517/14656566.2015.1041505Sudakin D. Naltrexone: Not Just for Opioids Anymore. J. Med. Toxicol. 2016;12(1):71–5. DOI: 10.1007/s13181-015-0512-xSudakin D. Naltrexone: Not Just for Opioids Anymore. J. Med. Toxicol. 2016;12(1):71–5. DOI: 10.1007/s13181-015-0512-xSundström J., Bruze G., Ottosson J., Marcus C., Näslund I., Neovius M. Weight loss and heart failure. A Nationwide Study of Gastric Bypass Surgery Versus Intensive Lifestyle Treatment. Circulation. 2017;135(17):1577–1585. DOI: 10.1161/CIRCULATIONAHA.116.025629Sundström J., Bruze G., Ottosson J., Marcus C., Näslund I., Neovius M. Weight loss and heart failure. A Nationwide Study of Gastric Bypass Surgery Versus Intensive Lifestyle Treatment. Circulation. 2017;135(17):1577–1585. DOI: 10.1161/CIRCULATIONAHA.116.025629Трошина Е.А., Ершова Е.В., Мазурина Н.В. Эндокринологические аспекты бариатрической хирургии. Consilium Medicum. 2019;21(4):50–55. [Troshina E.A., Ershova E.V., Mazurina N.V. Endocrinological aspects of bariatric surgery. Consilium Medicum. 2019;21(4):50–55. (In Russian)]. DOI: 10.26442/20751753.2019.4.190336Troshina E.A., Ershova E.V., Mazurina N.V. Endocrinological aspects of bariatric surgery. Consilium Medicum. 2019;21(4):50–55. (In Russian). DOI: 10.26442/20751753.2019.4.190336Дедов И.И., Мельниченко Г.А., Шестакова М.В., Трошина Е.А., Мазурина Н.В., Шестакова Е.А., Яшков Ю.И., Неймарк А.Е. и соавт. Лечение морбидного ожирения у взрослых. Ожирение и метаболизм. 2018;15(1):53–70. DOI: 10.14341/omet2018153-70Dedov I.I., Mel’nichenko G.A., Shestakova M.V., Troshina E.A., Mazurina N.V., Shestakova E.A., Yashkov Yu.I., Neimark A.E. et al. Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults). Obesity and metabolism. 2018;15(1):53–70. (In Russian). DOI: 10.14341/omet2018153-70Greenblatt H.K., Greenblatt D.J. Meldonium (Mildronate): A Performance-Enhancing Drug? Clin. Pharmacol. Drug Dev.2016.5(3):167–9. DOI: 10.1002/cpdd.264Greenblatt H.K., Greenblatt D.J. Meldonium (Mildronate): A Performance-Enhancing Drug? Clin. Pharmacol. Drug Dev.2016.5(3):167–9. DOI: 10.1002/cpdd.264Zhong Y., Zhong P., He S., Zhang Y., Tang L., Ling Y., Fu S. et al. Trimetazidine protects cardiomyocytes against hypoxia/ reoxygenation injury by promoting AMP-activated protein kinase-dependent autophagic flux. J. Cardiovasc. Pharmacol. 2017;69(6):389–397. DOI: 10.1097/FJC.0000000000000487Zhong Y., Zhong P., He S., Zhang Y., Tang L., Ling Y., Fu S. et al. Trimetazidine protects cardiomyocytes against hypoxia/ reoxygenation injury by promoting AMP-activated protein kinase-dependent autophagic flux. J. Cardiovasc. Pharmacol. 2017;69(6):389–397. DOI: 10.1097/FJC.0000000000000487

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