References

arthyper

Артериальная гипертензия

"Arterial’naya Gipertenziya" ("Arterial Hypertension")

1607-419X2411-8524

Antihypertensive League

10.18705/1607-419X-2008-14-2-110-115

arthyper-1198

Research Article

ОБЗОР

REVIEW

Современные представления о гипергомоцистеинемии как факторериска сердечно-сосудистых заболеваний

Hyperhomocystcinemia as a cardiovascular risk factor. Current concepts

Родионов

Р.

Rodionov

noemail@neicon.ru

Лентц

С.

Lentz

noemail@neicon.ru

Медицинский Факультет Университета АйовыРоссияUniversity of Iowa Carver College of MedicineRussian Federation

2008

28042008

142110115

2008

Родионов Р., Лентц С.

Rodionov R., Lentz S.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://htn.almazovcentre.ru/jour/article/view/1198

Резюме Тяжелая гипергомоцистеинемия, вызванная редкими наследственными нарушениями метаболизма гомоцис-теина, приводит к многократному увеличению риска атеротромбоза. Даже частичная коррекция уровня гомоцис-теина у пациентов с тяжелой гипергомоцистеинемией позволяет существенно уменьшить частоту возникновения сердечно-сосудистых осложнений. Умеренная гипергомоцистеинемия широко распространена в популяции и коррелирует с повышенным риском развития заболеваний сердечно-сосудистой системы. В экспериментальных моделях умеренная гипергомоцистеинемия вызывает эндотелиальную дисфункцию, предрасполагает к тромбозу и ускоряет развитие атеросклероза. На основании эпидемиологических и экспериментальных данных была выдвинута гипотеза, что коррекция умеренной гипергомоцистеинемии может существенно уменьшить риск развития заболеваний сердечно-сосудистой системы. Вопреки ожиданиям, серия крупных клинических исследований показала, что снижение уровня гомоцистеина при умеренной гипергомоцистеинемии не влияет на риск развития сердечнососудистых заболеваний. В данной статье обсуждаются современные представления о гипергомоцистеинемии как факторе риска развития заболеваний сердечно-сосудистой системы в свете отрицательных результатов клинических исследований по коррекции уровня гомоцистеина при умеренной гипергомоцистеинемии.

Resume Hyperhomocysteinemia is hypothesized to be a cardiovascular risk factor. Severe hyperhomocysteinemia due to rare genetic impairments of homocysteine metabolism predisposes to atherothrombosis. Even partial correction of homocysteine levels in patients with severe hyperhomocysteinemia leads to significant reduction in cardiovascular risk. Moderate hyperhomocysteinemia is common in the general population and is associated with the increased risk of cardiovascular disease. Moderate hyperhomocysteinemia leads to endothelial dysfunction, increased susceptibility to thrombosis and accelerated progression of atherosclerosis in animal models. Extensive epidemiological and experimental evidence lead to the hypothesis that correction of moderate hyperhomocysteinemia may significantly lower cardiovascular risk. Paradoxically, several large clinical trials failed to demonstrate any benefit from lowering of homocysteine levels in moderate hyperhomocysteinemia. This article discusses the current understanding of hyperhomocysteinemia as a cardiovascular risk factor in light of the negative results of clinical trials of homocysteine lowering therapy in moderate hyperhomocysteinemia.

гипергомоцистеинемиягомоцистеинсердечно-сосудистые заболеванияфактор риска

hyperhomocysteinemiahomocysteinecardiovascular diseaserisk factor

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