Список литературы

2687-0940

Актуальные проблемы медицины

2687-0940

10.52575/2687-0940-2025-48-4-427-442

262

ВНУТРЕННИЕ БОЛЕЗНИ

<strong>Клинико-патогенетические аспекты атеросклероза и неалкогольной жировой болезни печени</strong>

<strong>Clinical and Pathogenetic Aspects of Atherosclerosis and Non-Alcoholic Fatty Liver Disease</strong>

Вишневский

Валерий Иванович

Vishnevskij

Valery I.

vishnevsky.orel@mail.ru

Снимщикова

Ирина Анатольевна

Snimshchikova

Irina A.

Зюзина

Анастасия Андреевна

Ziuzina

Anastasiia A.

info@oreluniver.ru

Вишневский

Матвей Вадимович

Vishnevskij

Matvei V.

2025

48400

Проведен комплексный анализ научных публикаций в международных рецензируемых журналах за период 2010–2025 гг. с использованием систематического подхода к поиску, отбору и анализу работ, посвященных взаимосвязи атеросклероза и неалкогольной жировой болезни печени (НАЖБП). Атеросклероз и НАЖБП представляют собой метаболически взаимосвязанные патологические состояния, имеющие общие факторы риска и механизмы развития. НАЖБП ассоциирована с повышенным риском сердечно-сосудистых событий (ССС) независимо от традиционных факторов риска. Установлена связь между степенью выраженности стеатоза печени и прогрессированием субклинического атеросклероза. Определена ключевая роль инсулинорезистентности, дислипидемии, окислительного стресса и хронического воспаления в патогенезе обоих заболеваний. Терапевтические подходы, направленные на коррекцию метаболических нарушений, могут оказывать положительное влияние на течение обеих нозологий. Целесообразно рассматривать НАЖБП как независимый фактор риска ССС. Перспективны дальнейшие исследования, направленные на разработку комплексных стратегий лечения, учитывающих патофизиологическую взаимосвязь этих состояний.

The paper presents the results of a comprehensive analysis of scientific publications in international peer-reviewed journals for the period 2010-2025. The authors used a systematic approach to search, selection, and analysis of studies on the relationship between atherosclerosis and non-alcoholic fatty liver disease (NAFLD). Atherosclerosis and NAFLD are metabolically interconnected pathological conditions with common risk factors and mechanisms of development. NAFLD is associated with an increased risk of cardiovascular events (CVEs) independently of traditional risk factors. The study has revealed a relationship between the severity of liver steatosis and the progression of subclinical atherosclerosis. The key role of insulin resistance, dyslipidemia, oxidative stress, and chronic inflammation in the pathogenesis of both diseases has been identified. Therapeutic approaches aimed at correcting metabolic disorders may have a positive impact on the course of both conditions. It is reasonable to consider NAFLD as an independent risk factor for CVD. Further research is needed to develop comprehensive treatment strategies that take into account the pathophysiological relationship between these conditions.

атеросклерознеалкогольная жировая болезнь печениметаболический синдроминсулинорезистентностьсистемное воспалениеэндотелиальная дисфункция

atherosclerosisnon-alcoholic fatty liver diseasemetabolic syndromeinsulin resistancesystemic inflammationendothelial dysfunction

Работа выполнена в ОГУ имени И.С. Тургенева в рамках государственного задания № 075-00195-25-00 на 2025 год и на плановый период 2026 и 2027 годов, проект FSGN-2024-0014 (1024041900023-6-3.1.3; 3.2.12; 3.2.4).

Список литературы

Плотникова М.О., Снимщикова И.А., Вишневский В.И., Сараев И.А., Митяева Е.В., Конокотина О.А. 2024. Первичная профилактика ишемической болезни сердца: проблема, вызывающая обеспокоенность. Актуальные проблемы медицины. 47(2): 171–181. doi: 10.52575/2687-0940-2024-47-2-171-181

Adams L.A., Anstee Q.M., Tilg H., Targher G. 2017. Non-Alcoholic Fatty Liver Disease and its Relationship with Cardiovascular Disease and Other Extrahepatic Diseases. Gut. 66(6): 1138–1153. doi: 10.1136/gutjnl-2017-313884

Anstee Q.M., Darlay R., Cockell S., Meroni M., Govaere O., Tiniakos D., Burt A.D., Bedossa P., Palmer J., Liu Y.L., Aithal G.P., Allison M., Yki-Järvinen H., Vacca M., Dufour J.F., Invernizzi P., Prati D., Ekstedt M., Kechagias S., Francque S., Petta S., Bugianesi E., Clement K., Ratziu V., Schattenberg J.M., Valenti L., Day C.P., Cordell H.J., Daly A.K.; EPoS Consortium Investigators. 2020. Genome-Wide Association Study of Non-Alcoholic Fatty Liver and Steatohepatitis in a Histologically Haracterised Cohort. Journal of Hepatology. 73(3): 505–515. doi: 10.1016/j.jhep.2020.04.003

Ashraf H., Anushiravani A., Rayatpisheh M., Hamidi Alamdari D., Hossieni A., Kazeminezhad B. 2025. Association between Oxidative Stress and Liver Fibrosis Severity in Non-Alcoholic Fatty Liver Disease: Insights from the Pro-Oxidant Antioxidant Balance Method in a Population from Tehran and Mashhad, Iran. Frontiers in Medicine (Lausanne). Mar 12: 12: 1539605. doi: 10.3389/fmed.2025.1539605

Baratta F., Pastori D., Angelico F., Balla A., Paganini A.M., Cocomello N., Ferro D., Violi F., Sanyal A.J., Del Ben M. 2020. Nonalcoholic Fatty Liver Disease and Fibrosis Associated with Increased Risk of Cardiovascular Events in a Prospective Study. Clinical Gastroenterology and Hepatology. 18(10): 2324–2331.e4. doi: 10.1016/j.cgh.2019.12.026

Boursier J., Vergniol J., Guillet A., Hiriart J.B., Lannes A., Le Bail B., Michalak S., Chermak F., Bertrais S., Foucher J., Oberti F., Charbonnier M., Fouchard-Hubert I., Rousselet M.C., Calès P., de Lédinghen V. 2016. Diagnostic Accuracy and Prognostic Significance of Blood Fibrosis Tests and Liver Stiffness Measurement by FibroScan in Non-Alcoholic Fatty Liver Disease. Journal of Hepatology. 65(3): 570–8. doi: 10.1016/j.jhep.2016.04.023

Byrne C.D., Targher G. 2020. NAFLD as a Driver of Chronic Kidney Disease. Journal of Hepatology. 72(4): 785–801. doi: 10.1016/j.jhep.2020.01.013

Cai J., Zhang X.J., Li H. 2019. The Role of Innate Immune Cells in Nonalcoholic Steatohepatitis. Hepatology. 70(3): 1026–1037. doi: 10.1002/hep.30506

Capone F., Vettor R., Schiattarella G.G. 2023. Cardiometabolic HFpEF: NASH of the Heart. Circulation. 147: 451–3. doi: 10.1161/CIRCULATIONAHA.122.062874

Choi J., Lee S.R., Choi E.K., Ahn H.J., Kwon S., Park S.H., Lee H., Chung J., Han M., Lee S-W., Han K-D., Oh S., Lip G.Y.H. 2022. Non-Alcoholic Fatty Liver Disease and the Risk of Atrial Fibrillation in Young Adults: A Nationwide Population-Based Cohort Study. Frontiers in Cardiovascular Medicine. 9: 832023. doi: 10.3389/fcvm.2022.832023

Ciornolutchii V., Ismaiel A., Bogdan J., Popa S., Surdea-Blaga T., Dumitrascu D. 2025. From Liver to Limb: Exploring the Association between Fatty Liver Disease and Peripheral Artery Disease – A Systematic Review. European Journal of Clinical Investigation. 55(10); e70075. doi: 10.1111/eci.70075

Dulai P.S., Singh S., Patel J., Soni M., Prokop L.J., Younossi Z., Sebastiani G., Ekstedt M., Hagstrom H., Nasr P., Stal P., Wong V.W., Kechagias S., Hultcrantz R., Loomba R. 2017. Increased Risk of Mortality by Fibrosis Stage in Nonalcoholic Fatty Liver Disease: Systematic Review and Meta-Analysis. Hepatology. 65: 1557–65. doi: 10.1002/hep.29085

Eslam M., Newsome P.N., Sarin S.K., Anstee Q.M., Targher G., Romero-Gomez M., Zelber-Sagi S., Wai-Sun Wong V., Dufour J.F., Schattenberg J.M., Kawaguchi T., Arrese M., Valenti L., Shiha G., Tiribelli C., Yki-Järvinen H., Fan J.G., Grønbæk H., Yilmaz Y., George J. 2020. A New Definition for Metabolic Dysfunction-Associated Fatty Liver Disease: An International Expert Consensus Statement. Journal of Hepatology. 73(1): 202–209. doi: 10.1016/j.jhep.2020.03.039

Fujii H., Kawada N. and Japan Study Group of NAFLD. 2020. The Role of Insulin Resistance and Diabetes in Nonalcoholic Fatty Liver Disease. International Journal of Molecular Sciences. 21: 3863. doi: 10.3390/ijms21113863

Gong Z., Tas E., Yakar S., Muzumdar R. 2020. Hepatic Lipid Metabolism and Non-Alcoholic Fatty Liver Disease in Aging. Molecular and Cellular Endocrinology. 455: 115–130. doi: 10.1016/j.mce.2016.12.022

Hassanien M.A., Abou-El-Noeman S.A., Aboueladab E. 2014. Oxidative Stress, Antioxidant and Leptin Status in Patients with Nonalcoholic Steatohepatitis. European Journal of Academic Essays. 1(10): 17–22.

Ismaiel A., Dumitraşcu D.L. 2019. Cardiovascular Risk in Fatty Liver Disease: The Liver-Heart Axis-Literature Review. Frontiers in Medicine. 6: 202. doi: 10.3389/fmed.2019.00202

Kasper P., Martin A., Lang S., Kütting F., Goeser T., Demir M., Steffen H.M. 2021. NAFLD and Cardiovascular Diseases: A Clinical Review. Clinical Research in Cardiology. 110(7): 921–937. https://doi.org/10.1007/s00392-020-01709-7

Labenz C., Huber Y., Michel M., Nagel M., Galle P.R., Kostev K., Schattenberg J.M. 2020. Impact of NAFLD on the Incidence of Cardiovascular Diseases in a Primary Care Population in Germany. Digestive Diseases and Sciences. 65(7): 2112–9. doi: 10.1007/s10620-019-05986-9

Lauridsen B.K., Stender S., Kristensen T.S., Kofoed K.F., Køber L., Nordestgaard B.G., Tybjærg-Hansen A. 2018. Liver Fat Content, Non-Alcoholic Fatty Liver Disease, and Ischaemic Heart Disease: Mendelian Randomization and Meta-Analysis of 279 013 Individuals. European Heart Journal. 39(5): 385–393. doi: 10.1093/eurheartj/ehx662

Lee S.B., Park G.M., Lee J.Y., Lee B.U., Park J.H., Kim B.G., Jung S.W., Jeong I.D., Bang S.J., Shin J.W., Park N.H., Yang D.H., Kang J.W., Lim T.H., Kim H.K., Choe J., Lee H.C. 2018. Association between Non-Alcoholic Fatty Liver Disease and Subclinical Coronary Atherosclerosis: An Observational Cohort Study. Journal of Hepatology. 68(5): 1018–1024. doi: 10.1016/j.jhep.2017.12.012

Lee S.R., Han K.D., Choi E.K., Lip G.Y. 2021. Nonalcoholic Fatty Liver Disease and the Risk of Atrial Fibrillation Depending on Body Mass Index: A Nationwide Population-Based Study. Scientific Reports. 11(1): 3737. doi: 10.1038/s41598-021-83367-x

Ma W., Wu W., Wen W., Xu F., Han D., Lyu J., Huang Y. 2022. Association of NAFLD with Cardiovascular Disease and All-Cause Mortality: A Large-Scale Prospective Cohort Study Based on UK Biobank. Therapeutic Advances in Chronic Disease. 13: 20406223221122478. doi.org/10.1177/20406223221122478

Ma X., Jia J., Cui H., Zhou J., Tian F., Yang J., Zhang Y., Dai J., Cao L. 2024. Association between the Triglyceride to High Density Lipoprotein Cholesterol Ratio and the Incidence of Metabolic Dysfunction-Associated Fatty Liver Disease: A Retrospective Cohort Study. BMC Gastroenterology. Nov 1; 24(1): 389. doi: 10.1186/s12876-024-03471-w

Madan S.A., John F., Pyrsopoulos N., Pitchumoni C.S. 2020. Nonalcoholic Fatty Liver Disease and Carotid Artery Atherosclerosis in Children and Adults: A Meta-Analysis. European Journal of Gastroenterology & Hepatology. 27(11): 1237–48. doi: 10.1097/MEG.0000000000000429

Mantovani A., Petracca G., Csermely A., Beatrice G., Bonapace S., Rossi A., Tilg H., Byrne C.D., Targher G. 2022. Non-Alcoholic Fatty Liver Disease and Risk of New-Onset Heart Failure: An Updated Meta-Analysis of about 11 Million Individuals. Gut. Jul 25:gutjnl-2022-327672. doi: 10.1136/gutjnl-2022-327672

Mantovani A., Scorletti E., Mosca A., Alisi A., Byrne C.D., Targher G. 2020. Complications, Morbidity and Mortality of Nonalcoholic Fatty Liver Disease. Metabolism. 111S: 154170. doi: 10.1016/j.metabol.2020.154170

Margery A Connelly, Jonathan Velez Rivera, John R Guyton, Mohammad Shadab Siddiqui, Arun J Sanyal. 2020. Review Article: The Impact of Liver-Directed Therapies on the Atherogenic Risk Profile in Non-Alcoholic Steatohepatitis. Alimentary Pharmacology and Therapeutics. 52(4): 619–636. doi: 10.1111/apt.15935

Marso S.P., Bain S.C., Consoli A., Eliaschewitz F.G., Jódar E., Leiter L.A., Lingvay I., Rosenstock J., Seufert J., Warren M.L., Woo V., Hansen O., Holst A.G., Pettersson J., Vilsbøll T.; SUSTAIN-6 Investigators. 2016. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. The New England Journal of Medicine. 375(19): 1834–44. doi: 10.1056/NEJMoa1607141

Muzurović E., Mikhailidis D.P., Mantzoros C. 2021. Non-Alcoholic Fatty Liver Disease, Insulin Resistance, Metabolic Syndrome and Their Association with Vascular Risk. Metabolism. 119: 154770. doi: 10.1016/j.metabol.2021.154770

Ndrepepa G., Colleran R., Kastrati A. 2018. Gamma-Glutamyl Transferase and the Risk of Atherosclerosis and Coronary Heart Disease. Clinica Chimica Acta: International Journal of Clinical Chemistry. 476: 130–138. doi: 10.1016/j.cca.2017.11.026

Niederseer D, Wernly B, Aigner E, Stickel F, Datz C. 2021. NAFLD and Cardiovascular Diseases: Epidemiological, Mechanistic and Therapeutic Considerations. Clinical Medicine. 10(3):467. doi: 10.3390/jcm10030467

Nobakht Motlagh Ghoochani B.F., Ghafourpour M., Abdollahi F., Tavallaie S. 2019. Pro-Oxidant Antioxidant Balance in Patients with Non-Alcoholic Fatty Liver Disease. Gastroenterology and Hepatology from Bed to Bench. 12: 124–30. doi: 10.22037/ghfbb.v12i2.1482

Nseir W., Mograbi J., Ghali M. 2012. Lipid-lowering Agents in Nonalcoholic Fatty Liver Disease and Steatohepatitis: Human Studies. American Journal of Digestive Diseases. 57(7): 1773–81. doi: 10.1007/s10620-012-2118-3

Petta S., Valenti L., Bugianesi E., Targher G., Bellentani S., Bonino F. 2016. A "Systems Medicine" Approach to the Study of Non-Alcoholic Fatty Liver Disease. Digestive and Liver Disease. 48(3): 333–42. doi: 10.1016/j.dld.2015.10.027

Pouwels S., Sakran N., Graham Y., Leal A., Pintar T., Yang W., Kassir R., Singhal R., Mahawar K., Ramnarain D. 2022. Non-Alcoholic Fatty Liver Disease (NAFLD): A Review of Pathophysiology, Clinical Management and Effects of Weight Loss. BioMed Central Endocrine Disorders. Endocrine Disorders. 22(1): 63. doi: 10.1186/s12902-022-00980-1

Qu B., Qu T. 2015. Causes of Changes in Carotid Intima-Media Thickness: A Literature Review. Cardiovascular Ultrasound. 13: 46. doi: org/10.1186/s12947-015-0041-4

Ro J. H., Lee J. H., Lee H., Yun Y. H., Kim M., Kim Y. G. et al. 2020. The Relationship between Non-Alcoholic Fatty Liver Disease and the Risk of Atrial Fibrillation in Healthy Adults. Liver International. 40(2): 338–46. doi: 10.1111/liv.14236

Simon T.G., Roelstraete B., Khalili H., Hagström H., Ludvigsson J.F. 2021. Mortality in Biopsy-Confirmed Nonalcoholic Fatty Liver Disease: Results from a Nationwide Cohort. Gut. 70(7): 1375–1382. doi: 10.1136/gutjnl-2020-322786

Snimshchikova I.A., Plotnikova M.O., Kulakova A.S. 2024. New Horizons in the Study of WNT and JAK/STAT Signaling Pathways in Cardiometabolic Diseases. The Open Biomarkers Journal. 14; e18753 183297843

Stefan N., Häring H.U., Cusi K. 2019. Non-Alcoholic Fatty Liver Disease: Causes, Diagnosis, Cardiometabolic Consequences, and Treatment Strategies. Lancet Diabetes Endocrinol. 7(4): 313–24. doi: 10.1016/S2213-8587(18)30154-2

Targher G., Byrne C.D., Lonardo A., Zoppini G., Barbui C. 2016. Non-Alcoholic Fatty Liver Disease and Risk of Incident Cardiovascular Disease: A Meta-Analysis. Journal of Hepatology. 65(3): 589–600. doi: 10.1016/j.jhep.2016.05.013

Targher G., Byrne C.D., Tilg H. 2020. NAFLD and Increased Risk of Cardiovascular Disease: Clinical Associations, Pathophysiological Mechanisms and Pharmacological Implications. Gut. 9: 1691–1705. doi: 10.1136/gutjnl-2020-320622

Taylor R.S., Taylor R.J., Bayliss S., Hagström H., Nasr P., Schattenberg J.M., Ishigami M., Toyoda H., Wai-Sun Wong V., Peleg N., Shlomai A., Sebastiani G., Seko Y., Bhala N., Younossi Z.M., Anstee Q.M., McPherson S., Newsome P.N. 2020. Association between Fibrosis Stage and Outcomes of Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology. 158(6): 1611–1625.e12. doi: 10.1053/j.gastro.2020.01.043

Vilar-Gomez E., Calzadilla-Bertot L., Wai-Sun Wong V., Castellanos M., Aller-de la Fuente R., Metwally M., Eslam M., Gonzalez-Fabian L., Alvarez-Quiñones Sanz M., Conde-Martin A.F., De Boer B., McLeod D., Hung Chan A.W., Chalasani N., George J., Adams L.A., Romero-Gomez M. 2018. Fibrosis Severity as a Determinant of Cause-Specific Mortality in Patients with Advanced Nonalcoholic Fatty Liver Disease: A Multi-National Cohort Study. Gastroenterology. 155: 443–57. doi: 10.1053/j.gastro.2018.04.034

Xia G., Xu Y., Zhang C., Li M., Li H., Chen C. 2024. High Levels of Serum Hypersensitive C-Reactive Protein are Associated with Non-Alcoholic Fatty Liver Disease in Non-Obese People: A Cross-Sectional Study. European Journal of Medical Research. 29: 496. doi: org/10.1186/s40001-024-02065-2

Xu T., Li S., Wu S., Zhang S., Wang X. 2024. Non-Alcoholic Fatty Liver Disease: A New Predictor of Recurrent Ischemic Stroke and Transient Ischemic Attack in Patients with Carotid Atherosclerosis. European Journal of Radiology. 181: 111754. doi: 10.1016/j.ejrad.2024.111754

Ying M., Yu W., Qin W., Nanwei T. 2025. The Fibrosis-4 Index and its Association with Carotid Atherosclerosis in type 2 Diabetes: A Cross-Sectional Study in China. BMC Cardiovascular Disorders. 25(1): 35. doi: 10.1186/s12872-025-04491-4

Zinman B., Wanner C., Lachin J.M., Fitchett D., Bluhmki E., Hantel S., Devins T., Johansen O.E., Woerle H.J., Broedl U.C., Inzucchi S.E., or the EMPA-REG OUTCOME Investigators. 2015. Empagliflozin, Cardiovascular Outcomes and Mortality in type 2 Diabetes. The New England Journal of Medicine. 373: 2117–28. doi: 10.1056/NEJMoa1504720

Zou B., Yeo Y.H., Cheung R., Ingelsson E., Nguyen M.H. 2021. Fatty Liver Index and Development of Cardiovascular Disease: Findings from the UK Biobank. Digestive Diseases and Sciences. 66(6): 2092–100. doi: 10.1007/s10620-021-06954-y