Международный эндокринологический журнал Том 21, №5, 2025

Жорсткість артерій тісно пов’язана з ключовими компонентами кардіометаболічного синдрому, який становить комплекс взаємопов’язаних серцево-судинних і метаболічних факторів ризику, включно з надмірною вагою/ожирінням, артеріальною гіпертензією (АГ), інсулінорезистентністю (ІР)/гіперінсулінемією, дисліпідемією та іншими метаболічними порушеннями. Взаємозв’язок між метаболічними порушеннями та атеросклеротичними серцево-судинними захворюваннями (АССЗ) давно визнаний, хоча механізми, які поєднують ІР з АССЗ, залишаються недостатньо зрозумілими. Артеріальна жорсткість може виступати незалежним фактором розвитку цукрового діабету (ЦД), що не залежить від традиційних факторів ризику, як-от вік, індекс маси тіла чи рівень артеріального тиску. Взаємозв’язок між жорсткістю артерій і ризиком розвитку ЦД 2-го типу можна пояснити низкою потенційних патофізіологічних механізмів, а саме: порушення функції ендотелію здатне спричиняти діастолічну дисфункцію капілярів, що може посилювати жорсткість артеріальної стінки; підвищена жорсткість артерій потенційно призводить до пошкодження мікроциркуляторного русла; може викликати функціональні ушкодження органів із низьким гідродинамічним опором, таких як підшлункова залоза, печінка, нирки і головний мозок; може бути пов’язана з прогресуванням печінкової ІР; діастолічна дисфункція або редукція капілярної мережі здатні знижувати перфузію тканин і посилювати ІР; активація процесів оксидативного стресу і хронічного запалення низької інтенсивності здатні виступати спільними патогенетичними факторами ризику як для артеріальної жорсткості, так і для діабету; генетичні фактори здатні об’єднати артеріальну жорсткість і ЦД 2-го типу у рамках спільного патофізіологічного механізму. Виявлення жорсткості артерій як предиктора ЦД 2-го типу відкриває нові перспективи для розробки стратегій профілактики діабету. Метою огляду було проведення аналізу сучасного стану проблеми взаємозв’язків між артеріальною жорсткістю, серцево-судинними захворюваннями та ризиком ЦД 2-го типу, а також аналізу нових тенденцій та напрямів майбутніх досліджень. Пошук проводився в Scopus, Science Direct (від Elsevier) і PubMed, включно з базами даних Medline. Використані ключові слова «артеріальна жорсткість», «серцево-судинні захворювання», «предіабет», «цукровий діабет 2-го типу». Для виявлення результатів дослідження, які не вдалося знайти під час онлайн-пошуку, використовувався ручний пошук бібліографії публікацій.

Arterial stiffness is closely associated with key components of cardiometabolic syndrome, which is a complex of interrelated cardiovascular and metabolic risk factors, including overweight/obesity, hypertension, insulin resistance (IR)/hyperinsulinemia, dyslipidemia, and other metabolic disorders. The relationship between metabolic disorders and atherosclerotic cardiovascular diseases has long been recognized, although the mechanisms linking IR to cardiovascular diseases remain poorly understood. Arterial stiffness may be an independent factor in the development of diabetes mellitus (DM), unrelated to traditional risk factors such as age, body mass index, or blood pressure. The relationship between arterial stiffness and the risk of type 2 DM can be explained by a number of potential pathophysiological mechanisms, namely endothelial dysfunction can cause diastolic capillary dysfunction, which can increase arterial wall stiffness; increased arterial stiffness potentially leads to damage to the microcirculatory bed; may cause functional damage to organs with low hydrodynamic resistance such as the pancreas, liver, kidneys and brain; and may be associated with the progression of hepatic IR; diastolic dysfunction or reduction of the capillary network can reduce tissue perfusion and exacerbate IR; activation of oxidative stress and chronic low-grade inflammation can act as common pathogenic risk factors for both arterial stiffness and diabetes; genetic factors can combine arterial stiffness and type 2 DM within a common pathophysiological mechanism. The fact that arterial stiffness was found to be a predictor of type 2DM offers new insights into future diabetes prevention strategies. The review aimed to examine the current understanding of the relationship between arterial stiffness, cardiovascular diseases, and risk of type 2 DM, as well as to identify potential new trends and directions for future research. The search was conducted in Scopus, ScienceDirect (from Elsevier), and PubMed, including Medline, databases. The keywords used were “arterial stiffness”, “cardiovascular disease”, “prediabetes”, and “type 2 diabetes.” A manual search of the bibliography of publications was used to identify study results that could not be found during the online search.

артеріальна жорсткість; серцево-судинні захворювання; предіабет; цукровий діабет 2-го типу; огляд літератури

arterial stiffness; cardiovascular diseases; prediabetes; type 2 diabetes mellitus; literature review

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