lvrachЛечащий ВрачLechaschi Vrach1560-51752687-118110.51793/OS.2024.27.8.004lvrach-1273Research ArticleГАСТРОЭНТЕРОЛОГИЯ. ГЕПАТОЛОГИЯGASTROENTEROLOGY. HEPATOLOGYСовременные взгляды на тактику ведения пациентов с саркопенией в сочетании с неалкогольной жировой болезнью печениModern views on the management tactics of patients with sarcopenia in combination with non-alcoholic fatty liver diseasehttps://orcid.org/0000-0002-7603-8481АхмедовВ. А.AkhmedovV. A.

Ахмедов Вадим Адильевич, д.м.н., профессор, заведующий кафедрой медицинской реабилитации дополнительного профессионального образования

644037, Россия, Омск, ул. Петра Некрасова, 5

Vadim A. Akhmedov, Dr. of Sci. (Med.), Professor, Head of the Department of Medical Rehabilitation of Additional Professional Education

5 Petra Nekrasova str., Omsk, 644037

v_akhmedov@mail.ruhttps://orcid.org/0000-0002-9535-6100ИсаеваА. С.IsaevaA. S.

Исаева Анна Сергеевна, к.м.н., доцент, кафедры медицинской реабилитации дополнительного профессионального образования

644037, Россия, Омск, ул. Петра Некрасова, 5

Anna S. Isaeva, Cand. of Sci. (Med.), Associate Professor, Department of Medical Rehabilitation of Additional Professional Education

Petra Nekrasova str., Omsk, 644037

annisa1@yandex.ruМариненкоВ. С.MarinenkoV. S.

Мариненко Вячеслав Сергеевич, терапевт, аспирант кафедры госпитальной терапии и последипломного образования

385000, Майкоп, ул. Первомайская

Vyacheslav S. Marinenko, internist, PhD student of the Department of Hospital Therapy and Postgraduate Education

191 Pervomayskaya str., Maikop, 385000

kaf_goster@mkgtu.ruОмский государственный медицинский университетРоссияOmsk State Medical UniversityRussian FederationМайкопский государственный технологический университетРоссияMaikop State Technological UniversityRussian Federation202425082024082934Copyright © Ахмедов В.А., Исаева А.С., Мариненко В.С., 20242024Ахмедов В.А., Исаева А.С., Мариненко В.С.Akhmedov V.A., Isaeva A.S., Marinenko V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/1273

Введение. Распространенность саркопении в мире составляет 10% как у мужчин, так и у женщин. В последние годы все больше накапливается сведений о повышенной распространенности саркопении у пациентов с неалкогольной жировой болезнью печени. Известно, что гиподинамия сопровождается уменьшением мышечной массы и влияет на профиль выработки миокинов и на предотвращение дальнейшей потери мышечной массы и накопления внутрипеченочного жира. Секреция миокина иризина индуцируется физической нагрузкой, что, по-видимому, объясняет негативное влияние гиподинамии на стеатоз печени. Существует также связь между физической активностью и выработкой гепатокинов. Кроме того, потеря мышечной силы и отсутствие физической активности является фактором риска более прогрессирующей потери мышечной массы, накопления жира и усугубления воспаления, что приводит к порочному кругу повторяющейся гиподинамии и еще более выраженной саркопении.Результаты. В обзорной статье приводятся данные о влиянии различных типов физической нагрузки на саркопению. Отдельное внимание уделяется роли миокинов в патогенезе саркопении и современным препаратам — ингибиторам миостатина. Рассматриваются аспекты роли гипераммониемии в патогенезе саркопении и вопросы влияния на данный патогенетический механизм. Описываются аспекты нутритивной поддержки пациентов с саркопенией.

Background. The prevalence of sarcopenia in the world is 10% in both men and women. In recent years, there has been an increasing accumulation of information about the increased prevalence of sarcopenia in patients with non-alcoholic fatty liver disease. It is known that hypodynamia is accompanied by a decrease in muscle mass and affects the profile of myokine production and its effect on preventing further loss of muscle mass and accumulation of intrahepatic fat. Irisin myokine secretion is induced by physical activity, which seems to explain the negative effect of hypodynamia on hepatic steatosis. There is also an association between physical activity and hepatokine production. In addition, loss of muscle strength and physical inactivity is a risk factor for more progressive loss of muscle mass, fat accumulation and worsening inflammation, leading to a vicious cycle of recurrent hypodynamia and even more severe sarcopenia.Results. The review article provides data on the effect of various types of physical activity on sarcopenia. Special attention is paid to the swarm of myokines in the pathogenesis of sarcopenia and the modern drug myostatin inhibitor. Aspects of the role of hyperammonemia in the pathogenesis of sarcopenia and its influence on this pathogenetic mechanism are considered. The aspects of nutritional support for patients with sarcopenia are described.

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