milmedВоенная медицинаMilitary Medicine2074-5044Белорусский государственный медицинский университетmilmed-535Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESСовременный взгляд на проблемы ожирения и возможности медикаментозной коррекцииModern view of the problems of obesity and the possibility of medicamental correctionЧернышО. В.ChernyshO. V.БоваА. А.BovaA. А.РудойА. С.RudоyA. S.Кафедра военно-полевой терапии военно-медицинского факультета в УО «Белорусский государственный медицинский университет»Belarus20182010202601131135Copyright © Черныш О.В., Бова А.А., Рудой А.С., 20262026Черныш О.В., Бова А.А., Рудой А.С.Chernysh O.V., Bova A.А., Rudоy A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://milmed.ejournal.by/jour/article/view/535

В статье освещены вопросы этиологии и патогенеза ожирения, акцентировано внимание на заболеваниях, ассоциированных с ожирением с позиции последних международных клинических рекомендаций. Даны подробные лечебные рекомендации по использованию препарата лираглутид для снижения веса. Его применение у пациентов с ожирением в сочетании с модификацией образа жизни позволяет не только эффективно снижать массу тела, но и предотвращать сопутствующие заболевания и улучшать их течение, снижать риск сердечно–сосудистых заболеваний и их осложнений, что значительно улучшает качество жизни пациентов.

The article highlights the issues of the etiology and pathogenesis of obesity, focuses attention on diseases associated with obesity in terms of the latest international clinical recommendations. Detailed medical recommendations on the use of the drug liraglutide for weight reduction are given. Its use in obese patients in combination with lifestyle modification allows not only to effectively reduce body weight, but also to prevent comorbidities and improve their course, reduce the risk of cardiovascular diseases and their complications, which significantly improves the quality of life of patients.

ожирениелираглутидсахарный диабетobesityliraglutidediabetesReferencesИгнатьева, Е. В. Гены, контролирующие пищевое поведение и массу тела человека, их функциональные и геномные характеристики / Е. В. Игнатьева, Д. А. Афонников и др. // Вавиловский журнал генетики и селекции. – 2014. – Т. 18. – No 4/2. – C. 867–875.Игнатьева, Е. В. Гены, контролирующие пищевое поведение и массу тела человека, их функциональные и геномные характеристики / Е. В. Игнатьева, Д. А. Афонников и др. // Вавиловский журнал генетики и селекции. – 2014. – Т. 18. – No 4/2. – C. 867–875.Ландырь, А. П. Энергетика мышечной деятельности. / А. П. Ландырь, Е. Е. Ачкасов и др. // Спортивная медицина: наука и практика. – 2012. – №3 – С.30–33.Ландырь, А. П. Энергетика мышечной деятельности. / А. П. Ландырь, Е. Е. Ачкасов и др. // Спортивная медицина: наука и практика. – 2012. – №3 – С.30–33.Самородская И. В. Ожирение: оценка и тактика ведения / Под ред. Самородская И. В. – Санкт-Петербург: Спец.Лит; 2016.Самородская И. В. Ожирение: оценка и тактика ведения / Под ред. Самородская И. В. – Санкт-Петербург: Спец.Лит; 2016.Apovian, CM. Endocrine Society. Pharmacological management of obesity: an endocrine Society clinical practice guideline. / CM. Apovian, LJ. Aronne et al. // J Clin. Endocrinol. Metab. – 2015. – Vol. 100. – Р. 342–62.Apovian, CM. Endocrine Society. Pharmacological management of obesity: an endocrine Society clinical practice guideline. / CM. Apovian, LJ. Aronne et al. // J Clin. Endocrinol. Metab. – 2015. – Vol. 100. – Р. 342–62.Can, J. Effects of the oncedaily GLP-1 analog liraglutide on gastricemptying, glycemic parameters, appetite and energy metabolism in obese, nondiabetic adults / J. Can,B. Slothet al. // Int J Obes (Lond). – 2014. –Vol. 38. – Р. 784–93.Can, J. Effects of the oncedaily GLP-1 analog liraglutide on gastricemptying, glycemic parameters, appetite and energy metabolism in obese, nondiabetic adults / J. Can,B. Slothet al. // Int J Obes (Lond). – 2014. –Vol. 38. – Р. 784–93.Davies, MJ. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: The SCALE diabetes randomized clinical trial. /MJ. Davies, R. Bergenstal et al. //Journal of the American Medical Association. –2015. – Vol. 314. – Р. 687–699.Davies, MJ. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: The SCALE diabetes randomized clinical trial. /MJ. Davies, R. Bergenstal et al. //Journal of the American Medical Association. –2015. – Vol. 314. – Р. 687–699.Dombrowski, SU. Long term maintenance of weight loss with nonsurgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials / SU. Dombrowski, K. Knittle et al. // BMJ.–2014. – Vol. 348. – Р. 2646.Dombrowski, SU. Long term maintenance of weight loss with nonsurgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials / SU. Dombrowski, K. Knittle et al. // BMJ.–2014. – Vol. 348. – Р. 2646.Eckel, RH. Obesity and type 2 diabetes: what can be unified and what needs to be individualized? / RH. Eckel, SE. Kahn et al. // J Clin. Endocrinol. Metab. – 2011. – Vol. 96. – Р. 1654–63.Eckel, RH. Obesity and type 2 diabetes: what can be unified and what needs to be individualized? / RH. Eckel, SE. Kahn et al. // J Clin. Endocrinol. Metab. – 2011. – Vol. 96. – Р. 1654–63.Flegal, KM. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis / KM. Flegal, BK. Kit [et al.] // JAMA. – 2013. – № 309. – Р. 71–82.Flegal, KM. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis / KM. Flegal, BK. Kit [et al.] // JAMA. – 2013. – № 309. – Р. 71–82.Fock, K. Diet and exercise in management of obesity and overweight / K. Fock, J. Khoo // J Gastroenterol Hepatol. – 2013. – № 28. – Р. 59–63.Fock, K. Diet and exercise in management of obesity and overweight / K. Fock, J. Khoo // J Gastroenterol Hepatol. – 2013. – № 28. – Р. 59–63.Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013 // The Lancet. – 2014. –Vol. 384 (9945). – Р. 766–781.Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013 // The Lancet. – 2014. –Vol. 384 (9945). – Р. 766–781.Garvey, WT. American Association of Clinical Endocrinologists and American College of Endocrinology consensus conference on obesity: building an evidence base for comprehensive action. / WT. Garvey, AJ Garber et al. // Endocr Pract. – 2014. – 20 (9). – Р. 956–976.Garvey, WT. American Association of Clinical Endocrinologists and American College of Endocrinology consensus conference on obesity: building an evidence base for comprehensive action. / WT. Garvey, AJ Garber et al. // Endocr Pract. – 2014. – 20 (9). – Р. 956–976.http://minzdrav.gov.by/7 апреля 2016 года Всемирный день здоровья: профилактика и лечение диабетаhttp://minzdrav.gov.by/7 апреля 2016 года Всемирный день здоровья: профилактика и лечение диабетаhttp://www.oecd.org.http://www.oecd.org.http://www.ema.europa.eu/pressoffice/presshome.htmhttp://www.ema.europa.eu/pressoffice/presshome.htmKotseva, K. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. / K. Kotseva D. Wood et al. // Eur J Prev Cardiol. – 2016. – 23(6). – 636–48.Kotseva, K. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. / K. Kotseva D. Wood et al. // Eur J Prev Cardiol. – 2016. – 23(6). – 636–48.Leon, H. H. Role of the myokines production through the exercise / H. H. Leon, C. E. Melo et al. // Journal of Sport and Health Research. – 2012. – Vol. 4 (2). – Р. 157–166.Leon, H. H. Role of the myokines production through the exercise / H. H. Leon, C. E. Melo et al. // Journal of Sport and Health Research. – 2012. – Vol. 4 (2). – Р. 157–166.Li, G. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study / G. Li, P. Zhanget al. // Lancet Diabetes Endocrinol. – 2014. –Vol. 2. –Р. 474–80.Li, G. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study / G. Li, P. Zhanget al. // Lancet Diabetes Endocrinol. – 2014. –Vol. 2. –Р. 474–80.Madsbad, S. Comparable efficacy and safety of liraglutide 3.0 mg for weight management across baseline BMI subgroups: Results from the SCALE Obesity and Prediabetes trial. EASD. 2016.Madsbad, S. Comparable efficacy and safety of liraglutide 3.0 mg for weight management across baseline BMI subgroups: Results from the SCALE Obesity and Prediabetes trial. EASD. 2016.Pi-Sunyer, X. A randomized controlled trial of 3.0 mg of liraglutide in weight management. /X. Pi-Sunyer, A. Astrup et al. // New England Journal of Medicine. – 2015. – Vol. 373. – Р. 11–22.Pi-Sunyer, X. A randomized controlled trial of 3.0 mg of liraglutide in weight management. /X. Pi-Sunyer, A. Astrup et al. // New England Journal of Medicine. – 2015. – Vol. 373. – Р. 11–22.WHO. Obesity: Preventing and managing the global epidemic. Available at: http://www.who.int/iris/handle/10665/42330. Last accessed: August 2016.WHO. Obesity: Preventing and managing the global epidemic. Available at: http://www.who.int/iris/handle/10665/42330. Last accessed: August 2016.Selvin, E. Trends in prevalence and control of diabetes in the United States, 1988–1994 and 1999–2010 / E. Selvin, CM. Parrinello et al. // Ann Intern Med. – 2014. – Vol. 160. – Р. 517–25.Selvin, E. Trends in prevalence and control of diabetes in the United States, 1988–1994 and 1999–2010 / E. Selvin, CM. Parrinello et al. // Ann Intern Med. – 2014. – Vol. 160. – Р. 517–25.Sharma, AM. A proposed clinical staging system for obesity./ AM. Sharma, RF. Kushner // IntJObes (Lond). – 2009. – 33(3). – Р. 289–95.Sharma, AM. A proposed clinical staging system for obesity./ AM. Sharma, RF. Kushner // IntJObes (Lond). – 2009. – 33(3). – Р. 289–95.Wadden, TA. Weight maintenance and additional weight loss with liraglutide after low-calorie-dietinducedweight loss: the SCALE Maintenance randomized study / TA. Wadden, P. Hollander et al. // Int J Obes (Lond). – 2013. – Vol. 37. – Р. 1443–51.Wadden, TA. Weight maintenance and additional weight loss with liraglutide after low-calorie-dietinducedweight loss: the SCALE Maintenance randomized study / TA. Wadden, P. Hollander et al. // Int J Obes (Lond). – 2013. – Vol. 37. – Р. 1443–51.Warkentin, LM. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials / LM. Warkentin, D. Das et al. // Obes Rev. – 2014. – Vol. 15. – Р. 169–82.Warkentin, LM. The effect of weight loss on health-related quality of life: systematic review and meta-analysis of randomized trials / LM. Warkentin, D. Das et al. // Obes Rev. – 2014. – Vol. 15. – Р. 169–82.Wimalawansa, SJ. Pathophysiology of obesity: focused, cause-driven approach to control the epidemic / SJ., Wimalawansa // Global Adv Res J Pharm Pharmacol. – 2013. – Р. 1–13.Wimalawansa, SJ. Pathophysiology of obesity: focused, cause-driven approach to control the epidemic / SJ., Wimalawansa // Global Adv Res J Pharm Pharmacol. – 2013. – Р. 1–13.

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