transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2017-4-2-29-39transmed-261Research ArticleЭНДОКРИНОЛОГИЧЕСКИЕ ЗАБОЛЕВАНИЯMETABOLIC DISEASESВЗАИМОСВЯЗЬ МЕЖДУ ТИРЕОИДНОЙ ПАТОЛОГИЕЙ И САХАРНЫМ ДИАБЕТОМ 2-ГО ТИПАRELATIONSHIP BETWEEN THYROID DISEASES AND TYPE 2 DIABETES MELLITUShttps://orcid.org/0000-0002-4293-3162ШпаковАлександр ОлеговичShpakovAlexander O.

д. б. н., заведующий лабораторией молекулярной эндокринологии и нейрохимии

пр. Тореза, д. 44, Санкт-Петербург, 194223

Dr Sci, head of the laboratory of molecular endocrinology and neurochemistry

Torez ave. 44, Saint Petersburg, 194223

alex_shpakov@list.ruФедеральное государственное бюджетное учреждение науки «Институт эволюционной физиологии и биохимии им. И. М. Сеченова» Российской академии наук, Санкт-ПетербургРоссияSechenov Institute of Evolutionary Physiology and Biochemistry, Saint PetersburgRussian Federation201714062017422939Copyright © Шпаков А.О., 20172017Шпаков А.О.Shpakov A.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/261

У пациентов с сахарным диабетом 2-го типа (СД2) чаще, чем в остальной популяции, встречаются дисфункции тиреоидной системы. В основе этого лежит функциональная взаимосвязь между тиреотоксикозом и гипотиреозом, с одной стороны, и развитием инсулиновой резистентности и СД2, с другой, что доказывается как данными клинических исследований, так и результатами, полученными с использованием экспериментальных моделей этих заболеваний. Нарушение баланса тиреоидных гормонов при гипотиреозе и тиреотоксикозе может быть отправной точкой для развития инсулиновой резистентности и в дальнейшем, при неблагоприятном сценарии, вызывать СД2. С другой стороны, метаболические и гормональные нарушения, возникающие в условиях СД2, могут приводить к заболеваниям тиреоидной системы. Лечение тиреоидными гормонами пациентов с сочетанными СД2 и гипотиреозом приводит к восстановлению инсулиновой чувствительности и энергетического гомеостаза. Однако избыточное поступление тиреоидных гормонов ведет к снижению инсулиновой чувствительности, нарушениям углеводного и липидного обмена, что должно учитываться при разработке стратегии лечения СД2 и дисфункций щитовидной железы. Настоящий обзор посвящен современному состоянию проблемы взаимосвязи между СД2 с характерными для него инсулиновой резистентностью, гипергликемией и дислипидемией, и различными формами тиреоидной патологии.

In patients with type 2 diabetes mellitus (DM2), the thyroid dysfunctions are more common than in the rest of the population. This is based on the close functional relationship between thyrotoxicosis and hypothyroidism, on the one hand, and insulin resistance and DM2, on the other, as evidenced by the data of clinical investigations and the results obtained using experimental models of these diseases. The imbalance of thyroid hormones in hypothyroidism and thyrotoxicosis can be a starting point for the development of insulin resistance and subsequently, under the unfavorable scenario, leads to development of DM2. On the other hand, the metabolic and hormonal disturbances that occur in DM2 can lead to the diseases of thyroid system. The treatment with thyroid hormones of patients with combined DM2 and hypothyroidism leads to the restoration of insulin sensitivity and energy homeostasis. However, an excess of thyroid hormones leads to the decrease of insulin sensitivity, the disturbances of carbohydrate and lipid metabolism, which should be taken into account when developing a strategy to treat DM2 and thyroid dysfunctions. This review focuses on the current state of problem of the relationship between DM2 with insulin resistance, hyperglycemia and dyslipidemia, characteristic for this disease, and different forms of thyroid pathology.

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