sibmedСибирский научный медицинский журналСибирский научный медицинский журнал2410-25122410-2520ИЦиГ СО РАН10.18699/SSMJ20240115sibmed-1398Research ArticleОБЗОРЫREVIEWSКачество жизни как показатель состояния соединительной ткани у женщин с метаболическим синдромом без эстрогеновой поддержкиQuality of life as an indicator of connective tissue condition in women with metabolic syndrome without estrogen supporthttps://orcid.org/0000-0002-5754-4418КрутиковЕ. С.KrutikovE. S.

Крутиков Евгений Сергеевич, д.м.н., проф. 

295051, г. Симферополь, б-р Ленина, 5/7

Evgeniy S. Krutikov, doctor of medical sciences, professor 

295051, Simferopol, Lenina blvd., 5/7

nephrostar@yandex.ruРумянцеваЗ. С.RumyantsevaZ. S.

Румянцева Зоя Сергеевна, к.м.н. 

295051, г. Симферополь, б-р Ленина, 5/7

Zoya S. Rumyantseva, candidate of medical sciences 

295051, Simferopol, Lenina blvd., 5/7

zoyarum@inbox.ruhttps://orcid.org/0000-0002-6800-1419ТрибратН. С.TribratN. S.

Трибрат Наталья Сергеевна, к.б.н. 

295051, г. Симферополь, б-р Ленина, 5/7

Natalya S. Tribrat, candidate of biological sciences 

295051, Simferopol, Lenina blvd., 5/7

miu-miu07@mail.ruhttps://orcid.org/0000-0001-8216-4196ЗяблицкаяЕ. Ю.ZyablitskayaE. Yu.

Зяблицкая Евгения Юрьевна, д.м.н. 

295051, г. Симферополь, б-р Ленина, 5/7

Evgenia Yu. Zyablitskaya, doctor of medical sciences 

295051, Simferopol, Lenina blvd., 5/7

evgu79@mail.ruhttps://orcid.org/0000-0001-8267-8672ДемьяноваВ. Б.DemyanovaV. B.

Демьянова Виктория Борисовна 

295051, г. Симферополь, б-р Ленина, 5/7

Viktoria B. Demyanova 

295051, Simferopol, Lenina blvd., 5/7

natasha_horunzhaya@mail.ruhttps://orcid.org/0000-0002-8882-8317ПучкинаГ. А.PuchkinaG. A.

Пучкина Галина Анатольевна, к.м.н. 

295051, г. Симферополь, б-р Ленина, 5/7

Galina A. Puchkina, candidate of medical sciences 

295051, Simferopol, Lenina blvd., 5/7

puchkina.g.a@mail.ruhttps://orcid.org/0000-0002-0494-9358ЕфремоваН. В.EfremovaN. V.

Ефремова Наталия Владимировна 

295051, г. Симферополь, б-р Ленина, 5/7

Nataliya V. Efremova 

295051, Simferopol, Lenina blvd., 5/7

natasha_horunzhaya@mail.ruhttps://orcid.org/0000-0002-2886-6178ГорбуновА. А.GorbunovA. A.

Горбунов Александр Андреевич 

295051, г. Симферополь, б-р Ленина, 5/7

Alexandr A. Gorbunov 

295051, Simferopol, Lenina blvd., 5/7

sashaagor@mail.ruМедицинская академия им. С.И. Георгиевского Крымского федерального университета им. В.И. ВернадскогоРоссияGeorgievsky Medical Academy of Vernadsky Crimean Federal UniversityRussian Federation202407032024441147154Copyright © Крутиков Е.С., Румянцева З.С., Трибрат Н.С., Зяблицкая Е.Ю., Демьянова В.Б., Пучкина Г.А., Ефремова Н.В., Горбунов А.А., 20242024Крутиков Е.С., Румянцева З.С., Трибрат Н.С., Зяблицкая Е.Ю., Демьянова В.Б., Пучкина Г.А., Ефремова Н.В., Горбунов А.А.Krutikov E.S., Rumyantseva Z.S., Tribrat N.S., Zyablitskaya E.Y., Demyanova V.B., Puchkina G.A., Efremova N.V., Gorbunov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://sibmed.elpub.ru/jour/article/view/1398

В современной медицине неоспорима актуальность проблемы, связанной со старением женского организма. В связи со снижением интенсивности секреции половых стероидов присоединение метаболического синдрома сопровождается процессами, способными ухудшать качество жизни женщин. В условиях гипоэстрогенемии страдает их физическое состояние, которое напрямую зависит от структуры соединительной ткани, составляющей основу кожи, сосудов, почек, костей, суставов и связок. В настоящем обзоре литературы представлены современные данные об обратимых и необратимых клинических проявлениях климактерического синдрома. В основе обратимых процессов лежат изменения, которые поддаются коррекции: вазомоторные, психоэмоциональные, урогенитальные, сексуальные и скелетно-мышечные. Поздние проявления менопаузы со стороны нарушения метаболизма в соединительной ткани определяют наибольшую тяжесть течения, поэтому представляют серьезную проблему общественного здоровья и здравоохранения. В обзоре литературы детально показаны особенности иммунной регуляции метаболизма коллагена, характеристика изменения маркеров костного моделирования в условиях эстрогенного дефицита. Клинически доказана эффективность фитоэстрогенов при менопаузальных расстройствах и нарушениях метаболического профиля у женщин. Представлен механизм уменьшения вазомоторных симптомов, замедления процесса деструкции костной ткани у пациенток под действием данной группы препаратов. Кроме того, фитоэстрогены обеспечивают коррекцию липидного обмена, тем самым угнетая атерогенез и способствуя профилактике сердечно-сосудистых осложнений. Необходима разработка стратегии по нормализации жизненных функций пациенток перименопаузального возраста с симптомами климактерического периода с внедрением в клиническую практику мер по поддержанию качества жизни женщин.

In modern medicine, the relevance of the problem associated with the aging of the female body is undeniable. Due to the decrease in the intensity of secretion of sex steroids, the addition of metabolic syndrome is accompanied by processes which can worsen women quality of life. Under conditions of hypoestrogenemia, their physical condition suffers, which directly depends on the structure of the connective tissue that forms the basis of the skin, blood vessels, kidneys, bones, joints and ligaments. This literature review presents current data on reversible and irreversible clinical manifestations of climacteric syndrome. Reversible processes are based on changes that can be corrected: vasomotor, psycho-emotional, urogenital, sexual and musculoskeletal. Late manifestations of menopause on the part of metabolic disorders in the connective tissue determine the greatest severity of the course, and therefore represent a serious public health and health problem. The literature review shows in detail the features of the immune regulation of collagen metabolism, the characteristics of changes in bone modeling markers under conditions of estrogen deficiency. Clinically proven efficacy of phytoestrogens in menopausal disorders and metabolic disorders in women. This review shows the mechanism for reducing vasomotor symptoms, slowing down the process of bone tissue destruction in patients under the influence of this group of drugs. In addition, phytoestrogens provide the correction of lipid metabolism, thereby depressing atherogenesis and promoting prevention of cardiovascular complications. It is necessary to develop a strategy to normalize the vital functions of perimenopausal patients with symptoms of menopause with the introduction into clinical practice of measures to maintain the quality of life of women.

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