ЗНАЧЕНИЕ ИНСУЛИНОРЕЗИСТЕНТНОСТИ В ПАТОГЕНЕЗЕ И ПРОГНОЗЕ ИШЕМИЧЕСКОГО ИНСУЛЬТА
Ключевые слова:
инсулинорезистентность, ишемический инсульт, HOMA-IR, индекс TyG, эндотелиальная дисфункция, нейровоспаление, окислительный стресс, атеросклероз, биомаркерыАннотация
Ишемический инсульт остается одной из наиболее актуальных проблем современной медицины и является одной из ведущих причин смертности и длительной инвалидизации. Наряду с традиционными факторами риска, такими как артериальная гипертензия, сахарный диабет, дислипидемия и ожирение, в последние годы особое внимание уделяется роли инсулинорезистентности в развитии цереброваскулярных заболеваний. Инсулинорезистентность представляет собой не только нарушение метаболизма глюкозы, но и сложное метаболическое состояние, ассоциированное с эндотелиальной дисфункцией, атеросклерозом, гиперреактивностью тромбоцитов, хроническим воспалением, окислительным стрессом и нарушением целостности гематоэнцефалического барьера. Эти механизмы могут способствовать развитию и более тяжелому течению ишемического инсульта, а также влиять на функциональное восстановление после инсульта и риск повторных цереброваскулярных событий. В настоящей статье на основе современных научных данных проанализированы основные молекулярные и сосудистые механизмы участия инсулинорезистентности в патогенезе ишемического инсульта, биомаркеры, используемые для ее оценки, а также ее прогностическое значение.
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