medinfoАктуальные проблемы теоретической и клинической медициныActual Problems of Theoretical and Clinical Medicine2790-12892790-1297Казахстанско-Российский медицинский университет10.64854/2790-1289-2026-53-3-12medinfo-1147Research ArticleОБЗОР ЛИТЕРАТУРЫREVEWSДИФФЕРЕНЦИРОВАННАЯ ПРОФИЛАКТИКА МЕТАБОЛИЧЕСКОГО СИНДРОМА, АССОЦИИРОВАННОГО С ОЖИРЕНИЕМ, ПРИ ПСОРИАЗЕ: ОБЗОР ЛИТЕРАТУРЫ И АВТОРСКИЙ АЛГОРИТМhttps://orcid.org/0009-0007-1879-0468ЖумабековаБ. А.

докторант 

jumabekova52@gmail.comhttps://orcid.org/0000-0001-5019-8957АскароваГ. К.

заведующая курсом дерматовенерологии

gkaskarova@mail.ruhttps://orcid.org/0009-0001-8999-1749АкановЖ. А.

президент Общественного фонда «Казахстанское общество по изучению диабета»

aaaendoclinic@gmail.comhttps://orcid.org/0000-0001-5092-3143СвятоваГ. С.

руководитель научно-образовательного отдела 

gsvyatova1@mail.ruhttps://orcid.org/0009-0008-2149-1204ЖумабековаУ. А.

врач-интерн

jumabekovau07@icloud.comhttps://orcid.org/0009-0007-4919-5936ЖумабековА. А.

студент 4 курса

almukhametzh@gmail.comКазахстанский медицинский университет «Высшая школа общественного здравоохранения»KazakhstanКазахстанский медицинский университет «Высшая школа общественного здравоохранения», Казахстан, АлматыKazakhstanОбщественный фонд «Казахстанское общество по изучению диабета», Казахстан, АлматыKazakhstanЦентр молекулярной медицины, Казахстан, АлматыKazakhstanНУО «Казахстанско-Российский медицинский университет»Kazakhstan202605102026031147Copyright © Жумабекова Б., Аскарова Г., Аканов Ж., Святова Г., Жумабекова У., Жумабеков А., 20262026Жумабекова Б., Аскарова Г., Аканов Ж., Святова Г., Жумабекова У., Жумабеков А.Жумабекова Б., Аскарова Г., Аканов Ж., Святова Г., Жумабекова У., Жумабеков А.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://kazrosmedjournal.krmu.edu.kz/jour/article/view/1147Актуальность

Актуальность. Метаболический синдром у пациентов с псориазом встречается чаще, чем у лиц без псориаза: шансы его наличия выше более чем вдвое. Сочетание псориаза и метаболических нарушений связано с повышенным сердечно-сосудистым риском и требует комплексной профилактики.

Цель

Цель. Обобщить современные данные о патогенетических механизмах, инструментах стратификации риска и доказательной базе профилактических вмешательств при метаболическом синдроме, ассоциированном с ожирением, у пациентов с псориазом, а также представить разработанный нами дифференцированный алгоритм профилактики.

Материалы и методы

Материалы и методы. Проведён нарративный обзор публикаций 2015–2026 годов, найденных в PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, eLibrary и Google Scholar. Рассмотрены систематические и нарративные обзоры, метаанализы, интервенционные и наблюдательные исследования, работы с применением менделевской рандомизации и клинические руководства; дополнительно использованы результаты собственных ранее опубликованных исследований.

Результаты

Результаты. Связь псориаза и метаболических нарушений двунаправленна; общие механизмы включают системное воспаление, инсулинорезистентность, дисбаланс адипокинов и эндотелиальную дисфункцию. Исследования с применением менделевской рандомизации поддерживают причинное влияние повышенного индекса массы тела на риск псориаза. В метаанализе шести рандомизированных исследований снижение массы тела за счёт диеты или физической активности сопровождалось уменьшением PASI в среднем на 2,59 балла по сравнению с контролем. На основе обзора и собственных исследований предложен алгоритм для пациентов с псориазом и индексом массы тела более 28 кг/м². Предварительный интегральный скрининговый индекс используется для выделения трёх групп и определения предполагаемой интенсивности профилактики; иммунологический и генетический блоки рассматриваются как исследовательские компоненты.

Выводы

Выводы. Предложенный алгоритм систематизирует профилактические мероприятия и направления дальнейшего изучения персонализации при псориазе. Его способность прогнозировать метаболический синдром, клиническая эффективность и целесообразность дополнительных исследований требуют проспективной проверки на независимой когорте.

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