bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2024-1039bekhterev-1076Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWМетаболический синдром у подростков с психическими расстройствами: вопросы диагностики, профилактики и коррекцииMetabolic syndrome in adolescents with mental disorders: diagnostics, prevention and treatmenthttps://orcid.org/0000-0001-8844-0622ПрусоваТ. И.PrusovaT. I.

Прусова Татьяна Игоревна - лаборант-исследователь отделения терапии психических расстройств у лиц молодого возраста

920191, г. СанктПетербург, ул. Бехтерева, д. 3

Tatyana I. Prusova

St. Petersburg

ta_prusova@mail.ruhttps://orcid.org/0000-0001-9516-4427ЛепикО. В.LepikO. V.

Лепик Ольга Витальевна - младший научный сотрудник отделения терапии психических расстройств у лиц молодого возраста

920191, г. СанктПетербург, ул. Бехтерева, д. 3

Olga V. Lepik

St. Petersburg

ovlepik@gmail.comhttps://orcid.org/0000-0003-3677-2144КостеринД. Н.KosterinD. N.

Костерин Дмитрий Николаевич - к.м.н., научный сотрудник отделения терапии психических расстройств у лиц молодого возраста

920191, г. СанктПетербург, ул. Бехтерева, д. 3

Dmitry N. Kosterin

St. Petersburg

dmitrykosterin@bk.ruhttps://orcid.org/0000-0001-9647-7628ЯковлеваЮ. А.YakovlevaYu. A.

Яковлева Юлия Александровна - к.м.н., ведущий научный сотрудник отделения терапии психических расстройств у лиц молодого возраста

920191, г. СанктПетербург, ул. Бехтерева, д. 3

Yulia A. Yakovleva

St. Petersburg

yya.08@mail.ruhttps://orcid.org/0000-0002-7905-4583ПоповМ. Ю.PopovM. Yu.

Попов Михаил Юрьевич - д.м.н., главный научный сотрудник, руководитель отделения терапии психических расстройств у лиц молодого возраста

920191, г. СанктПетербург, ул. Бехтерева, д. 3

Mikhail Yu. Popov

St. Petersburg

popovmikhail@mail.ruФГБУ «Национальный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева» Минздрава РоссииРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian Federation202416122024584-24764Copyright © Прусова Т.И., Лепик О.В., Костерин Д.Н., Яковлева Ю.А., Попов М.Ю., 20242024Прусова Т.И., Лепик О.В., Костерин Д.Н., Яковлева Ю.А., Попов М.Ю.Prusova T.I., Lepik O.V., Kosterin D.N., Yakovleva Y.A., Popov M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1076

На протяжении последних десятилетий наблюдается рост распространенности метаболического синдрома (МС) среди подростков. К числу факторов риска его формирования относятся наличие психической патологии и прием психофармакологических средств. При этом, с одной стороны, риск фармакогенно-индуцированных метаболических нарушений у подростков выше, чем у взрослых, с другой - потенциальная обратимость МС на начальных этапах придает особую важность его раннему выявлению и своевременной коррекции.

Цель настоящего нарративного обзора—обобщить имеющиеся данные о диагностике, профилактике и коррекции МС у подростков с психическими расстройствами. Поиск релевантных источников проводился в электронных базах Medline и РИНЦ. Обобщение информации на основе 157 публикаций указывает на отсутствие общепринятых критериев диагностики МС в подростковом возрасте и ограниченность имеющихся данных об эффективных профилактических и терапевтических вмешательствах. В обзоре рассматриваются существующие подходы к диагностике компонентов МС и ассоциированных нарушений у подростков, обсуждаются медикаментозные и немедикаментозные методы профилактики и коррекции. Результаты включенных в обзор исследований свидетельствуют о том, что в формирование и прогрессирование МС вносят вклад многие факторы (как немодифицируемые, так и модифицируемые): генетические, системные иммуновоспалительные, средовые, фармакогенные. Дальнейшее изучение этих факторов у подростков с психическими расстройствами, а также разработка на их основе патогенетически направленных превентивных и терапевтических стратегий являются важными направлениями для будущих исследований.

Over the past decades the prevalence of metabolic syndrome (MS) among adolescents has increased significantly. Psychiatric disorders and treatment with psychopharmacological drugs are among the risk factors for the development of MS. The risks of drug-induced metabolic disturbances in adolescents are higher than in adults. Conversely, potential reversibility of MS at its initial stages emphasizes the importance of early detection and treatment. The aim of this narrative review is to summarize the available data on the diagnostics, prevention and treatment of MS in adolescents with mental disorders. Medline and RSCI electronic databases were searched to identify relevant sources of information. Synthesis of information based on 157 publications demonstrates the lack of universally accepted criteria for the diagnosis of MS in adolescents and the limited data on effective preventive or therapeutic interventions. In this review the diagnostics of the components of MS and associated disturbances in adolescents are overviewed, pharmacological and nonpharmacological approaches to MS prophylaxis and treatment are discussed. The results of the reviewed studies reveal a number of factors contributing to the development and progression of MS (both unmodifiable and modifiable): genetic, systemic immune-inflammatory, environmental, pharmacological. Further exploration of these factors in adolescents with mental disorders, as well as the development of preventive and therapeutic strategies based on these factors, are important directions for future research.

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