Метаболический синдром у подростков с психическими расстройствами: вопросы диагностики, профилактики и коррекции

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.

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