therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-8156РостГМУ10.21886/2712-8156-2025-6-2-47-57therapeutic-615Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHМоноцитарный хемоаттректантный протеин-1 у больных с дислипидемией и хронической болезнью почек 5 стадии на гемодиафильтрации, взаимосвязь с факторами риска и сердечно-сосудистыми осложнениямиMonocyte chemoattractant protein-1 in patients with dyslipidemia and chronic kidney disease stage 5 on hemodiafiltration, relationship with risk factors and cardiovascular complicationshttps://orcid.org/0009-0005-5332-533XГаззаеваС. А.GazzayevaS. A.

Газзаева Светлана Ахсарбековна, ассистент кафедры внутренних болезней №4

Владикавказ

Svetlana A. Gazzayeva, Assistant of the Department of Internal Diseases No4

Vladikavkaz

lana.gazzaeva@bk.ruhttps://orcid.org/0009-0009-6313-7032РемизовО. В.RemizovO. V.

Ремизов Олег Валерьевич, д.м.н., ректор

Владикавказ

Oleg V. Remizov, MD, Rector

Vladikavkaz

lana.gazzaeva@bk.ruhttps://orcid.org/0009-0002-4855-1111АстаховаЗ. Т.AstakhovaZ. T.

Астахова Замира Татарбековна, д.м.н., профессор, зав. кафедрой внутренних болезней №4

Владикавказ

Zamira T. Astakhova, Dr. Sci. (Med.), Professor, Head of the Department of Internal Diseases No. 4

Vladikavkaz

lana.gazzaeva@bk.ruhttps://orcid.org/0000-0002-9182-1335АвсараговаА. З.AvsaragovaA. Z.

Авсарагова Анжела Заурбековна, к.м.н, доцент кафедры внутренних болезней №4

Владикавказ

Angela Z. Avsaragova, Cand. Sci. (Med.), Associate Professor of the Department of Internal Diseases No4

Vladikavkaz

awsaragowa@yandex.ruФГБОУ ВО «Северо-Осетинская государственная медицинская академия» Минздрава РоссииРоссияNorth Ossetia State Medical AcademyRussian Federation202512072025624757Copyright © Газзаева С.А., Ремизов О.В., Астахова З.Т., Авсарагова А.З., 20252025Газзаева С.А., Ремизов О.В., Астахова З.Т., Авсарагова А.З.Gazzayeva S.A., Remizov O.V., Astakhova Z.T., Avsaragova A.Z.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/615

Цель: изучение взаимосвязей уровня МСР-1 в крови у больных с дислипидемией и хронической болезнью почек 5 стадии на гемодиафильтрации (ГДФ) с метаболическими и гемодинамическими параметрами, а также риском сердечно-сосудистых осложнений. Материал и методы: исследование одномоментное, когортное, с ретроспективным анализом сердечно-сосудистых осложнений. В исследование было включено 103 пациента, средний возраст составил 61,9±12,9 лет. Фиксировались сердечно-сосудистые осложнения, которые на момент обследования уже развились в период получения пациентами диализного лечения. Всем пациентам проводилось определение параметров липидограммы, включая липопротеин (а) и окисленные липопротеины. Также определялись параметры обмена веществ, признаки сосудистой кальцификации, сосудистой жесткости, нутритивного статуса. Результаты: среднее значение МСР-1 в исследованной когорте пациентов составило 54,3±13,6 пг/мл и колебалось от 31 до 79 пг/мл. У больных на ГДФ рост концентрации МСР-1 происходил однонаправленно с ростом уровней ЛП(а) и окЛПНП, играющих большую роль в процессе атерогенеза. Также выявлено однонаправленное повышение уровня МСР-1 в крови по мере нарастания выраженности уремической кальцификации клапанов и стенки аорты, гиперурикемии и признаков сосудистого воспаления (СРБ). Повышение уровня МСР-1 сопровождалось высокой вероятностью выявления сосудистой кальцификации и кальцификации клапанов сердца, периферического атеросклероза, коронарных поражений, мозгового инсульта (МИ) и комбинированной точки ИМ+МИ+ХСН. Заключение: МСР-1 оказывает негативное влияние на риск сердечно-сосудистых событий как в виде самостоятельного воздействия, так и в виде комбинированного воздействия с параметрами липидного обмена и гемодинамическими факторами. Последнее явилось мотивацией для разработки оригинальной шкалы ХС-ЛПНП+ЛП(а)+МСР-1, которая позволяет оценивать риск развития сердечно-сосудистых осложнений.

Objective: To study the interrelationships of MCP-1 levels in the blood of patients with dyslipidemia and stage 5 chronic kidney disease on hemodiafiltration (HDF) with metabolic and hemodynamic parameters, as well as the risk of cardiovascular complications. Materials and methods: a single-stage, cohort study with a retrospective analysis of cardiovascular complications. The study included 103 patients with an average age of 61.9 ± 12.9 years. Cardiovascular complications were recorded, which at the time of the examination had already developed during the period of dialysis treatment. Lipidogram parameters, including lipoprotein(a) and oxidized lipoproteins, were determined in all patients. Metabolic parameters, signs of vascular calcification, vascular stiffness, and nutritional status were also determined. Results: the average value of MCP-1 in the studied cohort of patients was 54.3 ± 13.6 pg/ml and ranged from 31 to 79 pg/ml. In patients with HDF, an increase in the concentration of MCP-1 occurred unidirectionally with an increase in the levels of LP(a) and LDL, which play an important role in the process of atherogenesis. There was also a unidirectional increase in MCP-1 levels in the blood as the severity of uremic calcification of the valves and aortic wall, hyperuricemia, and signs of vascular inflammation (CRP) increased. An increase in MCP-1 levels was accompanied by a high probability of detecting vascular calcification and calcification of the heart valves, peripheral atherosclerosis, coronary lesions, cerebral stroke (MI) and a combined MI + MI + CHF point. Conclusion: MCP-1 has a negative effect on the risk of cardiovascular events, both as an independent effect and as a combined effect with parameters of lipid metabolism and hemodynamic factors. The latter was the motivation for the development of the original LDL-C + LP(a) scale + MCP-1, which allows you to assess the risk of developing cardiovascular complications.

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