zabmedvestnikЗабайкальский медицинский вестникTransbaikalian Medical Bulletin1998-6173Читинская государственная медицинская академия10.52485/19986173_2023_3_89zabmedvestnik-207Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSКлиническая картина вальпроат-индуцированного метаболического синдромаClinical pattern of valproate-induced metabolic syndromeШнайдерН. А.ShnayderN. A.

192019 Санкт-Петербург, ул. Бехтерева, 3

660022 Красноярск, ул. Партизана Железняка, 1

3 Bekhtereva St., St. Petersburg, 192019

1 Partizan Zheleznyk Str., Krasnoyarsk, 660022

ГречкинаВ. В.GrechkinaV. V.

192019 Санкт-Петербург, ул. Бехтерева, 3

3 Bekhtereva St., St. Petersburg, 192019

ПетроваМ. М.PetrovaM. M.

660022 Красноярск, ул. Партизана Железняка, 1

1 Partizan Zheleznyk Str., Krasnoyarsk, 660022

НасыроваР. Ф.NasyrovaR. F.

192019 Санкт-Петербург, ул. Бехтерева, 3

3 Bekhtereva St., St. Petersburg, 192019

Институт персонализированной психиатрии и неврологии, Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. Бехтерева; Центр коллективного пользования «Молекулярные и клеточные технологии», Красноярский государственный медицинский университет имени проф. В.Ф. Войно-ЯсенецкогоРоссияInstitute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology; V.F. Voino-Yasenetsky State Medical UniversityRussian FederationИнститут персонализированной психиатрии и неврологии, Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. БехтереваРоссияInstitute of Personalized Psychiatry and Neurology, V.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian FederationЦентр коллективного пользования «Молекулярные и клеточные технологии», Красноярский государственный медицинский университет имени проф. В.Ф. Войно-ЯсенецкогоРоссияV.F. Voino-Yasenetsky State Medical UniversityRussian Federation2023060820240389105Copyright © Шнайдер Н.А., Гречкина В.В., Петрова М.М., Насырова Р.Ф., 20242024Шнайдер Н.А., Гречкина В.В., Петрова М.М., Насырова Р.Ф.Shnayder N.A., Grechkina V.V., Petrova M.M., Nasyrova R.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.zabmedvestnik.ru/jour/article/view/207

Цель: Обновить уровень знаний неврологов и терапевтов об особенностях клинической картины метаболического синдрома (МС), вызванного приемом вальпроевой кислоты (ВК).Материалы и методы. Обзор проводился по базам данных PubMed, Web of Science, Springer, Google Scholar и e-Library.Результаты. Риск развития ВК-индуцированного МС зависит дозы и длительности приема ВК, а также от генетической предрасположенности. Эта нежелательная реакция (НР) значительно ухудшает качество жизни пациентов, которые получают ВК длительно. Помимо увеличения веса и инсулинорезистентности, ВК-индуцированный МС сопровождается дислипидемией, артериальной гипертонией и сахарным диабетом 2-го типа. Изменения метаболома у пациентов, длительно получающих ВК, включают совокупность изменений уровня метаболических биомаркеров в биологических жидкостях и различных органах и тканях организма, включая пептиды, липиды, аминокислоты, нуклеиновые кислоты, углеводы, биогенные амины, витамины и минералы. Такие изменения метаболома могут существенно влиять не только на фенотип заболевания, но также на ожидаемый терапевтический ответ на ВК и на посттрансляционные процессы, включая вторичные изменения транскриптома и протеома у пациентов с неврологическими заболеваниями и психическими расстройствами.Заключение. Проблема ВК-индуцированного МС является важной междисциплинарной проблемой неврологии и терапии, требующей персонализированного подхода к прогнозированию и ранней диагностики с целью повышения безопасности психофармакотерапии и улучшения качества жизни пациентов с неврологическими заболеваниями и психическими расстройствами.

Aim. Update the level of knowledge of neurologists and therapists about the features of the clinical pattern of metabolic syndrome (MS) caused by taking valproic acid (VPA).Materials and methods. The review was conducted on the databases PubMed, Web of Science, Springer, Google Scholar and e-Library.Results. The risk of developing VPA-induced MS depends on the dose and duration of taking VPA, as well as on genetic predisposition. This ADR significantly worsens the quality of life of patients who receive VPA for a long time. In addition to weight gain and insulin resistance, VPA-induced MS is accompanied by dyslipidemia, arterial hypertension and type 2 diabetes mellitus. Changes in the metabolome in patients receiving VPA for a long time include a set of changes in the level of metabolic biomarkers in biological fluids and various organs and tissues of the body, including peptides, lipids, amino acids, nucleic acids, carbohydrates, biogenic amines, vitamins and minerals. Such changes in the metabolome can not only significantly affect the phenotype of the disease, but also the expected therapeutic response to VPA and significantly affect posttranslational processes, including secondary transcriptome and proteome changes in patients with neurological diseases and mental disorders.Conclusion. The problem of VPA-induced MS is an important interdisciplinary problem of neurology and therapy, requiring a personalized approach to prognosis and early diagnosis in order to increase the safety of psychopharmacotherapy and improve the quality of life of patients with neurological diseases and mental disorders.

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