cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2017-3-81-86cardiovascular-638Research ArticleОБЗОРЫREVIEWSРОЛЬ НАРУШЕНИЙ УГЛЕВОДНОГО ОБМЕНА В СТАРЕНИИ СЕРДЦАCARBOHYDRATE METABOLISM DISORDERS IN THE HEART AGEINGАкашеваД. У.AkashevaD. U.

Москва, тел.: +7 (903) 526-44-81

Moscow

dariga-akasheva@yandex.ruПокшубинаИ. А.PokshubinaI. A.

Врач-кардиолог.

Москва

Moscow

ПлоховаЕ. В.PlokhovaE. A.

Кандидат медицинских наук,  научный сотрудник отдела изучения процессов старения и профилактики возраст-ассоциированных заболеваний.

Москва

Moscow

ТкачеваО. Н.TkachevaО. N.

Доктор медицинских наук, профессор.

Москва

Moscow

ФГБУ “Государственный научно-исследовательский центр профилактической медицины” Минздрава РоссииNational Research Center for Preventive Medicine of the Ministry of HealthООО “Международный центр охраны здоровья”LLC “International Center for Health Protection”ФГБОУ ВО “Российский научно-исследовательский медицинский университет им. Н. И. Пирогова” Министерства здравоохранения Российской Федерации — ОСП “Российский геронтологический научно-клинический центр”N. I. Pirogov Russian National Research Medical University (RNRMU) — SD “Russian Gerontological Scientific-Clinical Center”2017200620171638186Copyright © Акашева Д.У., Покшубина И.А., Плохова Е.В., Ткачева О.Н., 20172017Акашева Д.У., Покшубина И.А., Плохова Е.В., Ткачева О.Н.Akasheva D.U., Pokshubina I.A., Plokhova E.A., Tkacheva О.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/638

Собственное старение сердца характеризуется структурно-функциональными изменениями, обусловленными только пожилым возрастом при отсутствии сердечно-сосудистых  заболеваний. Нарушения углеводного обмена, в основе которых лежит инсулинорезистентность,  часто встречаются у пожилых людей, и усугубляют процессы старения организма, в т.ч. сердца.  Структурные изменения сердца при его старении характеризуются развитием концентрического ремоделирования миокарда  левого желудочка, а функциональные — нарушением диастолической  функции при сохранной систолической.  В представленном  обзоре  описывается  влияние старения и нарушений углеводного обмена на структуру и функцию миокарда,  и обсуждается все более очевидный факт, что раннее выявление, коррекция нарушений углеводного обмена и инсулинорезистентности  могут предотвратить или задержать  прогрессирование возраст-ассоциированной сердечной недостаточности.

The heart  itself ageing  is characterized  by structural  and  functional changes, determined just by older age, even in absence of cardiovascular pathology. Carbohydrate  metabolism disorders,  based upon the insulin resistance, are  common  in elderly, and  worsen the processes of ageing,  including the heart.  Structural  changes  in the heart are characterized  by development of concentric  remodelling of the left ventricle myocardium, and functional — by diastolic function impairment, with saved  systolic function. The review focuses  on the influence of ageing  and  carbohydrate  metabolism  disorders  on the structure   and  function  of  myocardium,  and  the  obvious  fact  is discussed, that earlier screening  and correction  of insulin resistance and glucose metabolism disorders might prevent or delay the progression of age-related heart failure.

старение сердцадиастолическая дисфункциясахарный диабет 2 типаинсулинорезистентностьheart ageingdiastolic dysfunctiondiabetes type 2insulin resistanceReferencesRoger VL, Go AS, Lloyd-Jones DM, et al. Executive summary: heart disease and stroke statistics-2012 update: a report from the American Heart Association. Circulation 2012; 125: 188-97.Roger VL, Go AS, Lloyd-Jones DM, et al. Executive summary: heart disease and stroke statistics-2012 update: a report from the American Heart Association. Circulation 2012; 125: 188-97.Ferrari AU, Radaelli A, Centola M. Invited review: aging and the cardiovascular system. J Appl Physiol 2003; 95: 2591-7.Ferrari AU, Radaelli A, Centola M. Invited review: aging and the cardiovascular system. J Appl Physiol 2003; 95: 2591-7.Lakatta EG. Heart aging: a fly in the ointment? Circ Res 2001; 88: 984-6.Lakatta EG. Heart aging: a fly in the ointment? Circ Res 2001; 88: 984-6.Paternostro G, Vignola C, Bartsch DU, et al. Age-associated cardiac dysfunction in Drosophila melanogaster. Circ Res 2001; 88: 1053.Paternostro G, Vignola C, Bartsch DU, et al. Age-associated cardiac dysfunction in Drosophila melanogaster. Circ Res 2001; 88: 1053.Inuzuka Y, Okuda J, Kawashima T, et al. Suppression of phosphoinositide 3-kinase prevents cardiac aging in mice. Circulation 2009; 120: 1695-703.Inuzuka Y, Okuda J, Kawashima T, et al. Suppression of phosphoinositide 3-kinase prevents cardiac aging in mice. Circulation 2009; 120: 1695-703.Lakatta EG. Cardiovascular aging in health. Clin Geriatr Med 2000; 16: 419-44.Lakatta EG. Cardiovascular aging in health. Clin Geriatr Med 2000; 16: 419-44.Levy D. Left ventricular hypertrophy. Epidemiological insights from the Framingham Heart Study. Drugs 1988; 35 (Suppl 5): 1-5.Levy D. Left ventricular hypertrophy. Epidemiological insights from the Framingham Heart Study. Drugs 1988; 35 (Suppl 5): 1-5.Swinne CJ, Shapiro EP, Jamart J, et al. Age-associated changes in left ventricular outflow tract geometry in normal subjects. Am J Cardiol 1996; 78: 1070-3.Swinne CJ, Shapiro EP, Jamart J, et al. Age-associated changes in left ventricular outflow tract geometry in normal subjects. Am J Cardiol 1996; 78: 1070-3.Leibowitz D, Gilon D. Echocardiography and the Aging Heart. Current Cardiovascular Imaging Reports 2012; 5(6): 501-6.Leibowitz D, Gilon D. Echocardiography and the Aging Heart. Current Cardiovascular Imaging Reports 2012; 5(6): 501-6.Kawel N, Turkbey EB, Carr JJ, et al. Normal left ventricular myocardial thickness for middle aged and older subjects with SSFP cardiac MR: The Multi-Ethnic Study of Atherosclerosis. Circ Cardiovasc Imaging 2012; 5(4): 500-8.Kawel N, Turkbey EB, Carr JJ, et al. Normal left ventricular myocardial thickness for middle aged and older subjects with SSFP cardiac MR: The Multi-Ethnic Study of Atherosclerosis. Circ Cardiovasc Imaging 2012; 5(4): 500-8.Khouri MG, Maurer MS, El-Khoury Rumbarger L. Assessment of age-related changes in left ventricular structure and function by freehand three-dimensional echocardiography. Am J Geriatr Cardiol 2005; 14(3): 118-25.Khouri MG, Maurer MS, El-Khoury Rumbarger L. Assessment of age-related changes in left ventricular structure and function by freehand three-dimensional echocardiography. Am J Geriatr Cardiol 2005; 14(3): 118-25.Horn MA, Graham HK, Richards MA, et al. Age-related divergent remodeling of the cardiac extracellular matrix in heart failure: collagen accumulation in the young and loss in the aged. J Mol Cell Cardiol 2012; 53: 82-90.Horn MA, Graham HK, Richards MA, et al. Age-related divergent remodeling of the cardiac extracellular matrix in heart failure: collagen accumulation in the young and loss in the aged. J Mol Cell Cardiol 2012; 53: 82-90.Steiner I, Hájková P. Patterns of isolated atrial amyloid: a study of 100 hearts on autopsy. Cardiovasc Pathol 2006; 15(5): 287-90.Steiner I, Hájková P. Patterns of isolated atrial amyloid: a study of 100 hearts on autopsy. Cardiovasc Pathol 2006; 15(5): 287-90.Barasch E, Gottdiener JS, Larsen EK, et al. Clinical significance of calcification of thefibrous skeleton of the heart and aortosclerosis in community dwelling elderly. TheCardiovascular Health Study (CHS). Am Heart J 2006; 151: 39-47.Barasch E, Gottdiener JS, Larsen EK, et al. Clinical significance of calcification of thefibrous skeleton of the heart and aortosclerosis in community dwelling elderly. TheCardiovascular Health Study (CHS). Am Heart J 2006; 151: 39-47.Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part II: the aging heart in health: links to heart disease. Circulation 2003; 107: 346-54.Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part II: the aging heart in health: links to heart disease. Circulation 2003; 107: 346-54.Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation 2003; 107: 139-46.Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: Part I: aging arteries: a “set up” for vascular disease. Circulation 2003; 107: 139-46.Chinnaiyan KM, Alexander D, Maddens M, McCullough PA. Curriculum in cardiology: integrated diagnosis and management of diastolic heart failure. Am Heart J 2007; 153: 189-200.Chinnaiyan KM, Alexander D, Maddens M, McCullough PA. Curriculum in cardiology: integrated diagnosis and management of diastolic heart failure. Am Heart J 2007; 153: 189-200.Correia LC, Lakatta EG, O’Connor FC, et al. Attenuated cardiovascular reserve during prolonged submaximal cycle exercise in healthy older subjects. JACC 2002; 40: 1290-7.Correia LC, Lakatta EG, O’Connor FC, et al. Attenuated cardiovascular reserve during prolonged submaximal cycle exercise in healthy older subjects. JACC 2002; 40: 1290-7.Dannenberg AL, Levy D, Garrison RJ. Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol 1989; 64: 1066-8.Dannenberg AL, Levy D, Garrison RJ. Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol 1989; 64: 1066-8.Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nature Reviews Endocrinology 2014; 10: 293-302.Laakso M, Kuusisto J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nature Reviews Endocrinology 2014; 10: 293-302.Gaggini M, Morelli M, Buzzigoli E, et al. Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients 2013; 5: 1544-60.Gaggini M, Morelli M, Buzzigoli E, et al. Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients 2013; 5: 1544-60.Ahn J, Lee H, Im SW, et al. Allyl isothiocyanate ameliorates insulin resistance through the regulation of mitochondrial function. The J Nutrit Biochem 2014; 25: 1026-34.Ahn J, Lee H, Im SW, et al. Allyl isothiocyanate ameliorates insulin resistance through the regulation of mitochondrial function. The J Nutrit Biochem 2014; 25: 1026-34.Karaca U, Schram MT, Houben AJHM, et al. Microvascular dysfunction as a link between obesity, insulin resistance and hypertension. Diabetes Research and Clinical Practice 2014; 103: 382-7.Karaca U, Schram MT, Houben AJHM, et al. Microvascular dysfunction as a link between obesity, insulin resistance and hypertension. Diabetes Research and Clinical Practice 2014; 103: 382-7.Li Chen, Rui Chen, HuaWang, Fengxia Liang. Mechanisms Linking Inflammation to Insulin Resistance. International J Endocrinol 2015; Article ID 508409, 9 pages, http://dx.doi.org/10.1155/2015/508409.Li Chen, Rui Chen, HuaWang, Fengxia Liang. Mechanisms Linking Inflammation to Insulin Resistance. International J Endocrinol 2015; Article ID 508409, 9 pages, http://dx.doi.org/10.1155/2015/508409.Kalogeropoulos A, Georgiopoulou V, Harris TB, et al. Glycemic status and incident heart failure in elderly without history of diabetes mellitus: the health, aging, and body composition study. J Card Fail 2009; 15:593-9.Kalogeropoulos A, Georgiopoulou V, Harris TB, et al. Glycemic status and incident heart failure in elderly without history of diabetes mellitus: the health, aging, and body composition study. J Card Fail 2009; 15:593-9.Ingelsson E, Sundström J, Arnlöv J, et al. Insulin resistance and risk of congestive heart failure. JAMA 2005; 294: 334-41.Ingelsson E, Sundström J, Arnlöv J, et al. Insulin resistance and risk of congestive heart failure. JAMA 2005; 294: 334-41.Banerjee D, Biggs ML, Mercer L, et al. Insulin Resistance and Risk of Incident Heart Failure. Cardiovascular Health Study. Circ Heart Fail 2013; 6: 364-70.Banerjee D, Biggs ML, Mercer L, et al. Insulin Resistance and Risk of Incident Heart Failure. Cardiovascular Health Study. Circ Heart Fail 2013; 6: 364-70.Pagе A, Dumesnil JG, Clavel MA, et al. ASTRONOMER Investigators. Metabolic syndrome is associated with more pronounced impairment of left ventricle geometry and function in patients with calcific aortic stenosis: a substudy of the ASTRONOMER (Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin). JACC 2010; 55: 1867-74.Pagе A, Dumesnil JG, Clavel MA, et al. ASTRONOMER Investigators. Metabolic syndrome is associated with more pronounced impairment of left ventricle geometry and function in patients with calcific aortic stenosis: a substudy of the ASTRONOMER (Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin). JACC 2010; 55: 1867-74.Sundström J, Lind L, Nyström N, et al. Left ventricular concentric remodeling rather than left ventricular hypertrophy is related to the insulin resistance syndrome in elderly men. Circulation 2000; 101: 2595-600.Sundström J, Lind L, Nyström N, et al. Left ventricular concentric remodeling rather than left ventricular hypertrophy is related to the insulin resistance syndrome in elderly men. Circulation 2000; 101: 2595-600.Das SR, Drazner MH, Dries DL, et al. Impact of body mass and body composition on circulating levels of natriuretic peptides: results from the Dallas Heart Study. Circulation 2005; 112: 2163-8.Das SR, Drazner MH, Dries DL, et al. Impact of body mass and body composition on circulating levels of natriuretic peptides: results from the Dallas Heart Study. Circulation 2005; 112: 2163-8.Solang L, Malmberg K, Ryden L. Diabetes mellitus and congestive heart failure. Eur Heart J 1999; 20: 789-95.Solang L, Malmberg K, Ryden L. Diabetes mellitus and congestive heart failure. Eur Heart J 1999; 20: 789-95.Candido R, Forbes JM, Thomas MC, et al. A breaker of advanced glycation end products attenuates diabetes-induced myocardial structural changes. Circ Res 2003; 92: 785-92.Candido R, Forbes JM, Thomas MC, et al. A breaker of advanced glycation end products attenuates diabetes-induced myocardial structural changes. Circ Res 2003; 92: 785-92.Redfield MM, Jacobsen SJ, Burnett Jr JC, et al. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 2003; 289: 194-202.Redfield MM, Jacobsen SJ, Burnett Jr JC, et al. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA 2003; 289: 194-202.Delas Fuentes L, Brown AL, Mathews SJ, et al. Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass. Eur Heart J 2007; 28: 553-9.Delas Fuentes L, Brown AL, Mathews SJ, et al. Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass. Eur Heart J 2007; 28: 553-9.Ayalon N, Gopal DM, Mooney DM, et al. Preclinical left ventricular diastolic dysfunction in metabolic syndrome. Am J Cardiol 2014; 114: 838-42.Ayalon N, Gopal DM, Mooney DM, et al. Preclinical left ventricular diastolic dysfunction in metabolic syndrome. Am J Cardiol 2014; 114: 838-42.Utsunomiya H, Yamamoto H, Kunita E, et al. Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis. Cardiovasc Diabetol 2014; 13: 86.Utsunomiya H, Yamamoto H, Kunita E, et al. Insulin resistance and subclinical abnormalities of global and regional left ventricular function in patients with aortic valve sclerosis. Cardiovasc Diabetol 2014; 13: 86.Abel ED, O’Shea KM, Ramasamy R. Insulin resistance: metabolic mechanisms and consequences in the heart. Arterioscler Thromb Vasc Biol 2012; 32: 2068-76.Abel ED, O’Shea KM, Ramasamy R. Insulin resistance: metabolic mechanisms and consequences in the heart. Arterioscler Thromb Vasc Biol 2012; 32: 2068-76.Boudina S, Abel ED. Diabetic cardiomyopathy revisited. Circulation 2007; 115: 3213-23.Boudina S, Abel ED. Diabetic cardiomyopathy revisited. Circulation 2007; 115: 3213-23.Anderson EA, Hoffman RP, Balon TW, et al. Hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans. J Clin Invest 1991; 87: 2246-52.Anderson EA, Hoffman RP, Balon TW, et al. Hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans. J Clin Invest 1991; 87: 2246-52.Park JS, Nam JS, Cho MH, et al. Insulin resistance independently influences arterial stiffness in normoglycemic normotensive postmenopausal women. Menopause 2010; 17: 779-84.Park JS, Nam JS, Cho MH, et al. Insulin resistance independently influences arterial stiffness in normoglycemic normotensive postmenopausal women. Menopause 2010; 17: 779-84.Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA 1979; 24: 2035-8.Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA 1979; 24: 2035-8.Davis T, Davis WA. Predictors and outcome of heart failure complicating type 2 diabetes: The Fremantle Diabetes Study. American Diabetes Association 2015 Scientific Sessions; June 7, 2015; Boston, MA.Davis T, Davis WA. Predictors and outcome of heart failure complicating type 2 diabetes: The Fremantle Diabetes Study. American Diabetes Association 2015 Scientific Sessions; June 7, 2015; Boston, MA.Bell DS. Diabetic cardiomyopathy. Diabetes Care 2003; 26: 2949-51.Bell DS. Diabetic cardiomyopathy. Diabetes Care 2003; 26: 2949-51.Devereux RB, Roman MJ, Paranicas M, et al. Impact of diabetes on cardiac structure and function. The strong heart study. Circulation 2000; 101: 2271-6.Devereux RB, Roman MJ, Paranicas M, et al. Impact of diabetes on cardiac structure and function. The strong heart study. Circulation 2000; 101: 2271-6.Rutter MK, Parise H, Benjamin EJ, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function. Circulation 2003; 107: 448-54.Rutter MK, Parise H, Benjamin EJ, et al. Impact of glucose intolerance and insulin resistance on cardiac structure and function. Circulation 2003; 107: 448-54.Goldin A, Beckman JA, Schmidt AM, Creager MA. Advanced glycation end products: sparking the development of diabetic vascular injury. Circulation 2006; 114: 597-605.Goldin A, Beckman JA, Schmidt AM, Creager MA. Advanced glycation end products: sparking the development of diabetic vascular injury. Circulation 2006; 114: 597-605.Bertoni AG, Tsai A, Kasper EK, Brancati FL. Diabetes and idiopathic cardiomyopathy. A nationwide case-control study. Diabetes Care 2003; 26: 2791-5.Bertoni AG, Tsai A, Kasper EK, Brancati FL. Diabetes and idiopathic cardiomyopathy. A nationwide case-control study. Diabetes Care 2003; 26: 2791-5.

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