problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13443problendo-13443Research ArticleНарушение углеводного обменаCarbohidrates metabolism disturbanciesГепатогенный сахарный диабет: обзор литературы и описание трех клинических случаевHepatogenic diabetes: three cases report and literature reviewhttps://orcid.org/0000-0003-1848-8721АмосоваМ. В.AmosovaM. V.

Амосова Мария Вадимовна, к.м.н.  

Москва 

Maria V. Amosova, MD, PhD 

Moscow 

mariaamosova@mail.ruhttps://orcid.org/0000-0003-2147-3061ПолубояриноваИ. В.PoluboyarinovaI. V.

Полубояринова Ирина Владимировна, к.м.н.  

Москва 

Irina V. Poluboyarinova, MD, PhD 

Moscow 

polub-irina@mail.ruhttps://orcid.org/0000-0003-2011-1237СальниковаП. В.SalnikovaP. V.

Сальникова Полина Владимировна

Москва  

Polina V. Salnikova 

Moscow 

salnikovapolina@bk.ruhttps://orcid.org/0000-0003-0292-5907ЖеребчиковаК. Ю.ZherebchikovaK. Y.

Жеребчикова Кристина Юрьевна 

Москва 

Kristina Y. Zherebchikova, MD 

Moscow 

zherebchikova_k_yu@staff.sechenov.ruhttps://orcid.org/0000-0002-3026-6315ФадеевВ. В.FadeevV. V.

Фадеев Валентин Викторович, д.м.н., профессор 

Москва 

Valentin V. Fadeev, MD, PhD, Professor 

Moscow 

walfad@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian Federation2025200520257126674Copyright © Амосова М.В., Полубояринова И.В., Сальникова П.В., Жеребчикова К.Ю., Фадеев В.В., 20252025Амосова М.В., Полубояринова И.В., Сальникова П.В., Жеребчикова К.Ю., Фадеев В.В.Amosova M.V., Poluboyarinova I.V., Salnikova P.V., Zherebchikova K.Y., Fadeev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/13443

Гепатогенный диабет (ГепД) – это форма сахарного диабета, в основе патогенеза которой лежит первичное заболевание печени (как правило цирроз), осложнившееся развитием портальной гипертензии с образованием порто-кавальных шунтов. В развитии ГепД помимо традиционных факторов риска развития нарушений углеводного обмена большую роль играют патогенетические особенности заболеваний печени. Тем не менее, точный механизм развития гепатогенного диабета до конца не ясен, и ряд вопросов до сих пор остаётся открытым к обсуждению. Несмотря на то, что гепатогенный диабет имеет отчетливые патофизиологические и клинические особенности, в настоящее время он не рассматривается как самостоятельное заболевание. Вероятно, это связано с трудностями дифференциальной диагностики типа сахарного диабета из-за двунаправленного характера связи нарушений метаболизма глюкозы и хронических заболеваний печени. Известно, что сахарный диабет (СД) негативно влияет на развитие и прогрессирование хронических заболеваний печени (ХЗП) различной этиологии, их сочетание ассоциировано с худшими клиническими исходами в плане смертности, возникновения печеночной декомпенсации и развития гепатоцеллюлярной карциномы (ГЦК). К сожалению, ранняя диагностика и подбор оптимальной терапевтической стратегии лечения диабета могут быть затруднены из-за отсутствия установленных клинических рекомендаций, а также полиморбидности пациентов с ГепД.

Hepatogenic diabetes (HepD) is a form of diabetes where the primary pathogenesis is a liver disease, usually cirrhosis, complicated by the development of portal hypertension with the formation of porto-caval shunts. In the development of HepD, in addition to traditional risk factors for carbohydrate metabolism disorders, the pathogenetic features of liver diseases play a significant role. However, the exact mechanism of HepD development remains unclear, and several questions are still open for discussion. Despite having distinct pathophysiological and clinical features, hepatogenic diabetes is currently not considered as an independent disease. This is likely due to the difficulties in differentiating between types of diabetes due to the bidirectional relationship between glucose metabolism disorders and chronic liver diseases. It is known that diabetes negatively affects the development and progression of chronic liver diseases of various etiologies, and their combination is associated with worse clinical outcomes in terms of mortality, the occurrence of liver decompensation, and the development of hepatocellular carcinoma (HCC). Unfortunately, early diagnosis and the selection of optimal therapeutic strategies for diabetes may be challenging due to the lack of established clinical guidelines and the presence of comorbidities in patients with HepD.

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