microcirculationРегионарное кровообращение и микроциркуляцияRegional blood circulation and microcirculation1682-66552712-9756Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1682-6655-2025-24-4-21-31microcirculation-1472Research ArticleОБЗОРЫREVIEWSТромборезистентная функция эндотелия при ожиренииThromboresistant Endothelial Function in Obesityhttps://orcid.org/0009-0006-4891-8146ГерасименкоА. А.GerasimenkoA. A.

Герасименко Анастасия Алексеевна – студент Медицинского института

430000, г. Саранск, ул. Большевистская, д. 68

Gerasimenko Anastasia A. – Medical Institute student

68, Bolshevistskaya str., Saransk, 430000

anastasiagerasimenko@list.ruhttps://orcid.org/0009-0002-9776-595XПетрушкинаЮ. Н.PetrushkinaYu. N.

Петрушкина Юлия Николаевна – студент Медицинского института

430000, г. Саранск, ул. Большевистская, д. 68

Petrushkina Yulia N. – Medical Institute student

68, Bolshevistskaya str., Saransk, 430000

petrushkinajul@yandex.ruhttps://orcid.org/0000-0002-5350-1744РыжовА. В.RyzhovA. V.

Рыжов Артем Владимирович – ассистент кафедры нормальной и патологической физиологии

430000, г. Саранск, ул. Большевистская, д. 68

Ryzhov Artem V. – Assistant, Department of Normal and Pathological Physiology

68, Bolshevistskaya str., Saransk, 430000

artyom3690@gmail.comhttps://orcid.org/0009-0002-3029-791XПолозоваА. И.PolozovaA. I.

Полозова Александра Ивановна – лаборант кафедры нормальной и патологической физиологии

430000, г. Саранск, ул. Большевистская, д. 68

Polozova Alexandra I. – Laboratory Assistant, Department of Normal and Pathological Physiology

68, Bolshevistskaya str., Saransk, 430000

sashapolozova02@yandex.ruhttps://orcid.org/0009-0003-1130-0033ДергачеваЕ. С.DergachevaE. S.

Дергачева Екатерина Сергеевна – студент Медицинского института

430000, г. Саранск, ул. Большевистская, д. 68

Dergacheva Ekaterina S. – Medical Institute student

68, Bolshevistskaya str., Saransk, 430000

kate.smith.zen@gmail.comhttps://orcid.org/0000-0002-2624-6450ВласоваТ. И.VlasovaT. I.

Власова Татьяна Ивановна – д-р мед. наук, профессор, зав. кафедрой нормальной и патологической физиологии

430000, г. Саранск, ул. Большевистская, д. 68

Vlasova Tatyana I. – Doctor of Medical Sciences, Professor, Head, Department of Normal and Pathological Physiology

68, Bolshevistskaya str., Saransk, 430000

vlasova-t.i@mrsu.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Национальный исследовательский Мордовский государственный университет имени Н. П. Огарева»РоссияNational Research Mordovia State UniversityRussian Federation2025220120262442131Copyright © Герасименко А.А., Петрушкина Ю.Н., Рыжов А.В., Полозова А.И., Дергачева Е.С., Власова Т.И., 20262026Герасименко А.А., Петрушкина Ю.Н., Рыжов А.В., Полозова А.И., Дергачева Е.С., Власова Т.И.Gerasimenko A.A., Petrushkina Y.N., Ryzhov A.V., Polozova A.I., Dergacheva E.S., Vlasova T.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.microcirc.ru/jour/article/view/1472

В статье представлено рассмотрение ожирения как многофакторной патологии, сопровождающейся нарушением гемостатического баланса и повышением тромботического риска. На основе современных данных проанализированы ключевые патогенетические механизмы: хроническое субклиническое воспаление, инсулинорезистентность и оксидативный стресс, приводящие к дисбалансу адипокинового профиля и утрате вазопротективных свойств периваскулярной жировой ткани. Особое внимание уделено деградации гликокаликса, снижению экспрессии тромбомодулина и активности системы протеина C, повышению уровня фактора фон Виллебранда, экспрессии молекул межклеточной адгезии и подавлению фибринолитической активности за счет гиперэкспрессии PAI-1. Рассмотрена роль экзосом и микроРНК в регуляции адипоцитарно-эндотелиального взаимодействия. Обобщены потенциальные подходы к таргетированному воздействию на адипокиновые пути и персонализированную антитромботическую профилактику.

The article presents an analysis of obesity as a multifactorial pathology associated with impaired hemostatic balance and an increased thrombotic risk. Based on current data, key pathogenetic mechanisms are examined, including chronic subclinical inflammation, insulin resistance, and oxidative stress, which lead to adipokine profile imbalance and the loss of vasoprotective properties of perivascular adipose tissue. Particular attention is given to glycocalyx degradation, decreased thrombomodulin expression and protein C system activity, elevated von Willebrand factor levels, increased expression of intercellular adhesion molecules, and suppressed fibrinolytic activity due to PAI-1 overexpression. The role of exosomes and microRNAs in the regulation of adipocyte-endothelial interactions is also discussed. Potential approaches to targeted modulation of adipokine pathways and personalized antithrombotic prophylaxis are summarized.

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