Тромборезистентная функция эндотелия при ожирении

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.

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