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Том 17 №4 2015 год - Нефрология и диализ

Эволюционные и патофизиологические аспекты гиперурикемии


Зверев Я.Ф. Брюханов В.М.

Аннотация: Анализ литературных данных показывает, что биологическая целесообразность, усматриваемая в исчезновении энзима уриказы в ходе эволюции приматов, была, по-видимому, направлена на повышение содержания мочевой кислоты в крови для обеспечения антинатрийуретического и сосудистого эффектов, что, в свою очередь, позволило поддерживать относительно высокое артериальное давление в условиях низко-солевой диеты и обеспечило создание условий для прямохождения гоминид. Отмечается, что резко изменившиеся условия питания и жизненного стиля в ходе последних столетий трансформировало по сути адаптивные черты гиперурикемии в предпосылки развития ряда заболеваний и патологических состояний, включая подагру, уролитиаз и уратную нефропатию, метаболический синдром, гипертензию и другие сердечно-сосудистые заболевания. В то же время, выраженные антиоксидантные свойства мочевой кислоты, проявляемые в отношении мозговой ткани, позволяют предположить наличие благоприятного воздействия гиперурикемии на прогрессирование ряда нейродегенеративных заболеваний и рассеянного склероза, развитие интеллекта и когнитивных функций. Подчеркивается, что определение содержания мочевой кислоты в крови представляется важной, а в ряде случаев - необходимой процедурой, поскольку, с одной стороны, нивелирование гиперурикемии может облегчить течение ряда заболеваний, а с другой стороны, сама гиперурикемия может служить важным предиктором возникновения тех или иных патологических состояний.

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Ключевые слова: мочевая кислота, подагра, уратный нефролитиаз, уратная нефропатия, сердечно-сосудистые заболевания, нейродегенеративные заболевания, uric acid, gout, urate nephrolithiasis, urate nephropathy, cardiovascular disease, neurodegenerative diseases

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