Интерстициальные заболевания легких и сахарный диабет: анализ взаимоотношений мультифакториальных заболеваний

Влияние нарушений углеводного обмена на интерстициальные заболевания легких (ИЗЛ) изучено недостаточно. Так, во всем мире неуклонно увеличивается распространенность такого хронического метаболического заболевания, как сахарный диабет (СД). Развитие СД сопровождается формированием микро- и макрососудистых осложнений, при которых существенно повышаются заболеваемость и смертность. Микрососудистые осложнения проявляются в виде ретинопатии, невропатии и нефропатии, тогда как макрососудистые преимущественно поражают сердечно-сосудистую систему. Помимо классических осложнений, СД оказывает влияние на легкие, что связано с их обширной сосудистой сетью, высокой степенью васкуляризации и богатством соединительнотканных структур (коллагена и эластина). Установлено, что хроническая гипергликемия способствует развитию микроангиопатии и избыточному отложению внеклеточного матрикса в легочной ткани, что приводит к рестриктивному типу вентиляционных нарушений. ИЗЛ – это гетерогенная группа патологий, характеризуемая воспалением и / или фиброзом легочной паренхимы. К ним относится идиопатический легочный фиброз (ИЛФ) как наиболее распространенная форма идиопатической интерстициальной пневмонии с высоким уровнем летальности. ИЛФ представляет собой хроническое прогрессирующее фиброзное заболевание, которое приводит к появлению и нарастанию дыхательной недостаточности. Целью обзора являлось рассмотрение легких как органа-мишени СД и анализ возможной связи между СД и ИЗЛ, с особым акцентом на ИЛФ. Заключение. Диабетическая пневмопатия определяется как прогрессирующее поражение легких, обусловленное микрососудистыми осложнениями СД. Раннее выявление этого состояния и строгий контроль над уровнем гликемии могут способствовать предупреждению прогрессирования и снижению выраженности симптомов, связанных с диабетическим поражением легких.

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