gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2023-33-1-7-14gastro-j-680Research ArticleОБЗОРЫREVIEWSФизическая активность и желчнокаменная болезньPhysical Activity and Gallstone Diseasehttps://orcid.org/0000-0003-0069-7744ГригорьеваИ. Н.Grigor’evaI. N.

Григорьева Ирина Николаевна — доктор медицинских наук, профессор, главный научный сотрудник лаборатории гастроэнтерологии; профессор отдела образования НИИТПМ — филиала ИЦиГ СО РАН

630089, г. Новосибирск, ул. Б. Богаткова, д. 175/1

Irina N. Grigor’eva — Dr. Sci. (Med.), Prof., Chief Researcher of the Gastroenterology Laboratory, Head of the Group of Biochemical Research in Gastroenterology, Prof. of Education Department

630089, Novosibirsk, B. Bogatkova str., 175/1.

igrigorieva@ngs.ruhttps://orcid.org/0000-0002-5786-6927НотоваТ. Е.NotovaT. E.

Нотова Татьяна Евгеньевна — врач-терапевт, врач-гастроэнтеролог

630087, г. Новосибирск, ул. Немировича-Данченко, д. 130

Tatyana E. Notova — therapist, gastroenterologist

630087, Novosibirsk, Nemirovicha-Danchenko str., 130

notovivan007@mail.ruhttps://orcid.org/0000-0001-8514-2304РомановаТ. И.RomanovaT. I.

Романова Татьяна Ивановна — кандидат медицинских наук, ученый секретарь, старший научный сотрудник лаборатории гастроэнтерологии

630089, г. Новосибирск, ул. Б. Богаткова, д. 175/1

Tatyana I. Romanova — Cand. Sci. (Med.), Scientific Secretary, Senior Researcher of the Gastroenterology Laboratory

630089, Novosibirsk, B. Bogatkova str., 175/1

tarom_75@mail.ruНаучно-исследовательский институт терапии и профилактической медицины — филиал ФГБНУ «Федеральный исследовательский центр “Институт цитологии и генетики”» Сибирского отделения Российской академии наукРоссияScientific Research Institute of Therapy and Preventive Medicine — branch of the Federal Scientific Center “Institute of Cytology and Genetics” of the Siberian Branch of the Russian Academy of SciencesRussian FederationГосударственное бюджетное учреждение здравоохранения «Государственная Новосибирская областная клиническая больница»РоссияNovosibirsk State Regional Clinical HospitalRussian Federation202323042023331714Copyright © Григорьева И.Н., Нотова Т.Е., Романова Т.И., 20232023Григорьева И.Н., Нотова Т.Е., Романова Т.И.Grigor’eva I.N., Notova T.E., Romanova 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.gastro-j.ru/jour/article/view/680Цель обзора

Цель обзора: представить данные отечественных и зарубежных исследований об ассоциации физической активности (ФА) и желчнокаменной болезни (ЖКБ).

Основные положения

Основные положения. Низкая ФА является одним из четырех основных факторов риска развития хронических неинфекционных заболеваний (ХНИЗ). Частота низкой ФА у мужчин и женщин РФ (по данным диспансеризации 2016 г.) составляет 19 %. Глобальная распространенность ЖКБ составляет до 20 % среди взрослых. Во многих систематических обзорах и метаанализах подтверждена обратная ассоциация между ЖКБ и ФА в мире независимо от потенциальных факторов риска ЖКБ, при этом наблюдался четкий дозозависимый эффект — относительный риск (RR) ЖКБ составлял 0,87 (95 % ДИ 0,83–0,92) на 20 метаболических эквивалентов (МЕТ) ФА в неделю. По нашим результатам эпидемиологического обследования в рамках программы ВОЗ “MONICA” в г. Новосибирске (n = 870 чел.) среди женщин 25–64 лет с низкой общей ФА (менее 800 МЕТ-мин/нед), а также при наличии первого класса ФА в свободное время ЖКБ встречалась значительно чаще (1-й класс — 33 %, 2–4-й классы — 8,7–11,0 %, p < 0,01). ФА благоприятно влияет практически на все механизмы желчекамнеобразования: улучшает метаболизм холестерина в желчи, повышает сывороточный ХС ЛВП, синтез желчных кислот, стимулирует выброс холецистокинина, снижает гиперсекрецию муцина, увеличивает разнообразие и богатство кишечной микробиоты. Ежедневная ФА служит мерой профилактики ЖКБ: риск ЖКБ снижается на 66 % (95 % ДИ; 0,18–0,86).

Заключение

Заключение. ФА признана защитным агентом против образования камней в желчном пузыре.

Аim

Аim: to present data of Russian and foreign studies about association between physical activity (PA) and gallstone disease (GSD).

Key point

Key point. A low PA level is one of the four major risk factors for chronic non-infectiuos diseases. The frequency of low PA in men and women of the Russian Federation (according to the medical examination in 2016) is 19 %. The global prevalence of GSD is up to 20 % among adults. Many systematic reviews and meta-analyses have confirmed an inverse association between GSD and PA in the world, regardless of potential risk factors for GSD, with a clear dose-dependent effect — the relative risk (RR) of GSD was 0.87 (95 % CI 0.83–0.92) per 20 metabolic equivalents (MET) of PA per week. According to our results of an epidemiological survey in the framework of the WHO MONICA program in Novosibirsk (n = 870) among women aged 25–64 with low total PA (less than 800 MET/min/week), as well as with the first class of PA in leisure-time, GSD occurred much more often (class 1 — 33 %, classes 2–4 — 8.7–11.0 %, p < 0.01). PA favorably affects almost all mechanisms of gallstone formation: improves cholesterol metabolism in bile, increases serum HDL cholesterol, bile acid synthesis, stimulates the release of cholecystokinin, reduces mucin hypersecretion, increases the diversity and richness of the intestinal microbiota. Daily PA serves as a preventive measure for GSD: the risk of GSD is reduced by 66 % (95 % CI 0.18–0.86).

Conclusion

Conclusion. EASL has recognized PA as a protective agent against gallstone formation.

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