Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya5098810.26442/00403660.2020.10.000736ReviewsОбзорыReview ArticleThe prevalence of autoimmune endocrine diseases in vitiligo patientsРаспространенность аутоиммунных эндокринных заболеваний у больных витилигоhttps://orcid.org/0000-0002-8520-8702TroshinaE. A.ТрошинаЕкатерина Анатольевна
Russian Federation

чл.-кор. РАН, д.м.н., проф., зав. отд. терапевтической эндокринологии ФГБУ «НМИЦ эндокринологии»

vipe26@mail.ruhttps://orcid.org/0000-0002-8363-5188VolnukhinV. A.ВолнухинВладимир Анатольевич
Russian Federation

д.м.н., проф., гл. науч. сотр. отд. научно-прикладных методов исследования ГБУЗ МНПЦДК

vipe26@mail.ruhttps://orcid.org/0000-0002-9706-1920PetrovV. A.ПетровВиталий Александрович
Russian Federation

зав. дерматовенерологическим отд-нием Центрального отдела специализированной медицинской помощи ГБУЗ МНПЦДК

vipe26@mail.ruhttps://orcid.org/0000-0001-6876-3336NuralievaN. F.НуралиеваНурана Фейзуллаевна
Russian Federation

науч. сотр. отд. терапевтической эндокринологии ФГБУ «НМИЦ эндокринологии»

vipe26@mail.ruhttps://orcid.org/0000-0002-8771-8300YukinaM. Yu.ЮкинаМарина Юрьевна
Russian Federation

к.м.н., вед. науч. сотр. отд. терапевтической эндокринологии ФГБУ «НМИЦ эндокринологии»

vipe26@mail.ruhttps://orcid.org/0000-0001-6196-5322OrlovaE. M.ОрловаЕлизавета Михайловна
Russian Federation

д.м.н., доц. каф. детской эндокринологии ИВиДПО, вед. науч. сотр. детского отд-ния опухолей эндокринной системы ФГБУ «НМИЦ эндокринологии»

vipe26@mail.ruhttps://orcid.org/0000-0001-6231-971XFrigoN. V.ФригоНаталия Владиславовна
Russian Federation

д.м.н., зам. дир. по науч. работе, рук. отд. научно-прикладных методов исследования ГБУЗ МНПЦДК

vipe26@mail.ruEndocrinology Research CentreФГБУ «Национальный медицинский исследовательский центр эндокринологии» Минздрава РоссииMoscow Research and Practical Center for Dermatovenereology and CosmetologyГБУЗ «Московский научно-практический центр дерматовенерологии и косметологии» Департамента здравоохранения г. Москвы15102020921088962311202023112020Copyright ©; 2020, Consilium MedicumCopyright ©; 2020, ООО "Консилиум Медикум"2020Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/50988

Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.

Витилиго является распространенным полигенным аутоиммунным заболеванием, при котором в результате гибели меланоцитов образуются очаги депигментации на коже и/или слизистых оболочках. Существует несколько гипотез патогенеза заболевания, среди которых ведущая роль отводится аутоиммунной. В настоящем обзоре обобщены имеющиеся литературные данные, посвященные изучению распространенности и структуры коморбидной эндокринной аутоиммунной патологии у больных витилиго. В большинстве исследований, проведенных в странах Европы, Америки и Азии, у больных витилиго установлена более высокая, по сравнению с общей популяцией, распространенность аутоиммунных заболеваний щитовидной железы (в том числе аутоиммунного тиреоидита и болезни Грейвса), сахарного диабета и аутоиммунной надпочечниковой недостаточности. Результаты отдельных исследований свидетельствуют о частой ассоциации витилиго с аутоиммунными полигландулярными синдромами. В структуре коморбидной патологии наиболее часто встречается ассоциация витилиго с аутоиммунными заболеваниями щитовидной железы. В ряде работ установлена более высокая распространенность аутоиммунных эндокринных заболеваний у женщин, а также у больных несегментарным типом витилиго и в случаях наличия отягощенного семейного анамнеза. Кроме того, показано, что частота развития эндокринных заболеваний возрастает по мере увеличения площади депигментации. Полученные данные обосновывают целесообразность проведения своевременного обследования больных витилиго с целью раннего выявления коморбидных эндокринных заболеваний и назначения соответствующего лечения. Необходимо проведение дальнейших исследований по изучению влияния выявленных ассоциаций на течение витилиго и сопутствующих эндокринопатий, а также эффективность терапии и качество жизни пациентов.

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