mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2026-500mes-500Research ArticleГЛАВНАЯ ТЕМА: ПРИКЛАДНЫЕ АСПЕКТЫ СПОРТИВНОЙ МЕДИЦИНЫMAIN TOPIC: APPLIED ASPECTS OF SPORTS MEDICINEФакторы риска нарушений липидного обмена у несовершеннолетних спортсменов: обзорRisk factors for lipid metabolism disorders in underage athletes: A reviewhttps://orcid.org/0009-0009-8905-5342КрутоваА. В.KrutovaA. V.

Крутова Александра Владимировна, канд. мед. наук

Москва

Alexandra V. Krutova, Cand. Sci. (Med.)

Moscow

alkrutova@yandex.ruhttps://orcid.org/0000-0001-8549-9493МухортыхВ. А.MukhortykhV. А.

Мухортых Валерий Алексеевич, канд. мед. наук

Москва

Valery А. Mukhortykh, Cand. Sci. (Med.)

Moscow

valera-89@yandex.ruhttps://orcid.org/0009-0000-7061-8007КиселеваТ. А.KiselevaT. A.

Киселева Татьяна Александровна

Москва

Tatyana A. Kiseleva

Moscow

bunina.tatyana2016@yandex.ruhttps://orcid.org/0000-0002-9717-5872ЗябкинИ. В.ZyabkinI. V.

Зябкин Илья Владимирович, д-р. мед. наук

Москва

Ilya V. Zyabkin, Dr. Sci. (Med.)

Moscow

adm@kidsfmba.ruФедеральный научно-клинический центр детей и подростков Федерального медико-биологического агентства; Государственный научный центр Российской Федерации — Федеральный медицинский биофизический центр им. А.И. БурназянаРоссияFederal Scientific and Clinical Center for Children and Adolescents of the Federal Medical-Biological Agency of Russia; State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical-Biological Agency of RussiaRussian FederationФедеральный научно-клинический центр детей и подростков Федерального медико-биологического агентства; Государственный научный центр Российской Федерации — Федеральный медицинский биофизический центр им. А.И. Бурназяна; Федеральный исследовательский центр питания, биотехнологии и безопасности пищиРоссияFederal Scientific and Clinical Center for Children and Adolescents of the Federal Medical-Biological Agency of Russia; State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical-Biological Agency of Russia; Federal Research Centre of Nutrition, Biotechnology and Food SafetyRussian FederationФедеральный научно-клинический центр детей и подростков Федерального медико-биологического агентстваРоссияFederal Scientific and Clinical Center for Children and Adolescents of the Federal Medical-Biological Agency of RussiaRussian FederationФедеральный научно-клинический центр детей и подростков Федерального медико-биологического агентства; Государственный научный центр Российской Федерации — Федеральный медицинский биофизический центр им. А.И. Бурназяна; Российская медицинская академия непрерывного профессионального образованияРоссияFederal Scientific and Clinical Center for Children and Adolescents of the Federal Medical-Biological Agency of Russia; State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Medical-Biological Agency of Russia; Russian Medical Academy of Continuous Professional EducationRussian Federation202611092026283370377Copyright © Крутова А.В., Мухортых В.А., Киселева Т.А., Зябкин И.В., 20262026Крутова А.В., Мухортых В.А., Киселева Т.А., Зябкин И.В.Krutova A.V., Mukhortykh V.А., Kiseleva T.A., Zyabkin I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/500Введение

Введение. В последние годы в связи с ростом сердечно-сосудистых заболеваний и смертности среди молодых пациентов все больше внимания уделяется нарушению липидного обмена у детей. Несмотря на доказанный кардиопротективный эффект регулярных физических нагрузок, у значительной части профессиональных спортсменов (20–35,8%) выявляются нарушения липидного обмена. К ключевым факторам риска относятся: особенности питания, прием биологически активных добавок и некоторых лекарственных препаратов, чрезмерные тренировочные нагрузки и недостаточное восстановление. На сегодняшний день отсутствуют стандартизированные референтные значения показателей липидного профиля, адаптированные к возрастным, гендерным особенностям и специфике спортивной деятельности несовершеннолетних спортсменов. Также остается нерешенной задача разработки критериев стратификации риска сердечно-сосудистых заболеваний в педиатрической популяции, что приводит к поздней диагностике патологических состояний и несвоевременному назначению профилактических и терапевтических мероприятий.

Цель

Цель. Определение направлений профилактики нарушений липидного обмена у спортсменов юношеского возраста.

Обсуждение

Обсуждение. По результатам проведенного анализа литературы выявлено, что наиболее прогностически неблагоприятными являются немодифицируемые факторы: семейная гиперхолестеринемия и повышенный уровень липопротеина (а). Среди модифицируемых факторов ключевую роль играют нутритивные нарушения (избыток насыщенных жиров и углеводов в силовых видах спорта, хронический дефицит энергии в эстетических видах), специфика вида спорта, а также бесконтрольный прием спортивных добавок и фармакологических препаратов, в особенности анаболических стероидов. Отдельного внимания заслуживает гипергомоцистеинемия, распространенность которой у спортсменов выше, чем в целом по популяции.

Выводы

Выводы. Дислипидемии у несовершеннолетних спортсменов носят преимущественно вторичный характер, что требует комплексной оценки с учетом генетической предрасположенности, характера питания, вида спорта и фармакологического анамнеза. Обоснована целесообразность включения расширенного липидного скрининга в программу углубленных медицинских осмотров юных атлетов.

Introduction

Introduction. In recent years, due to the increase in cardiovascular diseases and mortality among young patients, increasing attention has been paid to lipid metabolism disorders in children. Despite the proven cardioprotective effect of regular physical activity, lipid metabolism disorders are detected in a significant proportion of professional athletes (20–35.8%). Key risk factors include: dietary patterns, intake of dietary supplements and certain medications, excessive training loads, and insufficient recovery. To date, there are no standardized reference values for lipid profile parameters adapted to the age, gender characteristics, and specificity of sports activity in adolescent athletes. Furthermore, the task of developing criteria for cardiovascular risk stratification in the pediatric population remains unresolved, leading to late diagnosis of pathological conditions and untimely initiation of preventive and therapeutic interventions.

Objective

Objective. To determine the directions for the prevention of lipid metabolism disorders in adolescent athletes.

Discussion

Discussion. Based on the results of the conducted literature analysis, it was revealed that the most prognostically unfavorable factors are non-modifiable factors: familial hypercholesterolemia and elevated lipoprotein(a) levels. Among modifiable factors, the key role is played by nutritional disorders (excess saturated fats and carbohydrates in strength sports, chronic energy deficiency in aesthetic sports), the specific characteristics of the sport, as well as the uncontrolled use of sports supplements and pharmacological agents, particularly anabolic steroids. Hyperhomocysteinemia deserves special attention, as its prevalence among athletes is higher than in the general population.

Conclusions

Conclusions. Dyslipidemias in adolescent athletes are predominantly secondary in nature, which requires a comprehensive assessment taking into account genetic predisposition, dietary patterns, type of sport, and pharmacological history. The feasibility of including extended lipid screening in the in-depth medical examination program for young athletes has been substantiated.

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