Агонисты рецепторов глюкагоноподобного пептида-1 в практике акушера-гинеколога

1. World Health Organization. Obesity. Available at: https://www.who.int/westernpacific/health-topics/obesity#tab=tab_1
2. World Obesity Federation. World Obesity Atlas 2023. Available at: https://www.worldobesityday.org/assets/downloads/World_Obesity_Atlas_2023_Report.pdf
3. World Obesity Federation. World Obesity Atlas 2025. Available at: https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2025
4. Титова В.В., Ушанова Ф.О., Демидова Т.Ю. Медикаментозная терапия ожирения: современные подходы и перспективы. FOCUS Эндокринология. 2024; 5(4): 40-8.
5. Fitch A.K., Bays H.E. Obesity definition, diagnosis, bias, standard operating procedures (SOPs), and telehealth: an Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. Obes. Pillars. 2022; 1: 100004. https://dx.doi.org/10.1016/j.obpill.2021.100004
6. Аметов А.С., Туркина С.В. Дисфункция жировой ткани: в фокусе ожирение, сахарный диабет и сердечно-сосудистые заболевания, неалкогольная жировая болезнь печени. Эндокринология: новости, мнения, обучение. 2024; 13(4): 84-93.
7. Schon S.B., Cabre H.E., Redman L.M. The impact of obesity on reproductive health and metabolism in reproductive-age females. Fertil. Steril. 2024; 122(2): 194-203. https://dx.doi.org/10.1016/j.fertnstert.2024.04.036
8. Amiri M., Ramezani Tehrani F. Potential adverse effects of female and male obesity on fertility: a narrative review. Int. J. Endocrinol. Metab. 2020; 18(3): e101776. https://dx.doi.org/10.5812/ijem.101776
9. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Ожирение. 2024. Доступно по: https://cr.minzdrav.gov.ru/preview-cr/28_3
10. Busetto L., Dicker D., Frühbeck G., Halford J.C.G., Sbraccia P., Yumuk V. et al. A new framework for the diagnosis, staging and management of obesity in adults. Nat. Med. 2024; 30(9): 2395-9. https://dx.doi.org/10.1038/s41591-024-03095-3
11. Hassapidou M., Vlassopoulos A., Kalliostra M., Govers E., Mulrooney H., Ells L. et al. European association for the study of obesity position statement on medical nutrition therapy for the management of overweight and obesity in adults developed in collaboration with the European Federation of the Associations of dietitians. Obes. Facts. 2023; 16(1): 11-28. https://dx.doi.org/10.1159/000528083
12. Filippi-Arriaga F., Agarwal N., Rodrigues-Martins D., Monteiro M.P., Huvinen E., Suliman S.G.I. et al. EASO position statement: women with obesity across the reproductive life – fertility, preconception, pregnancy, postpartum, and breastfeeding. Obes. Facts. 2025; 18(6): 625-39. https://dx.doi.org/10.1159/000546449
13. Куркин Д.В., Бакулин Д.А., Морковин Е.И., Петров В.И., Стрыгин А.В., Корянова К.Н., Горбунова Ю.В., Колосов Ю.А., Иванова О.В., Павлова Е.В., Джавахян М.А., Заборовский А.В., Сапарова В.Б., Макаренко И.Е., Драй Р.И., Чумаченко А.Н. Физиология и фармакология рецептора глюка­гоноподобного пептида-1. Фармация и фармакология. 2023; 11(4): 347-80.
14. Müller T.D., Adriaenssens A., Ahrén B., Blüher M., Birkenfeld A.L., Campbell J.E. et al. Glucose-dependent insulinotropic polypeptide (GIP). Mol. Metab. 2025; 95: 102118. https://dx.doi.org/10.1016/j.molmet.2025.102118
15. Tanday N., Flatt P.R., Irwin N. Metabolic responses and benefits of glucagon-like peptide-1 (GLP-1) receptor ligands. Br. J. Pharmacol. 2022; 179(4): 526-41. https://dx.doi.org/10.1111/bph.15485
16. Drucker D.J., Holst J.J. The expanding incretin universe: from basic biology to clinical translation. Diabetologia. 2023; 66(10): 1765-79. https://dx.doi.org/10.1007/s00125-023-05906-7
17. Ussher J.R., Drucker D.J. Glucagon-like peptide 1 receptor agonists: cardiovascular benefits and mechanisms of action. Nat. Rev. Cardiol. 2023; 20(7): 463-74. https://dx.doi.org/10.1038/s41569-023-00849-3
18. Цыганкова О.В., Веретюк В.В., Аметов А.С. Инкретины сегодня: множественные эффекты и терапевтический потенциал. Сахарный диабет. 2019; 22(1): 70-8.
19. Jensterle M., Janez A., Fliers E., DeVries J.H., Vrtacnik-Bokal E., Siegelaar S.E. The role of glucagon-like peptide-1 in reproduction: from physiology to therapeutic perspective. Hum. Reprod. Update. 2019; 25(4): 504-17. https://dx.doi.org/10.1093/humupd/dmz019
20. Farkas I., Vastagh C., Farkas E., Bálint F., Skrapits K., Hrabovszky E. et al. Glucagon-like peptide-1 excites firing and increases GABAergic miniature postsynaptic currents (mPSCs) in gonadotropin-releasing hormone (GnRH) neurons of the male mice via activation of nitric oxide (NO) and suppression of endocannabinoid signaling pathways. Front. Cell. Neurosci. 2016; 10: 214. https://dx.doi.org/10.3389/fncel.2016.00214
21. Outeiriño-Iglesias V., Romaní-Pérez M., González-Matías L.C., Vigo E., Mallo F. GLP-1 increases preovulatory LH source and the number of mature follicles, as well as synchronizing the onset of puberty in female rats. Endocrinology 2015; 156(11): 4226-37. https://dx.doi.org/10.1210/en.2014-1978
22. Heppner K.M., Baquero A.F., Bennett C.M., Lindsley S.R., Kirigiti M.A., Bennett B. et al. GLP-1R signaling directly activates arcuate nucleus kisspeptin action in brain slices but does not rescue luteinizing hormone inhibition in ovariectomized mice during negative energy balance. eNeuro. 2017; 4(1): ENEURO.0198-16.2016. https://dx.doi.org/10.1523/ENEURO.0198-16.2016
23. MacLusky N.J., Cook S., Scrocchi L., Shin J., Kim J., Vaccarino F. et al. Neuroendocrine function and response to stress in mice with complete disruption of glucagon-like peptide-1 receptor signaling. Endocrinology. 2000; 141(2): 752-62. https://dx.doi.org/10.1210/endo.141.2.7326
24. Nishiyama Y., Hasegawa T., Fujita S., Iwata N., Nagao S., Hosoya T. et al. Incretins modulate progesterone biosynthesis by regulating bone morphogenetic protein activity in rat granulosa cells. J. Steroid. Biochem. Mol. Biol. 2018; 178: 82-8. https://dx.doi.org/10.1016/j.jsbmb.2017.11.004
25. Bou Nemer L., Shi H., Carr B.R., Word R.A., Bukulmez O. Effect of body weight on metabolic hormones and fatty acid metabolism in follicular fluid of women undergoing in vitro fertilization: a pilot study. Reprod. Sci. 2019; 26(3): 404-11. https://dx.doi.org/10.1177/1933719118776787
26. Sola-Leyva A., Pathare A.D.S., Apostolov A., Aleksejeva E., Kask K., Tammiste T. et al. The hidden impact of GLP-1 receptor agonists on endometrial receptivity and implantation. Acta Obstet. Gynecol. Scand. 2025; 104(2): 258-66. https://dx.doi.org/10.1111/aogs.15010
27. Zhang Y., Xu F., Liang H., Cai M., Wen X., Li X. et al. Exenatide inhibits the growth of endometrial cancer Ishikawa xenografts in nude mice. Oncol. Rep. 2016; 35(3): 1340-8. https://dx.doi.org/10.3892/or.2015.4476
28. Kanda R., Hiraike H., Wada-Hiraike O., Ichinose T., Nagasaka K., Sasajima Y. et al. Expression of the glucagon-like peptide-1 receptor and its role in regulating autophagy in endometrial cancer. BMC Cancer. 2018; 18(1): 657. https://dx.doi.org/10.1186/s12885-018-4570-8
29. Artunc-Ulkumen B., Pala H.G., Pala E.E., Yavasoglu A., Yigitturk G., Erbas O. Exenatide improves ovarian and endometrial injury and preserves ovarian reserve in streptozocin induced diabetic rats. Gynecol. Endocrinol. 2015; 31(3): 196-201. https://dx.doi.org/10.3109/09513590.2014.975686
30. Hagemann A.R., Hagemann I.S., Mutch D.G., Devor E.J., Malmrose P.K., Zhang Y. et al. Enhancing progestin therapy with a glucagon-like peptide 1 agonist for the conservative management of endometrial cancer. Cancers (Basel). 2025; 17(4): 598. https://dx.doi.org/10.3390/cancers17040598
31. Tao X., Zhang X., Ge S.Q., Zhang E.H., Zhang B. Expression of SIRT1 in the ovaries of rats with polycystic ovary syndrome before and after therapeutic intervention with exenatide. Int. J. Clin. Exp. Pathol. 2015; 8(7): 8276-83.
32. Zhang W., Zhang J. Semaglutide pretreatment induces cardiac autophagy to reduce myocardial injury in septic mice. Discov. Med. 2023; 35(178): 853-60. https://dx.doi.org/10.24976/Discov.Med.202335178.80
33. Sills E.S., Harrity C., Chu H.I., Wang J.W., Yang F., Wood S.H. Semaglutide and human reproduction: caution at the intersection of energy balance, ovarian function, and follicular development. Reprod. Biol. Endocrinol. 2025; 23(1): 116. https://dx.doi.org/10.1186/s12958-025-01435-7
34. Saber S.M., Abd El-Rahman H.A. Liraglutide treatment effects on rat ovarian and uterine tissues. Reprod. Biol. 2019; 19(3): 237-44. https://dx.doi.org/10.1016/j.repbio.2019.07.003
35. Krasnyi A.M., Sadekova A.A., Smolnova T.Y., Chursin V.V., Buralkina N.A., Chuprynin V.D. et al. The levels of ghrelin, glucagon, visfatin and Glp-1 are decreased in the peritoneal fluid of women with endometriosis along with the increased expression of the CD10 protease by the macrophages. Int. J. Mol. Sci. 2022; 23(18): 10361. https://dx.doi.org/10.3390/ijms231810361
36. Ndumele Ch.E., Neeland I.J., Tuttle K.R., Chow S.L., Mathew R.O., Khan S.S. et al. A synopsis of the evidence for the science and clinical management of сardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American heart association. Circulation. 2023; 148(20): 1636-64. https://dx.doi.org/10.1161/CIR.0000000000001186
37. Guldan M., Unlu S., Abdel-Rahman S.M., Ozbek L., Gaipov A., Covic A. et al. Understanding the role of sex hormones in cardiovascular kidney metabolic syndrome: toward personalized therapeutic approaches. J. Clin. Med. 2024; 13(15): 4354. https://dx.doi.org/10.3390/jcm13154354
38. Демидова Т.Ю., Никитин И.Г., Кисляк О.А., Стародубова А.В. Роль агонистов рецепторов ГПП-1 в управлении кардиометаболическим здоровьем. FOCUS Эндокринология. 2024; 5(4): 76-87.
39. Thethi T.K., Pratley R., Meier J.J. Safety and cardiovascular outcomes of once-daily oral semaglutide in patients with type 2 diabetes: the PIONEER programme. Diabetes Obes. Metab. 2020; 22(8): 1263-77. https://dx.doi.org/10.1111/dom.14054
40. Davies M., Faerch L., Jeppesen O.K., Pakseresht A., Pedersen S.D., Perreault L. et al. Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021; 397(10278): 971-84. https://dx.doi.org/10.1016/S0140-6736(21)00213-0
41. MacIsaac R.J. Semaglutide: a key medication for managing cardiovascular-kidney-metabolic syndrome. Future Cardiol. 2025; 21(9): 663-83. https://dx.doi.org/10.1080/14796678.2025.2511412
42. McGowan B., Ciudin A., Baker J.L., Busetto L., Dicker D., Frühbeck G. et al. Framework for the pharmacological treatment of obesity and its complications from the European association for the study of obesity (EASO). Nat. Med. 2025; 31(10): 3229-32. https://dx.doi.org/10.1038/s41591-025-03765-w
43. Aronne L.J., Horn D.B., le Roux C.W., Ho W., Falcon B.L., Gomez Valderas E. et al. Tirzepatide as compared with semaglutide for the treatment of obesity. N. Engl. J. Med. 2025; 393(1): 26-36. https://dx.doi.org/10.1056/NEJMoa2416394
44. Bednarz K., Kowalczyk K., Cwynar M., Czapla D., Czarkowski W., Kmita D. et al. The role of GLP-1 receptor agonists in insulin resistance with concomitant obesity treatment in polycystic ovary syndrome. Int. J. Mol. Sci. 2022; 23(8): 4334. https://dx.doi.org/10.3390/ijms23084334
45. Monney M., Mavromati M., Leboulleux S., Gariani K. Endocrine and metabolic effects of GLP-1 receptor agonists on women with PCOS, a narrative review. Endocr. Connect. 2025; 14(5): e240529. https://dx.doi.org/10.1530/EC-24-0529
46. Carmina E., Longo R.A. Semaglutide treatment of excessive body weight in obese PCOS patients unresponsive to lifestyle programs. J. Clin. Med. 2023; 12(18): 5921. https://dx.doi.org/10.3390/jcm12185921
47. Шабатукова Е.В., Щербань Д.А., Кудратова Е.А., Скворцова А.А., Жукова О.В. Современная фармакотерапия синдрома поликистозных яичников. Акушерство и гинекология. 2025; 7: 153-60.
48. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Синдром поликистозных яичников. 2025.
49. Duah J., Seifer D.B. Medical therapy to treat obesity and optimize fertility in women of reproductive age: a narrative review. Reprod. Biol. Endocrinol. 2025; 23(1): 2. https://dx.doi.org/10.1186/s12958-024-01339-y
50. Howard M.D., Allen S.E. The use of GLP-1: receptor agonist medications for benign gynecology. Curr. Opin. Obstet. Gynecol. 2025; 37(4): 279-84. https://dx.doi.org/10.1097/GCO.0000000000001028
51. Varughese M.S., O'Mahony F., Varadhan L. GLP-1 receptor agonist therapy and pregnancy: Evolving and emerging evidence. Clin. Med. (Lond). 2025; 25(2): 100298. https://dx.doi.org/10.1016/j.clinme.2025.100298
52. Muller D.R.P., Stenvers D.J., Malekzadeh A., Holleman F., Painter R.C., Siegelaar S.E. Effects of GLP-1 agonists and SGLT2 inhibitors during pregnancy and lactation on offspring outcomes: a systematic review of the evidence. Front. Endocrinol. (Lausanne). 2023; 14: 1215356. https://dx.doi.org/10.3389/fendo.2023.1215356
53. Minis E., Stanford F.C., Mahalingaiah S. Glucagon-like peptide-1 receptor agonists and safety in the preconception period. Curr. Opin. Endocrinol. Diabetes Obes. 2023; 30(6): 273-9. https://dx.doi.org/10.1097/MED.0000000000000835
54. Dao K., Shechtman S., Weber-Schoendorfer C., Diav-Citrin O., Murad R.H., Berlin M. et al. Use of GLP1 receptor agonists in early pregnancy and reproductive safety: a multicentre, observational, prospective cohort study based on the databases of six Teratology information services. BMJ Open. 2024; 14(4): e083550. https://dx.doi.org/10.1136/bmjopen-2023-083550
55. Инструкция по медицинскому применению препарата СЕМАВИК®. Доступно по: https://semavic.ru/manual/?ysclid=mmpxmmoism135827637
56. Аметов А.С., Шохин И.Е., Рогожина Е.А., Бодрова Т.Г., Невретдинова М.Е., Белый П.А., Заславская К.Я., Щербакова В.С., Куркин Д.В., Корянова К.Н., Мищенко Е.С., Кесова Э.Ю., Козлов Е.Д., Самошкина Е.С., Андреев Д.Н., Казаишвили Ю.Г., Носков С.М., Балыкова Л.А. Сравнительный анализ физико-химических свойств, биоэквивалентности, безопасности и переносимости отечественного семаглутида. Фармация и фармакология. 2023; 11(4): 324-46.
57. Mounjaro (tirzepatide)
58. Jordy A.B., Breitschaft A., Christiansen E., Granhall C., Hansen C.W.F., Houshmand-Oregaard A. et al. Oral semaglutide does not affect the bioavailability of the combined oral contraceptive ethinylestradiol/levonorgestrel. Diabetes. 2018; 67(S1): 1135-P. https://dx.doi.org/10.2337/db18-1135-P
59. Kapitza C., Nosek L., Jensen L., Hartvig H., Jensen C.B., Flint A. Semaglutide, a once-weekly human GLP-1 analog, does not reduce the bioavailability of the combined oral contraceptive, ethinylestradiol/levonorgestrel. J. Clin. Pharmacol. 2015; 55(5): 497-504. https://dx.doi.org/10.1002/jcph.443
60. British Menopause Society. Use of incretin-based therapies in women using hormone replacement therapy (HRT). 2025. Available at://thebms.org.uk/wp-content/uploads/2025/05/23-BMS-TfC-Use-of-incretin-based-therapies-APRIL2025-E.pdf
61. Joshi G.P., Abdelmalak B.B., Weigel W.A., Soriano S.G., Harbell M.W., Kuo C.I. et al.; American Society of Anesthesiologists (ASA) Task Force on Preoperative Fasting. American Society of Anesthesiologists consensus-based guidance on preoperative management of patients (adults and children) on glucagon-like peptide-1 (GLP-1) receptor agonists. 2023. Available at: https://www.asahq.org/about-asa/newsroom/news-releases/2023/06/american-society-of-anesthesiologists-consensus-based-guidance-on-preoperative

Поступила 29.10.2025

Принята в печать 12.02.2026