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<article article-type="review-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zurniimtpe</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина труда и промышленная экология</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Occupational Health and Industrial Ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1026-9428</issn><issn pub-type="epub">2618-8945</issn><publisher><publisher-name>FSBSI “Izmerov Research Institute of Occupational Health”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31089/1026-9428-2026-66-2-113-122</article-id><article-id custom-type="edn" pub-id-type="custom">caocin</article-id><article-id custom-type="elpub" pub-id-type="custom">zurniimtpe-4088</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LITERATURE REVIEWS</subject></subj-group></article-categories><title-group><article-title>Ожирение и нарушения углеводного обмена как факторы, модифицирующие токсическое действие ксенобиотиков</article-title><trans-title-group xml:lang="en"><trans-title>Obesity and carbohydrate metabolism disorders as factors modifying the toxic effect of xenobiotics</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2677-0479</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рябова</surname><given-names>Юлия Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Ryabova</surname><given-names>Yuliya V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Зав. лаб. токсикологии Отдела токсикологии и генетики с экспериментальной клиникой лабораторных животных ФБУН «Уфимский научно-исследовательский институт медицины труда и экологии человека», канд. мед. наук.</p><p>e-mail: ryabovayuvl@yandex.ru</p></bio><bio xml:lang="en"><p>Head of the Laboratory of Toxicology, Department of Toxicology and Genetics with an Experimental Laboratory Animal Clinic (Ufa Research Institute of Occupational Health and Human Health), Cand. of Sci. (Med.).</p><p>e-mail: ryabovayuvl@yandex.ru</p></bio><email xlink:type="simple">ryabovayuvl@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФБУН «Уфимский научно-исследовательский институт медицины труда и экологии человека»<country>Россия</country></aff><aff xml:lang="en">Ufa Research Institute of Occupational Health and Human Health<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>27</day><month>03</month><year>2026</year></pub-date><volume>66</volume><issue>2</issue><fpage>113</fpage><lpage>122</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Рябова Ю.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Рябова Ю.В.</copyright-holder><copyright-holder xml:lang="en">Ryabova Y.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.journal-irioh.ru/jour/article/view/4088">https://www.journal-irioh.ru/jour/article/view/4088</self-uri><abstract><p>Влияние химических факторов производственной и окружающей среды на человека всё чаще реализуется на фоне имеющегося патологического состояния: в популяции растёт распространённость ожирения, метаболического синдрома, инсулинорезистентности и других нарушений углеводного обмена, а в ряде профессиональных групп их доля уже достигает и даже превышает треть работников.</p><p>Цель обзора — обобщить экспериментальные и эпидемиологические данные об ожирении, метаболическом синдроме, инсулинорезистентности и других нарушений углеводного обмена как факторах, модифицирующих токсическое действие ксенобиотиков в условиях профессионально-обусловленной и техногенной экспозиции.</p><p>Поиск оригинальных работ in vivo и исследований на людях проведён в российских и международных базах данных с учётом рекомендаций PRISMA; в анализ включены 27 источников 1987–2024 гг., где метаболические нарушения были инициированы или диагностированы до оценки воздействия химических агентов различной природы.</p><p>Результаты показывают, что рассматриваемые метаболической дисрегуляции в большинстве случаев усиливают токсические эффекты ксенобиотиков, изменяя их токсикокинетику и токсикодинамику и повышая выраженность гепато-, нефро- и кардиотоксичности, оксидативного стресса и воспаления. Данные эпидемиологических исследований в рабочей когорте и в общей популяции, хотя и чрезвычайно ограничены по числу работ, в целом подтверждают, что ожирение, метаболический синдром, инсулинорезистентность и другие нарушения углеводного обмена выступают не только фоном, но и самостоятельными детерминантами чувствительности к химической нагрузке. С учётом высокой распространённости этих состояний среди трудоспособного населения необходимо рассмотреть возможность учитывать их при оценке риска здоровью и разработке мер профилактики.</p><sec><title>Этика</title><p>Этика. Исследование не требовало заключения биоэтической комиссии.</p></sec><sec><title>Финансирование</title><p>Финансирование. Исследование не имело спонсорской поддержки.</p></sec><sec><title>Конфликт интересов</title><p>Конфликт интересов. Автор заявляет об отсутствии конфликта интересов.</p></sec><sec><title>Дата поступления</title><p>Дата поступления: 23.12.2025 / Дата принятия к печати: 11.02.2026 / Дата публикации: 27.03.2026</p></sec></abstract><trans-abstract xml:lang="en"><p>The influence of chemical factors of production and the environment on humans is increasingly realized against the background of an existing pathological condition: the prevalence of obesity, metabolic syndrome, insulin resistance and other disorders of carbohydrate metabolism is growing in the population, and in a number of occupational groups their share already reaches and even exceeds a third of workers.</p><p>The study aims to summarize experimental and epidemiological data on obesity, metabolic syndrome, insulin resistance, and other disorders of carbohydrate metabolism as factors modifying the toxic effects of xenobiotics in conditions of occupational and man-made exposure.</p><p>The search for original in vivo and human studies was conducted in Russian and international databases, taking into account the recommendations of PRISMA; the analysis included 27 sources from 1987–2024, where metabolic disorders were initiated or diagnosed before assessing the effects of chemical agents of various nature.</p><p>The results show that the metabolic dysregulations under consideration in most cases enhance the toxic effects of xenobiotics, altering their toxicokinetics and toxicodynamics and increasing the severity of hepatotoxicity, nephrotoxicity, and cardiotoxicity, oxidative stress, and inflammation. Data from epidemiological studies in the working cohort and in the general population, although extremely limited in the number of studies, generally confirm that obesity, metabolic syndrome, insulin resistance and other disorders of carbohydrate metabolism act not only as a background, but also as independent determinants of sensitivity to chemical stress. Given the high prevalence of these conditions among the working-age population, it is necessary to consider the possibility of taking them into account when assessing health risks and developing preventive measures.</p><sec><title>Ethics</title><p>Ethics. The study did not require the conclusion of a bioethical commission.</p></sec><sec><title>Funding</title><p>Funding. The study had no funding.</p></sec><sec><title>Conflict of interest</title><p>Conflict of interest. The author declares no conflict of interest.</p></sec><sec><title>Received</title><p>Received: 23.12.2025 / Accepted: 11.02.2026 / Published: 27.03.2026</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>ксенобиотики</kwd><kwd>среда обитания</kwd><kwd>факторы риска</kwd><kwd>ожирение</kwd><kwd>метаболический синдром</kwd><kwd>резистентность организма</kwd></kwd-group><kwd-group xml:lang="en"><kwd>xenobiotics</kwd><kwd>habitat</kwd><kwd>risk factors</kwd><kwd>obesity</kwd><kwd>metabolic syndrome</kwd><kwd>body resistance</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Шестакова Е.А., Лунина Е.Ю., Галстян Г.Р., Шестакова М.В., Дедов И.И. Распространённость нарушений углеводного обмена у лиц с различными сочетаниями факторов риска сахарного диабета 2 типа в когорте пациентов исследования NATION. 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