akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2025.657akusherstvo-2519Research ArticleREVIEW ARTICLEНАУЧНЫЙ ОБЗОРThe role of glucagon-like peptide-1 receptor agonists in the correction of immune and metabolic disorders in women with reproductive dysfunctionРоль агонистов глюкагоноподобного пептида-1 в коррекции иммунных и метаболических расстройств у женщин с нарушением репродуктивной функцииhttps://orcid.org/0009-0001-0873-5234КожуховН. Д.KozhukhovN. D.

Кожухов Николай Дмитриевич

127006 Москва, ул. Долгоруковская, д. 4

Nikolai D. Kozhukhov

4 Dolgorukovskaya Str., Moscow 127006

nikolaikozhukhov99@gmail.comhttps://orcid.org/0009-0005-3229-1126КарповаА. Р.KarpovaA. R.

Карпова Аэлита Рамилевна

450008 Уфа, ул. Ленина, д. 3

Aelita R. Karpova

3 Lenin Str., Ufa 450008

https://orcid.org/0009-0002-7002-1758СадретдиноваА. А.SadretdinovaA. A.

Садретдинова Алсу Альбертовна

450008 Уфа, ул. Ленина, д. 3

Alsu A. Sadretdinova

3 Lenin Str., Ufa 450008

https://orcid.org/0009-0007-7777-3019КодоеваД. Г.KodoevaD. G.

Кодоева Диана Гиглаевна

283003 Донецкая народная республика, Донецк, проспект Ильича, д. 16

Diana G. Kodoeva

16 Ilyich Avenue, Donetsk, Donetsk People's Republic 283003

https://orcid.org/0009-0002-8052-4498КардановаА. С.KardanovaA. S.

Карданова Амина Сослановна

127006 Москва, ул. Долгоруковская, д. 4

Amina S. Kardanova

4 Dolgorukovskaya Str., Moscow 127006

https://orcid.org/0009-0005-5639-2263ПрошинаА. С.ProshinaA. S.

Прошина Ангелина Сергеевна

394036 Воронеж, ул. Студенческая, д. 10

Angelina S. Proshina

10 Studentskaya Str., Voronezh 394036

https://orcid.org/0009-0008-2182-7097АвбакироваА. С.AvbakirovaA. S.

Авбакирова Альбина Саламбековна

414000 Астрахань, ул. Бакинская, д. 121

Albina S. Avbakirova

121 Bakinskaya Str., Astrakhan 414000

https://orcid.org/0009-0007-4942-4671КиличевД. Р.KilichevD. R.

Киличев Джамал Рамисович

410012 Саратов, ул. Большая Казачья, д. 112

Dzhamal R. Kilichev

112 Bolshaya Kazachya Str., Saratov 410012

https://orcid.org/0009-0006-1835-7667МетовИ. Ш.MetovI. Sh.

Метов Ислам Шамильевич

410012 Саратов, ул. Большая Казачья, д. 112

Islam Sh. Metov

112 Bolshaya Kazachya Str., Saratov 410012

https://orcid.org/0009-0007-7677-8838МагомедовЛ. М.MagomedovL. M.

Магомедов Лукманхаким Магомедсаидович

410012 Саратов, ул. Большая Казачья, д. 112

Lukmankhakim M. Magomedov

112 Bolshaya Kazachya Str., Saratov 410012

https://orcid.org/0009-0004-3080-1623ГацаевД. К.GatsaevD. K.

Гацаев Джамал Казбекович

410012 Саратов, ул. Большая Казачья, д. 112

Dzhamal K. Gatsaev

112 Bolshaya Kazachya Str., Saratov 410012

https://orcid.org/0009-0005-1595-723XБалабановаМ. Э.BalabanovaM. E.

Балабанова Мария Эрнестовна

355017 Ставрополь, ул. Мира, д. 310

Maria E. Balabanova

310 Mira Str., Stavropol 355017

https://orcid.org/0009-0006-0815-2641МуталиеваХ. Б.MutalievaKh. B.

Муталиева Хади Башировна

355017 Ставрополь, ул. Мира, д. 310

Khadi B. Mutalieva

310 Mira Str., Stavropol 355017

https://orcid.org/0009-0009-3867-7360АлибековаЗ. М.AlibekovaZ. M.

Алибекова Заира Магомедкаримовна

355017 Ставрополь, ул. Мира, д. 310

Zaira M. Alibekova

310 Mira Str., Stavropol 355017

ФГБОУ ВО «Российский университет медицины» Министерства здравоохранения Российской ФедерацииРоссияRussian University of Medicine, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Башкирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияBashkir State Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Донецкий государственный медицинский университет имени М. Горького» Министерства здравоохранения Российской ФедерацииРоссияM. Gorky Donetsk National Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Воронежский государственный медицинский университет имени Н.Н. Бурденко» Министерства здравоохранения Российской ФедерацииРоссияBurdenko Voronezh State Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Астраханский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияAstrakhan State Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Саратовский государственный медицинский университет имени В.И. Разумовского» Министерства здравоохранения Российской ФедерацииРоссияRazumovsky Saratov State Medical University, Ministry of Health of the Russian FederationRussian FederationФГБОУ ВО «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияStavropol State Medical University, Ministry of Health of the Russian FederationRussian Federation20200108202500Online First2519Copyright © Kozhukhov N.D., Karpova A.R., Sadretdinova A.A., Kodoeva D.G., Kardanova A.S., Proshina A.S., Avbakirova A.S., Kilichev D.R., Metov I.S., Magomedov L.M., Gatsaev D.K., Balabanova M.E., Mutalieva K.B., Alibekova Z.M., 20202020Кожухов Н.Д., Карпова А.Р., Садретдинова А.А., Кодоева Д.Г., Карданова А.С., Прошина А.С., Авбакирова А.С., Киличев Д.Р., Метов И.Ш., Магомедов Л.М., Гацаев Д.К., Балабанова М.Э., Муталиева Х.Б., Алибекова З.М.Kozhukhov N.D., Karpova A.R., Sadretdinova A.A., Kodoeva D.G., Kardanova A.S., Proshina A.S., Avbakirova A.S., Kilichev D.R., Metov I.S., Magomedov L.M., Gatsaev D.K., Balabanova M.E., Mutalieva K.B., Alibekova Z.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2519

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) exert prominent metabolic and immunomodulatory properties that make them promising agents for the correction of reproductive disorders in obese women. Weight loss, increased insulin sensitivity, normalization of androgen profiles, and restoration of ovulatory function are primarily relevant in polycystic ovary syndrome (PCOS) and unexplained infertility. At the level of immune regulation, GLP-1RAs contribute to downregulated pro-inflammatory cytokine expression, increased percentage of regulatory T cells (Treg), and recovered Th17 (T helper 17 cells)/Treg balance, thereby improving endometrial receptivity and conditions for successful implantation. A close association has been established between obesity, insulin resistance, and chronic inflammation collectively contributing to reduced fertility and increased risk of recurrent miscarriage. GLP-1RAs target key pathogenic mechanisms underlying these conditions, extending beyond their glucose-lowering effects. Furthermore, their potential in decreasing the incidence of immune-related reproductive losses has been observed. Despite high efficacy before pregnancy, the use of GLP-1RAs during gestation remains limited due to potential embryotoxicity. The lack of large-scale randomized clinical trials in reproductive cohorts restrains the broad integration of these agents into clinical protocols. A promising direction is introduction of GLP-1RAs in preconception preparation regimens for women with obesity, PCOS, and immune imbalance.

Агонисты рецепторов глюкагоноподобного пептида-1 (АрГПП-1) обладают выраженными метаболическими и иммуномодулирующими свойствами, что делает их перспективными средствами для коррекции репродуктивных нарушений у женщин с ожирением. Снижение массы тела, повышение чувствительности к инсулину, нормализация андрогенного профиля и восстановление овуляторной функции особенно актуальны при синдроме поликистозных яичников (СПКЯ) и необъяснимом бесплодии. На уровне иммунной регуляции АрГПП-1 способствуют снижению экспрессии провоспалительных цитокинов, увеличению доли регуляторных Т-клеток (англ. regulatory T cells, Treg) и восстановлению баланса Th17 (англ. T helper 17 cells; Т-хелперы 17)/Treg, тем самым улучшая рецептивность эндометрия и условия для успешной имплантации. Установлена тесная связь между ожирением, инсулинорезистентностью и хроническим воспалением, которые совместно способствуют снижению фертильности и повышению риска привычного выкидыша. АрГПП-1 воздействуют на ключевые патогенетические звенья этих состояний, выходя за рамки сахароснижающей терапии. Кроме того, наблюдается их потенциал в снижении частоты иммунозависимых репродуктивных потерь. Несмотря на высокую эффективность до наступления беременности, применение АрГПП-1 в гестационный период остается ограниченным из-за потенциальной эмбриотоксичности. Отсутствие масштабных рандомизированных клинических исследований в репродуктивной когорте сдерживает широкую интеграцию этих препаратов в клинические протоколы. Перспективным направлением остается включение АрГПП-1 в схемы прегравидарной подготовки у женщин с ожирением, СПКЯ и иммунным дисбалансом.

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