EVALUATION OF CONTENT OF CITOKINS IN PATIENTS’ BLOOD WITH NON-ALCOHOLIC STEATOHEPATITIS COMBINED WITH DIABETES MELLITUS TYPE 2 UNDER THE INFLUENCE OF COMBINED SUCTIONAL THERAPY
About the author:
Pavlovskyi S. A.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The purpose of the study is to optmize the treatment of patents with non-alcoholic steatohepatts associated with diabetes type 2 by pathogenetc approach, depending on the specifcs of the course of the disease. Object and methods of research: the study was conducted on 25 patents. Patents’ age was (56.2 ± 2.05) years (control group – 20 healthy individuals). The observaton tme is 1 month. In order to identfy the diagnosis of NASH complex the data of clinical, laboratory, biochemical and instrumental studies were taken into consideraton, according to the standards of examinaton of patents with pathology of organs of the gastrointestnal tract. By the tme of the examinaton, the patents did not receive NASH treatment according to standard procedures. A mandatory diagnostc method was the implementaton of an ultrasound study to determine the size of the partcles of the liver. The biochemical blood test included: determinaton of protein (total protein content, thymol test), lipid (total cholesterol, triglycerides, high, low and very low density lipoprotein), pigmentary metabolism (total bilirubin), enzyme (aspartate aminotransferase, AST), alanine aminotransferase, ALT), alkaline phosphatase, gamma-glutamyltranspeptdase, and glucose levels in the onset of blood; general blood test. The content of adiponectn was determined by the immune enzyme method (ELISA method, analyzer and test system, Mediagnost GmbH, Germany). Determinaton of the content of interleukin-6 (IL-6) was carried out in a supernatant from peripheral blood lymphocytes, which was obtained afer oxygen-free incubaton and centrifugaton, parameters were evaluated using ECLIA (Sobas Roche) and tumor necrosis factor-alpha (FNP-α, immunochemical method with chemiluminescent detecton, Immulite 100, Siemens AG, Germany). The content of C-reactve protein in blood was determined in blood serum using latex turbidimetric method – “Cobas 6000 (with 501 module; Roche Diagnostcs (Switzerland). Treatment of NASH was carried out in accordance with the “Unifed clinical protocol of primary, secondary (specialized) medical aid. Non-alcoholic steatohepatts” (Order of the Ministry of Health of Ukraine dated November 06, 2014, No. 826). In the applicaton of integrated treatment with combined hypoglycemic therapy (diabetes and pioglitazone), the results of treatment showed a signifcant improvement in the subjectve state of patents. Complaints about the feeling of discomfort in the right hypochondrium, general weakness, biterness in the mouth, ﬂatulence, nausea and dizziness have decreased signifcantly. Pain syndrome decreased by 1.4 tmes; dyspepsia syndrome – 1.7 tmes, loss of appette – 1.7 tmes, astenovegetatve syndrome – 1.3 tmes. Objectvely, the subcategory of sclera has decreased by 1.5 tmes; tongue bursts – 2 tmes; liver decrease in 1,3 tmes, pain of the liver during palpaton decreased by 1,4 tmes); the compacton of the liver parenchyma decreased by 1.5 tmes). The cytokine background in patents under the inﬂuence of treatment was characterized by the following changes: the level of FNP-α decreased by 1.4; in the II stage – in 1,52 and in the third – in 1,2 tmes. The content of IL-6 decreased in patents with the corresponding stages І, ІІ and ІІІ – in 1,2; in 1.18 and 1.41 tmes. The content of Creactve protein content at stages І, ІІ and ІІ decreased by 1.21; in 1.19 and 1.2 tmes. An increase in the content of adiponectn was found to be 1.44 tmes. In all patents, the cytolysis, mesenchymal-inﬂammatory syndrome, cytology, hemograms, and lipid metabolism have stabilized, which confrms the positve lipidotrophic eﬀect of the complex eﬀects of diabetes and pioglitazone on the functonal state of hepatocytes, and indicates a decrease in insulin resistance and improved B-cell functon.
non-alcoholic faty liver disease, diabetes mellitus type 2, combinaton therapy, cytokines
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 170-175 pages, index UDK 616.36-003.826