CLINICAL AND PATHOGENETIC FEATURES OF NONALCOHOLIC STEATOHEPATITIS FOR COMORBIDITY WITH CHRONIC KIDNEY DISEASE AND OBESITY

Antoniv A. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The purpose of our study was to study the changes in the functional state of the liver in patients with non-alcoholic steatohepatitis in combination with chronic kidney disease and obesity. Object and methods of research. 140 patients with NASH were examined: 68 patients with NASH and obesity of the I degree (group 1) and 72 patients with NASH and comorbid obesity of the I degree and CKD of the І-ІІ stages (group 2). To determine the dependence of the NASH course on the presence of CKD, the group of patients was randomized according to age, sex, degree of obesity. Results of research and their discussion. The article deals with the theoretical generalization of the clinical study of non-alcoholic steatohepatitis peculiarities in comorbidity with obesity and CKD of the І-ІІІ stage, characterized by higher frequency and intensity of clinical and biochemical syndromes, the manifestation of which is likely to increase with the occurrence of secondary arterial hypertension (portal hypertension syndromes, cholestasis, mesenchymal inflammation). Conclusion. Comorbid course of NASH with CKD is characterized by higher degree of liver steatosis compared with that in patients with NASH (p<0.05) and higher diagnostic threshold of the hepatorenal index values, which correlates with the Steato-test index (p<0.001) with strong interdependence.

non-alcoholic steatohepatitis, chronic kidney disease, obesity, clinical syndromes, liver steatosis

1. Babak OYa, Kolesnikova YeV, Sytnik KA. Profilakticheskiye meropriyatiya pri nealkogol’noy zhirovoy bolezni pecheni: sushchestvuyet li sposob snizit’ risk razvitiya zabolevaniya? Suchasna gastroyenterologíya. 2013;3(71):103-9. [in Russian].
2. Buyeverov AO, Bogomolov PO. Nealkogol’naya zhirovaya bolezn’ pecheni: obosnovaniye patogeneticheskoy terapii. Klinicheskiye perspektivy v gastroenterologii, gepatologii. 2009;1:3-9. [in Russian].
3. Anstee QM, Targher G, Day CP. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol. 2013;10:330-44. PMID: 23507799. DOI: 10.1038/nrgastro.2013.41
4. Abenavoli L, Peta V. Role оf adipokines and cytokines in non-alcoholic fatty liver disease. Rev. Recent Clin. Trials. 2014;9(3):134-40.
5. Castera L, Vilgrain V, Angulo P. Noninvasive evaluation of NAFLD. Nat. Rev. Gastroenterol. Hepatol. 2013;10(11):666-75.
6. Day CP, Anstee QM, Targher G. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat. Rev. Gastroenterol. Hepatol. 2013;10:330-44.
7. Kowdley KV. Advances in the diagnosis and treatment of nonalcoholic steatohepatitis. Gastroenterol. Hepatol. (N Y). 2014;10(3):184-6.
8. Mazen N, Mato JM, Shelly CL. Nonalcoholic fatty liver disease: Update on pathogenesis, diagnosis, treatment and the role of S-adenosylmethionine. Exper. Biol. and Med. 2015;240:809-20.
9. Festi D, Schiumerini R, Scaioli E, Colecchia A. Letter: FibroTest for staging fibrosis in non-alcoholic fatty liver disease – authors’ reply. Aliment. Pharmacol. Ther. 2013;37(6):656-7.
10. Gambino R, Cassader M, Pagano G. Meta-analysis: natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of noninvasive tests for liver disease severity. Ann. Med. 2011;43:617-49.

«Bulletin of problems biology and medicine» Issue 3 (145), 2018 year, 80-83 pages, index UDK 616.36-003.826+616.61-036.12]-036.1-07-08

10.29254/2077-4214-2018-3-1-145-80-83