LIFE QUALITY EVALUATION OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE AND CONCOMITANT SUBCLINICAL HYPOTHYROIDISM
About the author:
Feysa S. V., Chopei I. V., Siksai L. T., Tovt-Korshynska M. I.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The article is devoted to the study of life quality as an integral indicator of health status in patients with a combination of non-alcoholic fatty liver disease (NAFLD) and subclinical hypothyroidism. The purpose of the work is to evaluate the quality of life indicators for the patients with non-alcoholic fatty liver disease on carbohydrate metabolism disorder background and concomitant subclinical hypothyroidism, and to compare them with the corresponding indicators of euthyroid patients suffering from non-alcoholic fatty liver disease with pre-diabetes or type 2 diabetes mellitus (T2-DM). Material and methods. There have been examined 110 patients with non-alcoholic fatty liver disease (groups 1-5) and 20 healthy persons (check group 6). Subclinical hypothyroidism was diagnosed in 40 patients with non-alcoholic fatty liver disease, including 20 persons who were suffering from diabetes mellitus (group 1) and 20 patients with pre-diabetes (group 2). Another 30 patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus were included in group 3; 20 persons with non-alcoholic fatty liver disease and concomitant pre-diabetes – in group 4, and 20 patients with non-alcoholic fatty liver disease and normal carbohydrate metabolism, without concomitant diseases, formed group 5 (groups 3, 4 and 5 consisted of patients with normal thyroid status, i.e. euthyroid persons). We used clinical, laboratory and instrumental (ultrasonography) methods to verify diagnoses of non-alcoholic fatty liver disease, type 2 diabetes mellitus, pre-diabetes and subclinical hypothyroidism. For evaluation of life quality we used the Medical Outcomes Study Short Form 36 (MOS SF-36) questionnaire, which consists of 36 questions grouped in 8 scales. The questionnaire allows to evaluate the physical (scale 1-4) and mental (scale 5-8) components of health. Statistical processing of results was carried out by use the “Statistica 10.0”. Results. It has been detected that the presence of isolated non-alcoholic fatty liver disease (without concomitant diseases) significantly affects only the physical functioning indicators and physical role functioning, without causing significant changes in other scales of the questionnaire. The addition of concomitant carbohydrate metabolism disorders (pre-diabetes or type 2 diabetes mellitus) in patients with non-alcoholic fatty liver disease is accompanied by a significant (p ˂ 0,05) deterioration of indicators of the physical role functioning scale and the scale of the general health perceptions, which are the elements of physical health component, as well as decrease of indicators of vital activity scale and emotional role functioning which are the components of mental health. In cases when non-alcoholic fatty liver disease on carbohydrate metabolism disorders background combines with concomitant subclinical hypothyroidism (a combination of three diseases), there are changes in all 8 scales, most of which are significantly different from the corresponding indicators of persons with isolated non-alcoholic fatty liver disease (without concomitant diseases) and from indicators of patients with a combination of NAFLD and carbohydrate metabolism disorders on the euthyroidism background. Conclusion. Concomitant subclinical hypothyroidism is an reliable factor of the deterioration of the life quality in patients with combination of non-alcoholic fatty liver disease and carbohydrate metabolism disorder. This allows to consider subclinical hypothyroidism to be not just a laboratory abnormality, but a complete illness, which requires correction if combined with another pathology.
life quality, subclinical hypothyroidism, non-alcoholic fatty liver disease, carbohydrate metabolism disorder, combined course
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 193-196 pages, index UDK 616.36–003.826:616.441-008.63