EVALUATION OF MARKERS OF TARGET ORGANS PRECLINICAL DAMAGE IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE COMBINED WITH METABOLIC SYNDROME DEPENDING ON THE OBESITY STAGE

Abstract

Purpose. Тo assess the indicators of early predictors of NAFLD in patients with MS by assessing the functional state of the liver and systemic inflammation, depending on the degree of obesity. Material and methods. The study included 90 patients with NAFLD, divided in to 3 groups: group 1 – 30 patients with NADH without MS, group 2 – patients with NADH combined with MS: with BMI 25 – 29.9 kg/m 2 (n = 30) – group 2a, with BMI > 30 kg/m 2 (n = 30) – group 2b. The control group consisted of 20 apparently healthy individuals. All patients were evaluated for the activity of ALT, AST, LDH, SDH, CHE, total bilirubin level; levels of leptin, adiponectin, TNF-α. Results. Significant increase in the level of SDH in patients of both groups was found. In patients of group 2a LDH level exceeded the value in healthy persons by 2.5 times (p < 0.05) and was 1.3 times higher than in patients of group 1 (p < 0.05); in patients of group 2b was exceeded the control index in 3.7 times (p < 0.05), in 1,6 times as compared to the patients of group 1 (p < 0.05) and 1,3 times in comparison with patients of group 2a (p < 0.05). The activity of CHE in patients of group 1 significantly was not different from the index of control (p > 0.05), in patients of group 2b significant decrease of CHE activity was found (р < 0.05). The presence of hyperleptinemia, hypoadiponectinemia, and systemic inflammatory response according to the level of TNF -α was characteristic for patients with NAFLD and MS. Conclusions. Hyperleptinemia, hypoadiponectinemia, the presence of a systemic inflammatory response to the level of TNF-α, and a violation of the synthetic and detoxification functions of the liver, which are more pronounced in patients with NAFLD and MS with concomitant obesity of І–ІІІ degrees, can be considered not only as markers of preclinical lesions of target organs, but and as an indicators of the severity of the combined flow of NAFLD and MS.