Possibilities of using electrical and viscoelastic parameters of erythrocytes for the diagnosis of steatohepatitis in patients with fatty liver disease

M. Kruchinina, M. V. Parulikova, A. Belkovets, A. Gromov
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Abstract

Aim: to study the possibilities of using electrical and viscoelastic parameters of erythrocytes to differentiate steatohepatitis from liver steatosis. Patients and Methods: 84 men (48.9±2.5 years) with fatty liver disease diagnosed by abdominal ultrasound were examined. Liver fibrosis severity, which did not exceed grade 1, was determined by indirect elastometry on the FibroScan® 502 Echosens device (France), with confirmation using the FibroTest–ActiTest test system (BioPredictive, France). Patients were divided into 2 groups according to the severity of hepatic necroinflammatory activity, assessed using the same test system. Group 1 (n=44) included patients with hepatic steatosis with minimal histologic disease activity (A 0–1); group 2 (n=40) included patients with steatohepatitis with significant necro-inflammatory activity (A 2–3). The electrical and viscoelastic parameters of erythrocytes were determined by dielectrophoresis at 4 frequencies of an inhomogeneous alternating electric field. Results and Discussion: the most significant electrical and viscoelastic indicators allowing to differentiate steatohepatitis from fatty liver disease were reduced values of strain amplitude at a frequency of 1 MHz (p=0.0003), dipole moment (p=0.009), capacity (p=0.014) and cell polarizability at a frequency of 1 MHz (p=0.03) and more high summarized viscosity (p=0.006), rigidity (p=0.005) and electrical conductivity (p=0.008). Diagnostic panel, including a set of electrical and viscoelastic parameters of erythrocytes, for the differentiation of steatohepatitis from steatosis demonstrated the following: AUC 0.904, sensitivity 0.9, specificity 0.83. Correlations of erythrocyte parameters with indicators of cytolysis syndrome (transaminase activity, serum iron levels, direct bilirubin) and serum inflammatory markers (fibrinogen, C-reactive protein, ferritin) were established. Conclusion: the electrical and viscoelastic parameters of erythrocytes studied using the dielectrophoresis should be considered as a new promising method in determining the severity of fatty liver disease. KEYWORDS: fatty liver disease, steatohepatitis, steatosis, electrical and viscoelastic parameters, erythrocytes, dielectrophoresis, diagnostic model. FOR CITATION: Kruchinina M.V., Parulikova M.V., Belkovets A.V., Gromov A.A. Possibilities of using electrical and viscoelastic parameters of erythrocytes for the diagnosis of steatohepatitis in patients with fatty liver disease. Russian Medical Inquiry. 2023;7(5):249–257 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-2.
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利用红细胞电和粘弹性参数诊断脂肪肝患者脂肪性肝炎的可能性
目的:探讨利用红细胞电性和粘弹性参数鉴别脂肪性肝炎和肝脂肪变性的可能性。患者与方法:对84例经腹部超声诊断为脂肪肝的男性(48.9±2.5岁)进行检查。肝纤维化严重程度不超过1级,通过间接弹性测量法在FibroScan®502 Echosens设备(法国)上确定,并使用FibroTest-ActiTest测试系统(BioPredictive,法国)进行确认。根据肝坏死炎症活动的严重程度将患者分为2组,采用相同的测试系统进行评估。第1组(n=44)包括组织学疾病活动度最小的肝脂肪变性患者(A 0-1);第二组(n=40)包括有明显坏死-炎症活动的脂肪性肝炎患者(A 2 - 3)。在非均匀交变电场的4个频率下,用介质电泳法测定了红细胞的电学参数和粘弹性参数。结果和讨论:区分脂肪性肝炎和脂肪性肝病的最重要的电学和粘弹性指标是1 MHz频率下的应变幅度(p=0.0003)、偶极矩(p=0.009)、容量(p=0.014)和1 MHz频率下的细胞极化率(p=0.03)和更高的总粘度(p=0.006)、刚度(p=0.005)和电导率(p=0.008)。鉴别脂肪性肝炎和脂肪变性的诊断结果包括红细胞电性和粘弹性参数,AUC为0.904,敏感性为0.9,特异性为0.83。建立红细胞参数与细胞溶解综合征指标(转氨酶活性、血清铁水平、直接胆红素)和血清炎症指标(纤维蛋白原、c反应蛋白、铁蛋白)的相关性。结论:用电泳法研究红细胞的电性和粘弹性参数,可作为判断脂肪肝严重程度的一种新方法。关键词:脂肪肝,脂肪性肝炎,脂肪变性,电和粘弹性参数,红细胞,电泳,诊断模型。引文:Kruchinina m.v., Parulikova m.v., Belkovets a.v., Gromov A.A.使用红细胞电和粘弹性参数诊断脂肪肝患者脂肪性肝炎的可能性。俄罗斯医学调查。2023;7(5):249-257(俄文)。DOI: 10.32364 / 2587-6821-2023-7-5-2。
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