Возможности использования электрических и вязкоупругих параметров эритроцитов для диагностики стеатогепатита у пациентов с жировой болезнью печени

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.