Неалкогольная жировая болезнь печени и послеоперационный гипотиреоз у женщин: клинико-патогенетические параллели

Abstract

Objective – to establish the clinical and pathogenetic patterns of the formation and course of non-alcoholic fatty liver disease in women with postoperative hypothyroidism. Material and methods. In a single-stage study of the "case-control" type of 170 women (Me aged 50 years), anthropometric data, parameters of carbohydrate, lipid, and protein metabolism, liver function tests were studied in the presence and absence of postoperative hypothyroidism. Results. It was found that in 86.2% of women with postoperative hypothyroidism, non-alcoholic fatty liver disease develops mainly in the form of steatohepatosis without distinct functional liver disorders. Insulin resistance and atherogenic dyslipidemia are found in the vast majority of them, the degree of their severity is determined by the presence of excess body weight with android and intermediate types of fat distribution. The greatest diagnostic value in the aspect of the probability of developing non-alcoholic fatty liver disease and metabolic disorders have a body mass index of Ketle and the ratio of the waist to the circumference of the hips. For the detection of metabolic disorders, the most significant insulin resistance index HOMA-IR, HDL, VLDL, ApoB, ApoB/ApoA1 index. Conclusion. In women with postoperative hypothyroidism in 86.2% of cases non-alcoholic fatty liver disease develops mainly in the form of steatohepatosis, characterized by a oligosymptomatic course without distinct functional liver disorders, the development of insulin resistance and atherogenic dyslipidemia, the severity of which is determined by the body mass index and the type of fat distribution