РОЛЬ АДИПОКИНОВ В ВОПРОСАХ ДИАГНОСТИКИ НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ

Abstract

Introduction. Currently, the main cause of chronic liver diseases and one of the leading indications for transplantation is considered to be non-alcoholic fatty liver disease (NAFLD). The pathophysiology of the disease closely correlates with the abnormal relationship between adipose tissue and the liver, since inflammation is tightly linked to lipid metabolism. Metabolic dysfunction is manifested by insulin resistance of hepatic tissue, processes of fat accumulation in the cell (steatosis), inflammation in the form of steatohepatitis and, as the end of this process, fibrosis. Much attention is now being paid to hormones produced by adipose tissue, namely adipokines, due to their immunometabolic activity. The accumulated clinical database associates adipokines with the progression of NAFLD which may serve to expand the boundaries of diagnosis and the course of this disease. Aim. To determine the diagnostic significance of adipokines as markers of the development and progression of NAFLD in patients taking into account their nutritional status. Materials and methods. The study included a comprehensive assessment of nutritional status, including anthropometric parameters, bioimpedance analysis, assessment of actual nutrition, and evaluation of biochemical and hormonal parameters of patients. The study was performed at the Novosibirsk Regional Clinical Hospital for War Veterans No. 3 and the Research Institute for Therapy and Preventive Medicine, a branch of the Novosibirsk Institute of Cytology and Genetics. A total of 349 people participated in the study, including 113 NAFLD patients without obesity, 122 NAFLD patients with obesity, and 114 conditionally healthy individuals. Results. In patients with NAFLD, both obese and non-obese, compared to the control group, there are changes in body composition, biochemical parameters , as well as non-adherence to diet were detected when assessing actual nutrition. According to the results of the hormonal study, the patients have an increased level of adipokines. Adipsin values are significantly higher in the group of patients with NAFLD combined with obesity compared to the group of patients with NAFLD without obesity. The levels of visfatin, adipsin and PAI-1 confirmed their relationship with the nutritional status of patients with NAFLD, biochemical parameters, and non-invasive steatosis indices, while the level of visfatin was also associated with the fibrosis index FIB-4. Conclusion. The levels of adipokines can be considered as a non-invasive diagnostic marker reflecting the course and progression of NAFLD in patients with different nutritional status.