Ліпідні маркери прогнозування неалкогольної жирової хвороби печінки в юнаків із гіпоандрогенією

Abstract

Metabolic syndrome (MS) and the conditions associated with it are pressing problems for humanity. The gastroenterological component of MS is considered to be non-alcoholic fatty liver disease (NAFLD). There are no scientific studies on the influence of hypoandrogenism (HA) on metabolic control and the formation of NAFLD in adolescent boys. Purpose - to determine the prognostic value of changes in the lipid profile for the formation of NAFLD in adolescent boys with HA. Materials and methods. In 2019-2021 was carried out a comprehensive examination of 107 adolescent boys aged 13-18 with HA: the clinical examination, blood tests to determine the level of γ-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, lipidogram, testosterone, immunoreactive insulin. The morpho-functional state of the hepatobiliary system was studied by ultrasound, according to the results of which adolescent boys with HA were divided into observation groups (the Group 1 - with normal liver parameters, the Group 2 - with signs of steatosis). Prognostic assessment of the formation of liver steatosis in HA was carried out using ROC analysis with AUC calculation. Results. According to the ultrasound signs of NAFLD was detected in a third of adolescent boys with HA. The state of insulin resistance was established in 22% of adolescent boys, significantly more often in patients with NAFLD. Analysis of blood lipid spectrum indicators in young men with HA showed the presence of proatherogenic changes more pronounced in the group with NAFLD. ROC analysis for quantitative biochemical indicators demonstrated that while using the distribution point for β-lipoproteins >5.8 g/l for the detection of liver enlargement as a sign of NAFLD in adolescent boys with HA the sensitivity was 72.0%, the specificity - 55.3%. The value of the area under the ROC curve was 0.624 [0.514; 0.725] with the level of statistical significance p=0.045. Conclusions. A third part of adolescent boys with HA according to ultrasound examination had signs of NAFLD at the stage of steatosis. Atherogenic dyslipidemia was found in all adolescents with HA, which was more pronounced in patients with NAFLD. The predictive value of determining the level of β-lipoproteins for the detection of NAFLD in adolescent boys with HA was revealed. The determination of β-lipoproteins may be economically feasible in relation to the diagnostic examination of adolescent boys with HA. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.