Clinical features of the non-alcohol fat liver disease in advanced age patients with type 2 diabetes mellitus

Abstract

Age features of the course of non-alcoholic fat liver disease are insufficient in literature and need to be refined in the context of correction of treatment regimens, taking into account the age of the patient.Objective is to study the features of the course of non-alcoholic fat liver disease (NAFLD) in men and women associated with type 2 diabetes in the elderly (60-75 years).Material and methods. Retrospective study of the history of the disease of 58 patients of the elderly (60-75 years of age), patients with NAFLD in combination with diabetes type 2. In order to identify the diagnosis of NAFLD complex the data of clinical, laboratory, biochemical and instrumental studies were taken in full compliance with the standards of the examination of patients with pathology of the organs of the gastrointestinal tract -cabbage tract. By the time of the examination, the patients did not receive treatment for NAFLD according to standard procedures. Statistical processing of the results was carried out using Statistica 6.1.Results. The average age of patients was (64,58 ± 0,66) years. Among them, men — 24,1%, women — 75,9%. The term for diabetes was 1 to 53 years, on average (14,61 ± 1,43) years, more than half of patients were ill from 11 to 20 years — 55.2%. 28 patients (46.7%) had NAFLD in the stage of fatty liver infiltration. Steatohepatitis, dyslipidemia were diagnosed in 53,3% of cases (30 patients). In this group, in 20.69% of cases, stage I of fatty hepatosis was diagnosed, in 51.73% of cases — stage II, in 27.58% of cases — stage III. The diameter of the portal vein was more than 10 mm in 16 patients (27.58%). The palpation of the liver was enlarged and protruded at (1.81 ± 0.07) cm from the edge of the rib arch (from 1.0 to 2.5 cm) in 36 patients (62,063%). The functional state of the liver remained satisfactory. Protein, pigmentary and lipid metabolism were characterized by indicators in the reference limits of the indicator in healthy individuals; Thymol test for women, showed the expressed signs of mesenchymal-inflammatory syndrome. Low levels of high density lipoprotein, high levels of low and very low density lipoprotein and high levels of atherogenicity are detected; increase in the content of triglycerides in men. Conclusions. In men and women with non-alcoholic fatty liver disease on the background of type 2 diabetes, the development of diabetic complications proceeded in the same manner. However, women have a lower percentage of cases of discirculatory mixed encephalopathy of the 1st stage, in men I-III st .; more often a damage to the retina, dysmetabolic myocardiopathy and nephropathy were found. The stage of fatty liver infiltration was found in 28 patients (46.7%), steatohepatitis, dyslipidemia was diagnosed in 53.3% of cases. Half of the patients have stage II hepatosis, significant deviations in the lipid profile of the blood, which keeps a high risk of atherosclerosis, especially in men.