Abstract
Objective — to study the nature of changes in carbohydrate and lipid metabolism, depending on the distribution and activity of visceral adipose tissue (VAT), and the degree of liver steatosis in patients with nonalcoholic fatty liver disease (NAFLD) against the background of a metabolic syndrome (MS). Materials and methods. Were examined 62 patients with NAFLD: 26 men (40 %) and 36 women (60 %). The mean age of patients was 57.3 ± 9.2 years. The control group consisted of 30 healthy donors of the same age group of males and females. All patients were assessed the parameters of an objective examination and laboratory and instrumental examination in accordance with the current order MOH № 826 from 06.11.2014. In addition to the standard survey, the body composition of patients was monitored, and the visceral adiposity index (VAI) was calculated by the method of Amato MC (2010) to determine visceral adipose tissue dysfunction (VAT). Statistical processing of data was carried out using the SPSS 17.0 software package. Results. In patients with NAFLD, elevated insulin levels 29.23 ± 5.26 μS/ml were established in comparison with control group 6.83 ± 2.08 μS/ml and a significant increase in the HOMA index to 8.93 ± 3.01 μmol fructose/1 g Nv (p < 0.05). The maximum levels of insulin and the HOMA-IR index were found in patients with high IVO that exceeded 5μm. unit. Concentrations of total cholesterol (CH), triglycerides (TG), low density lipoprotein (LDL) in patients with NAFLD were also significantly higher than those in the control group (p < 0.05). The maximal TG level 2.87 ± 0.14 mmol was observed in patients with high IVO (p < 0.05). In addition to the changes in carbohydrate and lipid metabolism rates, with the degree of fusion of IVO, the steatosis rates (p < 0.05) also increased. Conclusions. The obtained data evidence about the dependence of the depth of the carbohydrate and lipid metabolism violations on the activity. In patients with NAFLD against the background of MS, index HOMA-IR and CH, TG, LDL and degree of steatosis significantly increased with the growth of IVO (p < 0.05), which makes it possible to consider IVO as a significant additional prognostic criterion for the risk of development of not only metabolic disorders, but also as a risk factor for the progression of fibroblastic processes.
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