Role of biochemical and hemodynamic indicators in assessing the progression of liver fibrosis of various origins

Abstract

Objective — to determine the peculiarities of biochemical and hemodynamic indices in patients with chronic HCV and NAFLD, their interrelations with the liver elastography data.Materials and methods. 195 patients, among whom there were 94 (48.2 %) patients with chronic HCV and 101 (51.8 %) patients with NAFLD. Determined content alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, and gamma-glutamyl transpeptidase, hydroxyprolins, hexosamines orosomucoid, medium molecular peptides, bile acids and lipoproteins. The transient elastography of liver was carried out in the Shear Wave Elastography (SWE) on the Soneus P7 scanner (Ukraine). The Dopplerography was used to assess the hepatic and splenic arteries, hepatic and splenic veins. In each vessel the volume velocity of the blood flow, the average linear velocity of blood flow, vessels diameter, perfusion index and resistance index were measured.Results. The analysis of liver fibrosis indicators showed a tendency to activation of collagen synthesis, which was testified by an increase of protein-bound hydroxyproline content in patients. The level of connective tissue decay products (free hydroxyproline) had a tendency to decrease in patients with chronic HCV (p < 0.05). The obtained data and the established correlation in the group of patients with chronic HCV between protein-bound hydroxyproline level with hepatic stiffness according to SWE data in kPa (r = 0,44, p < 0.05). Median values of Young’s module were higher in patients with chronic HCV (p < 0.05). Positive correlation with Young’s module (r = 0.65, p < 0.05) is established in chronic HCV patients. The patients with chronic HCV have established a positive correlation between Young's module (Е) and Vmean in the splenic artery (r = 0.59, p < 0.05). A positive correlation between the concentration of MMP and Vmean in the hepatic artery (r = 0.54, p < 0.05) has been identified in the group of patients with NAFLD.Conclusions. According to the biochemical study of blood, the indices of the and cholestatic syndromes were reliably higher in patients with viral disease factor than in patients with NAFLD (p < 0.05). In the same category of patients, lower indicators of protein-syntesized liver function were observed (p < 0.05). In patients with chronic HCV and NAFLD, according to Dopplerography data, the diameters of hepatic and splenic veins were increased while decreasing the linear velocity of blood flow (p < 0.05).