THE INTENSITY OF OXIDATIVE STRESS AND THE STATE OF THE FACTORS OF ANTIOXIDANT PROTECTION IN PATIENTS WITH NONALCOHOLIC STEATOHEPATITIS THROUGH THE PRISM OF COMORBIDITY WITH OSTEOARTHRITIS AND OBESITY

Abstract

Objective. To investigate the pathogenetic role of processes of free radical oxidation of lipids (FROL), oxidative modification of proteins (OMP) and factors of antioxidant defense (AOD) in development and mechanisms of mutual burden in patients with nonalcoholic steatohepatitis in the context of comorbidities with osteoarthritis and obesity. Material and methods . 90 patients were divided into three groups: group I (n = 30) patients suffering from OA II-III for Kellgren and Lawrense with normal body mass (BMI = 21-25 kg / m 2 ), group II (n = 30) - patients with NASH and obesity without OA (BMI> 30 kg / m 2 ), group III (n = 30) - patients with OA with NASH and obesity (BMI more than 30 kg / m 2 ). The control group consisted of 30 healthy individuals of the corresponding age. The average age of patients was (62,3 ± 5,7) years. Results. The peculiarity of the clinical course of NASH against the background of obesity and OA is the highest among the groups of comparing growth of MA content in plasma and Er - respectively in 1,97 and 2,12 times (p<0,05) compared with the normative ones. For patients with nonalcoholic steatohepatitis, obesity and osteoarthritis, the following changes in the content of intermediate molecular products of POL in the blood were: a possible increase in the content of IDB in the blood in 2,44 times; DC- in 2,92 times and the content of KCT in the blood – in 4,14 times (p <0,05). In addition, a probable increase in OMP intensity was found: the content of AKDNFHNC and AKDNFHMC exceeded the values in 2,40 and 1,85 times (p <0,05) respectively. In assessing the state of functioning of the AOP system for the comorbid flow of NASH, OB and OA, the maximum reduction in the content of GR - in 1,86 times (p <0,05) was established. Regarding the functioning of the glutathione dependent enzyme (glutathione peroxidase), the expected maximum increase in the enzyme activity was confirmed in 1,72 times (p <0,05). In the course of the correlation analysis between the indicators of the intensity of the POL and the main markers of cytolytic, cholestatic, mesenchymal - inflammatory syndromes, the presence of direct communication has been established, the inverse correlation connection is between the content of glutathione recovered and markers of the above syndromes. Conclusion. As a result of the study, it was found that the comorbidity of NASH with OB and OA increases the intensity of oxidative stress. The uncontrolled intensification of the processes of free radical oxidation of lipids and proteins in patients with non-alcoholic steatohepatitis, which developed on the background of obesity, determines the degree of activity of the pathological process in the liver.