The aim of the work was to study the features of fatty acids of erythrocyte membranes and blood serum in patients with alcoholic fatty liver disease (AFLD) with different necroinflammatory activity to identify biomarkers of steatohepatitis. Material and methods. 43 men (48.5 ± 8.1 years) with AFLD with different degrees of necroinflammatory activity according to the AshTest test were examined: Group 1 (n = 23) with minimal activity of A0–1 (steatosis), Group 2 (n = 20) – with pronounced activity of A2–3 (steatohepatitis). The study of the composition of fatty acids (FAs) of erythrocyte membranes and blood serum was carried out using gas chromatography/mass spectrometry (Agilent 7000B, USA). Results. The levels of arachidonic acid C20:4n-6 (p = 0.000018), total content (C20:5n-3+ C22:6n-3) (p = 0.0027), total content of all omega-3 polyunsaturated fatty acids (PUFA) (p = 0.003), levels of docosahexaenoic acid C22:6n-3 (p = 0.0046), docosapentaenoic acid C22:5n-3 (p = 0.0054), docosatetraenoic acid C22:4n-6 (p = 0.01), eicosapentaenoic acid C20:5n-3 (p = 0.048) in erythrocyte membranes and the same acid in blood serum (p = 0.0015) were statistically significantly higher in patients with alcoholic steatohepatitis. In contrast, the concentrations of α-linolenic acid C18:3n-3 (p = 0.0032), hexadecadienoic acid C16:2 n-6 (p = 0.026), palmitoleic acid C16:1;9 (p = 0.033), pentadecanoic acid C15:0 (p = 0.04), the SFA/PUFA ratios (p = 0.017), SFA/UFA (p=0.029) were lower in patients with alcoholic steatohepatitis compared to steatosis. The use of levels of individual FAs or their total content in erythrocyte membranes provided sufficient levels of diagnostic accuracy in distinguishing the degree of necroinflammatory activity in patients with AFLD: arachidonic acid – AUC 0.940, sensitivity 85.7%, specificity 84.6%; total PUFA content – AUC 0.874, sensitivity 78.6%, specificity 84.6%; docosapentaenoic acid – AUC 0.876, sensitivity 78.6%, specificity 76.9%; sum content (C20:5n-3 + C22:6n-3) – AUC 0.863, sensitivity 71.5%, specificity 84.6%. The combined ᾽panel᾽, including a minimum amount of FAs of erythrocyte membranes – C20:4n-6, C18:3n-3, SFA/PUFA, provided the highest levels of diagnostic accuracy – AUC 0.954; 95% CI 0.8-1.0, sensitivity 92.7%, specificity 90.3%. Conclusion. FAs of erythrocyte membranes, blood serum should be considered as promising pathogenetically substantiated biomarkers for identifying patients with steatohepatitis in AFLD.
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