METABOLIC AND ADIPOCYTOKINE PRECONDITIONS FOR PROGRESSION OF NON-ALCOHOLIC STEATOHEPATITIS IN OBESITY PATIENTS DUE TO COMORBIDITY WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Keywords:nonalcoholic steatohepatitis, Chronic obstructive pulmonary disease, obesity
The increasing prevalence of chronic obstructive pulmonary disease (COPD) and nonalcoholic steatohepatitis (NASH) is a problem of high importance.
Objective: to determine the state of blood lipid spectrum, glycemia, the degree of insulin resistance and their regulation by adipose tissue hormones in NASH patients against the background of obesity, depending on comorbidity with COPD.
Methods. 130 patients were examined, including 35 NASH patients with obesity of the 1st stage (1 group), 60 NASH patients with obesity of the 1st stage and COPD 2-3 D (group 2), and 35 patients with COPD 2-3 D (group 3).
Results: Blood lipid concentration in patients of the 1st and the 2nd groups exceeded the norm by 29.5% and 39.8% respectively (p<0.05). In the 3rd group - by 14.9% (p<0.05). The content of total cholesterol in the blood also points out its probable increase by 36.3%, 45.7% and 14.9% (p<0.05) in comparison with practically healthy individuals (PHI) in patients of the 1st, 2nd and 3rd groups. A probable increase in the concentration of triacylglycerols (TG) in blood (1.9 and 2.2 times, respectively (p<0.05)) was recorded in the 1st and 2nd groups of patients, while in patients of the 3rd group the changes were quite significant (1.6 times increase, p<0.05).
Conclusions. Comorbidity of COPD in obese patients and NASH is an additional, powerful-inducing factor of lipid distress syndrome with significantly higher increase (compared with NASH without lung pathology) TG in blood, which form the basis of liver steatosis, total cholesterol, low density lipoproteins, with significantly higher decrease high density lipoproteins, the atherogenic index, which are accompanied by hyperleptinemia, adiponectin deficiency, correlate with the degree of liver steatosis, fibrosis index, cytolytic activity, cholestatic, mesenchymal-inflammatory syndromes and are interrelated with hyperleptinemia, hypoadiponectinemia.
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