Особливості порушень вуглеводного й ліпідного обмінів при неалкогольній жировій хворобі печінки та її коморбідності з артеріальною гіпертензією
2020
The features of carbohydrate and lipid metabolism with comorbidity of non-alcoholic fatty liver disease and hypertension or renoparenchymal arterial hypertension were studied, the main factors affecting these indicators were evaluated. 269 patients were examined: 60 patients have been attacted by non-alcoholic fatty liver disease, 121 patients have been attacted by its comorbidity and hypertension, 88 patients have been attacted by its comorbidity with renoparenchymal arterial hypertension, the average age of the patients was (48.07±10.81) years. The control group consisted of 20 healthy individuals comparable in age and sex with the sick. Anthropometric data and blood pressure were evaluated. The concentrations of blood lipids, aminotransferase, gamma-glutamyl transpeptidases, insulin, glycosylated hemoglobin and other blood biochemical parameters, insulin resistance by the HOMA index, glomerular filtration rate were determined. Ultrasound was used. It was revealed that non-alcoholic fatty liver disease, regardless of its comorbidity with hypertension or renoparenchymal arterial hypertension, is characterized by disturbances in carbohydrate and lipid metabolism. Comorbidity causes an increase in these changes and can play an important role in the pathogenesis of diseases. The triglycerides and the NOMA index are significantly higher with comorbidity with both hypertension and renoparenchymal arterial hypertension. The indicators of low density lipoproteins are significantly higher with comorbidity with renoparenchymal arterial hypertension. Indicators of carbohydrate and lipid metabolism are closely related to indicators of blood pressure, body mass and waist / hip indices, markers of liver damage, kidney function, and the duration of the disease. The spectrum of correlation is different in patients with non-alcoholic fatty liver disease and with its comorbidity with hypertension or renoparenchymal arterial hypertension. Comorbidity is characterized by correlation between indicators of carbohydrate and lipid metabolism, on the one hand, and blood pressure and renal function, on the other. These changes indicate a pro-atherogenic potential in patients with a comorbid course of the disease, which, combined with impaired carbohydrate metabolism, leads to a significant increase in cardiovascular risk and diabetes mellitus type 2.
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