Возможности метода диэлектрофореза эритроцитов в дифференцировании жировой болезни печени алкогольного и неалкогольного генеза у мужчин

The aim of the work is to study the possibilities of distinguishing between men with fatty disease of alcoholic  and non-alcoholic origin using the viscoelastic parameters of erythrocytes - deformation amplitude,  summerized indicators of viscosity and rigidity (baseline and after exposure to ethanol in vitro) obtained using the method of erythrocyte dielectrophoresis; to determine associations of the amplitude of deformation, summerized viscosity and rigidity of erythrocytes with blood lipid levels. The study involved 54 men (44,62±1.52 years) with fatty liver disease according to ultrasound of the abdominal organs, the severity of fibrosis corresponded to 0-1 (FibroScan® 502 Echosens, France). All patients underwent a study of the viscoelastic parameters of erythrocytes - the amplitude of deformation, summerized indicators of viscosity  and rigidity by the dielectrophoresis method: the baseline level of indicators was determined, as well as their  values after exposure of red blood cells with 10 μl of 0,0 2% ethanol solution in vitro for 300 s. The dynamics of changes in the viscoelastic parameters of erythrocytes during the experiment with alcohol in patients with fatty liver disease of unknown origin made it possible to highlight two groups with diametrically opposite trends in erythrocyte indices. The group with a decrease in the amplitude of erythrocyte deformation against the background of an increase in summerized viscosity and rigidity ( n = 26) consisted mainly of patients with metabolic syndrome who do not drink or occasionally consume alcohol in low doses (less than 20 g in terms of pure ethanol). Group with increased erythrocyte deformability and decrease in summerized viscosity and  rigidity ( n = 28) includes systematic alcohol consumers who were in a state of abstinence. Ethanol exposure,  important energy substrate of this group, built into metabolic processes, led to an increase in the amplitude of  cell deformation. Correlations of the viscoelastic parameters of erythrocytes with the style of alcohol  consumption, components of the metabolic syndrome, lipid profile indicators, and liver tests were established.  Direct associations of the amplitude of erythrocyte deformation with the level of HDL cholesterol and inverse - with the values of total cholesterol, LDL cholesterol, triglycerides were identified. Summarized viscosity and rigidity correlated with the levels of these lipid indicators inversely compared with the amplitude  of deformation. The diagnostic accuracy of distinguishing between NAFLD and AFLD using models, including  the viscoelastic parameters of erythrocytes and their changes after exposure to ethanol, using Random Forest and SVM methods reached 99 %, sensitivity of 98 % and specificity of 99 %.