МЕТАБОЛИЧЕСКИЙ ТАНДЕМ НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ И САХАРНОГО ДИАБЕТА II ТИПА

According to the forecasts of the World Health Organization, by 2020, non-alcoholic fatty liver disease (NAFLD) will occupy the 1-st place among all liver diseases. The prevalence of type 2 diabetes is as rapid as that of NAFLD. The etiopathogenetic community of type 2 diabetes mellitus and NAFLD is a subject of debate. The binding pathogenetic link of one and the other disease is a violation of lipid metabolism, insulin resistance and chronic, subclinical inflammation. Realization of these pathogenetic mechanisms, unified for NAFLD and SD2 type, is carried out primarily at the level of hepatocyte. NAFLD is a predictor of severe cardiovascular complications, multiple polytopic drug resistance, creates difficulties in the effective therapy of not only type 2 diabetes, but also many other diseases. Liver transplantation in patients with cirrhosis in the outcome of NAFLD already occupies the 2 nd place after cirrhosis of the liver of the viral etiology. In patients with NAFLD, mortality in the 1st month after surgery is significantly higher than that for cirrhosis of another etiology, and there is an increased risk of other complications of liver transplantation, such as sepsis, graft rejection and cardiovascular pathology. According to modern views, NAFLD is a liver lesion, including fatty dystrophy, fatty dystrophy with inflammation and damage to hepatocytes (nonalcoholic / metabolic steatohepatitis) and fibrosis (with the possibility of cirrhosis). Specific diagnostic criteria and standard therapy NAFLD, in practice, does not exist, most likely the diagnosis of NAFLD - “diagnosis of exclusion”. Despite the high prevalence of NAFLD to date, the problem of its effective therapy has not been solved. None of the drugs used in the treatment of NAFLD has a high evidence base. Correction of body weight, changes in food addiction, physical activity are the most effective measures preventing the development of NAFLD and elimination of those negative metabolic processes that are predictors of development of severe forms of type 2 diabetes and high risks of cardiovascular diseases.