gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1276Research ArticleГЕПАТОЛОГИЯHEPATOLOGYРаспространенность неалкогольной жировой болезни печени при ожирении и ее взаимосвязь с факторами риска сердечно-сосудистых заболеваний и сахарного диабета 2-го типаPrevalence of non-alcoholic fatty liver disease at obesity and its interrelation with cardio-vascular disease and 2nd type diabetes mellitus risk factorsМельниченкоГ. А.MelnichenkoG. A.ЕлисееваА. Ю.YeliseyevaA. Yu.МаевскаяМ. В.MayevskayaM. V.ФГБУ «Эндокринологический научный центр» Минздравсоцразвития РФРоссияГБОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздравсоцразвития РФРоссия2012170420122224553Copyright © Мельниченко Г.А., Елисеева А.Ю., Маевская М.В., 20122012Мельниченко Г.А., Елисеева А.Ю., Маевская М.В.Melnichenko G.A., Yeliseyeva A.Y., Mayevskaya M.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1276

Цель исследования. Оценить распространенность неалкогольной жировой болезни печени (НАЖБП) у больных с ожирением и определить ее взаимосвязь с кардиометаболическими факторами риска сердечно-сосудистых заболеваний (ССЗ) и сахарного диабета 2-го типа (СД-2).Материал и методы. Проведен ретроспективный анализ историй болезни 560 пациентов в возрасте от 18 до 55 лет, страдающих ожирением. В ходе исследования изучался анамнез, анализировались антропометрические параметры, уровень артериального давления, определялись липидный спектр крови, активность АлАТ, АсАТ, маркёры вирусных гепатитов – HbsAg, HCV-at (для исключения вирусной этиологии заболевания печени), уровни глюкозы и иммунореактивного инсулина натощак и на 120-й минуте стандартного глюкозотолерантного теста. Инсулинорезистентность оценивалась по показателю HOMA-IR. Метаболический синдром верифицирован по критериям IDF 2005 г. Для диагностики НАЖБП проводилось УЗИ печени.Результаты. В ходе обследования у 77,7% пациентов выявлена НАЖБП. В результате многофакторного анализа подтверждена взаимосвязь НАЖБП с факторами риска ССЗ и СД-2, такими как артериальная гипертензия, дислипидемия, нарушения углеводного обмена и инсулинорезистентность.Выводы. Результаты исследования диктуют необходимость более тщательного обследования больных, страдающих ожирением и НАЖБП, с целью раннего выявления и коррекции кардиометаболических факторов риска сердечно-сосудистых заболеваний и СД-2.

Aim of investigation

Aim of investigation. To estimate prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with obesity and to determine its interrelation with cardiometabolic risk factors of cardio-vascular diseases (CVD) and diabetes mellitus of the 2nd type (type 2 DM).

Material and methods

Material and methods. Retrospective analysis of case records of 560 obese patients aged 18 to 55 years was carried out. At the investigation past history, anthropometric data, level of blood pressure were analyzed, blood lipid spectrum, activity of ALT, AST, markers of viral hepatites – HbsAg, HCV-at (to rule out viral etiology of liver disease), fasting and at 120-th minute of the standard glucose tolerance test blood glucose and immunoreactive insulin were determined. Insulin resistance was estimated by HOMA-IR score. Metabolic syndrome was verified by IDF (2005) criteria. Liver US was carried out to diagnose NAFLD.

Results

Results. During investigation NAFLD was revealed in 77,7% of patients. At multi-factor analysis of variance interrelation of NAFLD with CVD and type 2 DM risk factors, such as systemic hypertension, dyslipidemia, disorders of carbohydrate metabolism and insulin resistance was confirmed.

Conclusions

Conclusions. Study results determine necessity of more careful investigation of patients with obesity and NAFLD for early diagnostics and treatment of cardiometabolic risk factors of cardio-vascular diseases and type 2 DM.

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The authors declare that there are no conflicts of interest present.