Liver fibrosis and markers of endothelial function at metabolic syndrome and early disorders of carbohydrate metabolism
Abstract
Aim of investigation. Complex estimation of endothelial function at non-alcoholic fatty liver disease (NAFLD) in association with early disorders of carbohydrate metabolism, in relation to liver fibrosis severity.
Material and methods. Overall 67 patients with metabolic syndrome (MS) in combination to early carbohydrate metabolism disorders (71,6% women), mean age was 47,5 (42–49 years), body mass index — 34,6 kg/m2 (32,4–38,4 kg/m2) were investigated. In 72% of patients presence of NAFLD at steatosis stage and in 18% —at non-alcoholic steatohepatitis stage was found.
Results. In patients with MS in association to early disorders of carbohydrate metabolism liver fibrosis at F1 METAVIR stage was revealed in 25%, at F2 — in 16%, at F3 — in 13% and at F4 — in 1,5% of all cases. Along with increase of fibrosis stage progressive elevation of TNF-α (p=0,0265), IL-6 (p=0,0012) and endothelin-1 (p=0,0137) contents on background of decrease of adiponectin concentration (p=0,0026) and gain of humeral artery diameter after compression (p=0,005) was marked.
Conclusions. Presence and severity of liver fibrosis at MS in combination to early disorders of carbohydrate metabolism are related to increase of proinflammatory cytokines, endothelin-1 concentration on a background of reduction of adiponectin contents and decrease of endothelium vasodilation capacity.
About the Authors
L. V. Chesnokova
State educational government-financed institution of higher professional education «Tyumen state medical academy», Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Chesnokova Larisa V — MD, lecturer, chair of hospital course of internal diseases with endocrinology module
625007, Tyumen, Odessa street, 54
I. M. Petrov
State educational government-financed institution of higher professional education «Tyumen state medical academy», Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Petrov Ivan M — MD, assistant-professor, chair of hospital of internal diseases and endocrinology module
625007, Tyumen, Odessa street, 54
Ye. A. Sidorova
State educational government-financed institution of higher professional education «Tyumen state medical academy», Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Sidorova Yevgeniya A — post-graduate student, chair of hospital course of internal diseases with endocrinology module
625007, Tyumen, Odessa street, 54
I. A. Troshina
State educational government-financed institution of higher professional education «Tyumen state medical academy», Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Yu. A. Petrova
State educational government-financed institution of higher professional education «Tyumen state oil-and-gas university»
Russian Federation
Russian Federation
References
1. Елисеева Л.Н., Будашова Т.М., Долганова Т.Ю., Бочарникова М.И. Особенности выявления неалкогольной жировой болезни печени в клинической практике. Рос мед вести 2009; 14(1):31-6.
2. Чеснокова Л.В., Петров И.М., Трошина И.А., Медведева И.В. Содержание провоспалительных цитокинов в зависимости от стадии фиброза у больных с метаболическим синдромом и неалкогольной жировой болезнью печени. Клин мед 2013; 12(91):34-8.
3. Stefan N., Kantartzis K., Häring H. Causes and metabolic consequences of fatty liver. Endocr Rev 2008; 29(7):939-60.
4. Ивашкин В.Т., Драпкина О.М., Шульпекова Ю.О. Диагностика и лечение неалкогольной жировой болезни печени. Рос мед вести 2009; 3(14):1-12.
5. Saltiel A.R., Pessin J.E. Insulin signaling pathways in time and space. Trends Cell Biol 2002; 12:65-71.
6. Dandona P., Aljada A., Bandyopadhyay A. Inflammation: the link between insulin resistance, obesity and diabetes. Trends Immunol 2004; 25:4-7.
7. Щекотова А.П., Котельникова Л.П., Мугатаров И.Н., Федачук Н.Н. Эндотелиальная дисфункция, воспаление и фиброз при гепатобилиарной патологии. Фундаментальные исследования 2013; 5(2):451-5.
8. Kyosuke S., Hidetaka N. Chapter five Screening for adiponectin secretion regulators. Vitam Horm 2012; 90:125-41.
9. Орлова Е.А. Анализ нитритов и нитратов в ткани при экспериментальной острой почечной недостаточности. Укр журн экстремальной медицины 2002; 1(3):79-82.
10. Ratziu V., Bellentani S., Cortez-Pinto H., Day C., Marchesini G. A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol 2010; 53(2):372-84.
11. D′Aiuto F., Parkar M., Nibali L., Suvan J., Lessem J., Tonetti M.S. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: results from a randomized controlled clinical trial. Am Heart J 2006; 151:977-84.
12. Li X., Tse H.F., Jin L.J. Novel endothelial biomarkers: Implications for periodontal disease and CVDJDR. Diabet Med 2011; 90:1062-9.
13. Ивашкин В.Т., Маевская М.В. Липотоксичность и метаболические нарушения при ожирении. Рос журн гастроэнтерол гепатол колопроктол 2010; 20(1):4-13.
14. Hink U., Huige L., Hanke M., Mathias O., et al. Mechanisms underlying endothelial dysfunction in diabetes mellitus. Circ Res 2001; 88:14.
15. Deanfield J.E., Halcox J.P., Rabelink T.J. Endothelial function and dysfunction. Circulation 2007; 115:1285-95.
16. Fisman E.Z., Tenenbaum A. The ubiquitous interleukin-6: a time for reappraisal. Cardiovasc Diabetol 2010; 9:62.
17. Wang J., Wang H., Luo W., Guo C., et al. Leptininduced endothelial dysfunction is mediated by sympathetic nervous system activity. J Am Heart Assoc 2013; 2:e000299.
18. Fisman E.Z., Tenenbaum A. Adiponectin: A manifold therapeutic target for metabolic syndrome, diabetes, and coronary disease? Cardiovasc Diabetol 2014; 13(1):103.
19. Toda N., Okamura T. Obesity impairs vasodilatation and blood flow increase mediated by endothelial nitric oxide: an overview. J Clin Pharmacol 2013; 53(12):1228-39.
20. Sanyal A.J., Banas C., Sargeant C., et al. Similarities and differences in outcomes of cirrhosis due to nonalcoholic steatohepatitis and hepatitis C. Hepatology 2006; 43:682-9.
21. Кособян Е.П., Смирнова О.М. Современные концепции патогенеза неалкогольной жировой болезни печени. Сахарный диабет. 2010; 1:55-64.
22. Targher G., Marra F., Marchesini G. Increased risk of cardiovascular disease in non-alcoholic fatty liver disease: causal effect or epiphenomenon? Diabetologia 2008; 51:1947-53.
23. Ройтберг Г.Е., Шархун О.О., Платонова О.Е., Ушакова Т.И. Неалкогольная жировая болезнь печени как фактор риска атеросклероза. Эксп клин гастроэнтерол 2010; 7:20-4.
Review
For citations:
Chesnokova L.V., Petrov I.M., Sidorova Ye.A., Troshina I.A., Petrova Yu.A. Liver fibrosis and markers of endothelial function at metabolic syndrome and early disorders of carbohydrate metabolism. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2014;24(6):45-50. (In Russ.)
Views:
97
Email this article 
