Changes in the brain vessels in patients with non-alcoholic fatty liver disease and carbohydrate metabolism disorder
Background. The studies of brain vessels in patients with non-alcoholic fatty liver disease (NAFLD) can reveal new aspects of early detection of cerebral hemodynamic disorders, and will also allow the identification of a high-risk patients group. The purpose was to investigate the peculiarities of changes in the brain vessels in patients with NAFLD in combination with insulin resistance (IR) or type 2 diabetes mellitus (T2DM). Materials and methods. The study involved 74 patients with NAFLD (34 patients with non-alcoholic fatty hepatosis (NAFH) and 40 patients with non-alcoholic steatohepatitis (NASH)). The comparison group included 38 patients (16 patients with IR and 22 patients with T2DM). The condition of the blood flow in the brain was studied using ultrasound duplex scan of the extracranial portion of the common carotid artery (eCCA), the external carotid artery (eCA), the extracranial portion of the internal carotid artery, middle cerebral artery, the vertebral artery (VA), ophthalmic artery. The peak systolic velocity (PSV) and the time-average maximum (TAMX) of blood flow velocity in the studied vessels was determined. Results. The asymmetric damage to the vessels of the brain with more severe left ventricular dysfunction with NAFH is conspicuous; it is more pronounced in patients with the NASH stage, especially in combination with IR. Hemodynamically, the most significant changes were found in eCCA, namely, the decrease in PSV was found to be 38.1 ± 2.3 cm/s on the right, and 36.6 ± 3.4 cm/s on the left, TAMX reduction 20.4 ± 2.1 cm/s on the right, and 16.7 ± 1.8 cm/s on the left. Conclusions. The patients with NAFLD, as well as IR and T2DM had a decrease in the speed of blood flow in extracranial vessels of the brain, mainly in the eCCA, eCA and VA (segment 3). The most pronounced blood flow deficiency has been observed in patients with NASH in combination with IR, mainly on the left, especially in еCCA.
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