DOI: https://doi.org/10.22141/2308-2097.53.4.2019.182403

Autonomic and cognitive disturbances in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus

Ye.S. Sirchak, O.O. Boldizhar, V.I. Griga, O.I. Petrichko

Abstract


Background. There are multifunctional researches for better understanding the effect of cognitive disorders on treatment, mobility, mortality of patients, especially persons with multimorbid pathology. The purpose was to study the features of cognitive and neurovegetative dysfunction in patients with different forms of non-alcoholic fatty liver disease (NAFLD) (non-alcoholic fatty hepatosis (NAFH) and non-alcoholic steatohepatitis (NASH)) and type 2 diabetes mellitus (T2DM). Materials and methods. Fifty patients with NAFLD (24 — with NAFH and 26 — with NASH) were examined. The comparison group included 22 patients with T2DM. Dysfunction of central and autonomic nervous system was evaluated with the help of neuropsychometric testing. Results. The analysis of conducted research indicates autonomic dysfunction in the surveyed patients. Cognitive impairment (mostly mild and moderate) was detected in all persons in both groups. The most pronounced disturbances were determined in the areas of attention and concentration, memory, less pronounced — in visually constructive area, especially in patients with NASH combined with type 2 diabetes. Stressful situations have a significant impact on the lives of these persons, but they are not critical enough to any issues. Patients with NASH associated with type 2 diabetes have the lowest level of resistance to stress — (56.7 ± 3.1) points; p < 0.01. They experienced a slight vulnerability even from minor impacts. Conclusions. According to neuropsychometric testing, cognitive impairment and autonomic dysfunction were found in patients with NAFLD and type 2 diabetes. The most pronounced cognitive impairment was found in patients with NASH combined with type 2 diabetes and obesity class I, according to the results of the Montreal Cognitive Assessment (r = 0.90; p < 0.01), the Boston test (r = 0.94; p < 0.01) and the Wisconsin Card Sorting Test (r = 0.92; p < 0.01).


Keywords


non-alcoholic fatty liver disease; type 2 diabetes mellitus; cognitive impairment; autonomic dysfunction

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