Indicators of carbohydrate and fat metabolism in patients with various degrees of fatty liver dystrophy

Authors

DOI:

https://doi.org/10.22141/2308-2097.56.1.2022.484

Keywords:

non-alcoholic fatty liver disease, fat metabolism, controlled parameter of ultrasonic attenuation, steatosis

Abstract

Background. Non-alcoholic fatty liver disease (NAFLD) ranks first among chronic liver diseases and covers almost a quarter of the population. Enough data have been accumulated on the mutual influence of metabolic changes and steatosis of the liver of varying degrees on the existence and progression of each other. The coexistence of non-alcoholic steatohepatitis (NASH) with various comorbidal conditions has already been recorded in many studies, a direct relationship has been determined between the presence of fatty degeneration and various components of the metabolic syndrome — arterial hypertension, type 2 diabetes, obesity and dyslipidemia. The purpose was to determine the relationship between carbohydrate and fat metabolism in patients with NAFLD depending on the degree of fat accumulation in the liver. Materials and methods. Data were obtained from 72 patients with NAFLD, who were divided into two groups according to the degree of steatosis. The I group included 46 patients with moderate steatosis (the proportion of hepatocytes containing fatty is 33–66 %). The indicator of the controlled parameter of ultrasonic attenuation (CAP) ranged from 232 to 256 dB/m. The II group consisted of 26 patients with severe steatosis (the proportion of hepatocytes containing fatty inclusions more than 66 %), with CAP more than 256 dB/m. The trophological status, the parameters of carbohydrate and fat metabolism were determined. A statistical analysis of the data was carried out — the mean values in the groups were compared and the contribution of variables to the value of CAP was estimated ­using the method of multiple regression analysis. Results. The level of insulin and HOMA-IR in patients with severe fatty degeneration of the liver was (22.7 ± 9.7) and (5.4 ± 2.7) μU/ml, respectively. These indicators were higher than the corresponding indicators of group I (p < 0.05), (17.1 ± 10.3) and (4.01 ± 2.9) μU/ml for insulin and HOMA-IR, respectively. Glucose, lipid spectrum did not differ significantly between the groups, except for the fraction of very-low density lipoproteins (VLDL), which were significantly higher in patients with a higher degree of fatty degeneration and amounted to 3.4 (2.3–4.1) and 3.0 (2.4–3.8) mmol/L in groups II and I, respectively. Multiple regression analysis was performed to determine the contribution of fat and carbohydrate metabolism to CAP values. As a result of step-by-step analysis, two indicators remained in the model, namely the HOMA index (regression coefficient β 5.285, p = 0.04) and BMI (regression coefficient β 4.666, p = 0.001). It was determined that changes in BMI and HOMA are responsible for 31 % of changes in the value of CAP. Conclusions. Insulin values, HOMA index, BMI and VLDL are higher in patients with severe steatosis. According to the results of multiple regression analysis, a significant contribution of HOMA and BMI values to the CAP was revealed.

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References

Eslam M, Sarin SK, Wong VW, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Hepatol Int. 2020 Dec;14(6):889-919. doi: 10.1007/s12072-020-10094-2.

Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nat Med. 2018 Jul;24(7):908-922. doi: 10.1038/s41591-018-0104-9.

Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84. doi: 10.1002/hep.28431.

Yang X, Chang X, Wu S, et al. Performance of liver stiffness measurements obtained with FibroScan is affected by glucose metabolism in patients with nonalcoholic fatty liver disease. Lipids Health Dis. 2021 Mar 23;20(1):27. doi: 10.1186/s12944-021-01453-5.

Cariou B, Byrne CD, Loomba R, Sanyal AJ. Nonalcoholic fatty liver disease as a metabolic disease in humans: A literature review. Diabetes Obes Metab. 2021 May;23(5):1069-1083. doi: 10.1111/dom.14322.

Adams LA, Anstee QM, Tilg H, Targher G. Non-alcoholic fatty liver disease and its relationship with cardiovascular disease and other extrahepatic diseases. Gut. 2017 Jun;66(6):1138-1153. doi: 10.1136/gutjnl-2017-313884.

Chi-Cervera LA, Montalvo GI, Icaza-Chávez ME, et al. Clinical relevance of lipid panel and aminotransferases in the context of hepatic steatosis and fibrosis as measured by transient elastography (FibroScan®). J Med Biochem. 2021 Jan 26;40(1):60-66. doi: 10.5937/jomb0-24689.

Sirli R, Sporea I. Controlled Attenuation Parameter for Quantification of Steatosis: Which Cut-Offs to Use? Can J Gastroenterol Hepatol. 2021 Mar 26;2021:6662760. doi: 10.1155/2021/6662760.

Bessesen DG, Kushner R. Treatment of the Obese Patient. Springer; 2014. 336 p. doi: 10.1007/978-1-4939-1203-2.

Dewidar B, Kahl S, Pafili K, Roden M. Metabolic liver disease in diabetes - From mechanisms to clinical trials. Metabolism. 2020 Oct;111S:154299. doi: 10.1016/j.metabol.2020.154299.

Hydes T, Alam U, Cuthbertson DJ. The Impact of Macronutrient Intake on Non-alcoholic Fatty Liver Disease (NAFLD): Too Much Fat, Too Much Carbohydrate, or Just Too Many Calories? Front Nutr. 2021 Feb 16;8:640557. doi: 10.3389/fnut.2021.640557.

Pastori D, Baratta F, Novo M, et al. Remnant Lipoprotein Cholesterol and Cardiovascular and Cerebrovascular Events in Patients with Non-Alcoholic Fatty Liver Disease. J Clin Med. 2018 Oct 23;7(11):378. doi: 10.3390/jcm7110378.

Chin J, Mori TA, Adams LA, Beilin LJ, Huang RC, Olynyk JK, Ayonrinde OT. Association between remnant lipoprotein cholesterol levels and non-alcoholic fatty liver disease in adolescents. JHEP Rep. 2020 Jul 24;2(6):100150. doi: 10.1016/j.jhepr.2020.100150.

Bullón-Vela V, Abete I, Tur JA, et al. Relationship of visceral adipose tissue with surrogate insulin resistance and liver markers in individuals with metabolic syndrome chronic complications. Ther Adv Endocrinol Metab. 2020 Oct 23;11:2042018820958298. doi: 10.1177/2042018820958298.

Chi-Cervera LA, Montalvo GI, Icaza-Chávez ME, et al. Clinical relevance of lipid panel and aminotransferases in the context of hepatic steatosis and fibrosis as measured by transient elastography (FibroScan®). J Med Biochem. 2021 Jan 26;40(1):60-66. doi: 10.5937/jomb0-24689.

Published

2022-05-09

How to Cite

Yagmur, V., Kislova, R., Klenina, I., Tatarchuk, O., & Melanich, S. (2022). Indicators of carbohydrate and fat metabolism in patients with various degrees of fatty liver dystrophy. GASTROENTEROLOGY, 56(1), 29–33. https://doi.org/10.22141/2308-2097.56.1.2022.484

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Original Researches

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