Features diagnostics and military medical examination of non-alcoholic fatty liver disease

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

Non-alcoholic fatty liver disease is a widespread and steadily progressive pathology throughout the world. The basis of the pathogenesis of this disease is a violation of the structure and function of the intestinal microbiome with a change in the permeability of the intestinal mucosa barrier, the development of intestinal endotoxemia, cytokine aggression, oxidative stress, chronic systemic inflammation of low intensity, insulin resistance and hyperinsulinemia. The clinical picture of the pre-cirrhotic stage of the disease is characterized by a low severity of symptoms. Non-alcoholic fatty liver disease is a diagnosis of exclusion and requires a comprehensive evaluation of the patient. Currently, there is a tendency to an increase in the number of conscripts and overweight military personnel who have this pathology. The formulation of a clinical and expert diagnosis in non-alcoholic fatty liver disease has important features that must be taken into account when conducting a military medical examination.

About the authors

V. B. Grinevich

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Author for correspondence.
Email: kravchuk2003@mail.ru

профессор, полковник медицинской службы запаса

Russian Federation, Saint Petersburg

А. V. Datsko

The Main Center for Military Medical Expertise of the Ministry of Defense of the Russian Federation

Email: olga.petrova.71@mail.ru

полковник медицинской службы

Russian Federation, Moscow

Yu. А. Kravchuk

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: kravchuk2003@mail.ru

профессор, полковник медицинской службы запаса

Russian Federation, Saint Petersburg

I. А. Bakushkin

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: kravchuk2003@mail.ru

кандидат медицинских наук, подполковник медицинской службы запаса

Russian Federation, Saint Petersburg

М. М. Arapkhanova

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: kravchuk2003@mail.ru
Russian Federation, Saint Petersburg

О. N. Petrova

The Main Center for Military Medical Expertise of the Ministry of Defense of the Russian Federation

Email: olga.petrova.71@mail.ru

подполковник медицинской службы

Russian Federation, Moscow

S. V. Koryakin

The Main Center for Military Medical Expertise of the Ministry of Defense of the Russian Federation

Email: olga.petrova.71@mail.ru

подполковник медицинской службы

Russian Federation, Moscow

References

  1. Гриневич В.Б., Кравчук Ю.А., Арапханова М.М. и др. Роль желчных кислот в многообразии механизмов формирования печеночных проявлений метаболического синдрома // Эксперимент. и клин. гастроэнтерол. – 2020. – № 11 (183). – С. 20–24.
  2. Драпкина О.М., Ивашкин В.Т. Эпидемиологические особенности неалкогольной жировой болезни печени в России (результаты открытого многоцентрового проспективного исследования наблюдения DIREGL 01903) // Рос. журн. гастроэнтерол., гепатол., колопроктол. – 2014 – Т. 24, № 4. – С. 32–38.
  3. Ивашкин В.Т., Маевская М.В., Павлов Ч.С. Клинические рекомендации по диагностике и лечению неалкогольной жировой болезни печени Российского общества по изучению печени и Российской гастроэнтерологической ассоциации // Рос. журн. гастроэнтерол., гепатол., колопроктол. – 2016. – Т. 26, № 2. – С. 24–42.
  4. Лазебник Л.Б., Голованова Е.В., Туркина С.В. и др. Неалкогольная жировая болезнь печени у взрослых: клиника, диагностика, лечение. Рекомендации для терапевтов, третья версия // Эксперимент. и клин. гастроэнтерол. – 2021. – № 1. – С. 4–52.
  5. Постановление Правительства Российской Федерации от 04.07.2013 г. № 565 (ред. от 01.06.2020 г.) «Об утверждении Положения о военно-врачебной экспертизе». URL: http://www.consultant.ru/document/cons_doc_LAW_ 149096/ (дата обращения: 05.09.2021).
  6. Райхельсон К.Л., Пальгова Л.К., Кондрашина Э.А. и др. Лекарственные поражения печени. Клинические рекомендации для врачей. / Санкт-Петербургское общество гастроэнтерологов, гепатологов и диетологов. – СПб, 2017. – 116 с.
  7. Селиверстов П.В., Джадхав С.Н., Цурцумия Д.Б. и др. Неалкогольная жировая болезнь печени: возможности диагностики // Рус. мед. журн. – 2019. – № 5. – С. 36–40.
  8. Халимов Ю.Ш., Матвеев С.Ю., Воронин С.В. и др. Опыт проведения военно-врачебной экспертизы военнослужащих, работающих на химически опасных объектах // Воен.-мед. журн. – 2018 – Т. 339, № 8. – С. 12–17.
  9. Черкашина Е.А. Актуальные вопросы диагностики и лечения неалкогольной жировой болезни печени // Мед. совет. – 2015. – № 4. – С. 67–70.
  10. Albhaisi S., Sanyal A. Recent advances in understanding and managing non-alcoholic fatty liver disease // F1000Res. – 2018, 7 (F1000 Faculty Rev):720.
  11. Barrera F., George J. The role of diet and nutritional intervention for the management of patients with NAFLD // Clin. Liver. Dis. – 2014. – Vol. 18, Iss. 1. – P. 91–112.
  12. Bedogni G., Bellentani S., Miglioli L. et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population // BMC Gastroenterology. – 2006. – Vol. 6. – Art. 33.
  13. Bedogni G., Miglioli L., Masutti F. et al. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study // Hepatology. – 2005. – Vol. 42, Iss. 1. – Р. 44–52.
  14. Bedossa P. FLIP Pathology Consortium. Utility and appropriateness of the fatty liver inhibition of progression (FLIP) algorithm and steatosis, activity, and fibrosis (SAF) score in the evaluation of biopsies of nonalcoholic fatty liver disease // Hepatology. – 2014. – Vol. 60, Iss. 2. – Р. 565–575.
  15. Buzzetti E., Pinzani M., Tsochatzis E.A. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD) // Metabolism. – 2016. – Vol. 65, Iss. 8. – Р. 1038–1048.
  16. Chalasani N., Younossi Z., Lavine J.E. et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases // Hepatology. – 2018. – Vol. 67, Iss. 1. – Р. 328–357.
  17. EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evaluation of liver disease severity and prognosis // J. Hepatol. – 2015. – Vol. 63, Iss. 1. – Р. 237–264.
  18. EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease // J. Hepatol. – 2016. – Vol. 64, Iss. 6. – Р. 1388–1402.
  19. Enomoto H., Bando Y., Nakamura H. et al. Liver fibrosis markers of nonalcoholic steatohepatitis // World. J. Gastroenterol. – 2015. – Vol. 21, Iss. 24. – Р. 7427–7435.
  20. Fedchuk L., Nascimbeni F., Pais R. et al. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease // Aliment. Pharmacol. Ther. – 2014 – Vol. 40, Iss. 10. – Р. 1209–1222.
  21. Fishbein M., Castro F., Cheruku S. et al. Hepatic MRI for fat quantitation: its relationship to fat morphology, diagnosis, and ultrasound // J. Clin. Gastroenterol. – 2005. – Vol. 39, Iss. 7. – Р. 619–625.
  22. Gerber L., Otgonsuren M., Mishra A. et al. Non-alcoholic fatty liver disease (NAFLD) is associated with low level of physical activity: a population-based study // Aliment. Pharmacol. Therapy. – 2012. – Vol. 36, Iss. 8. – P. 772–781.
  23. Glen J., Floros L., Day C., Pryke R. Guideline Development Group. Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance // BMJ. – 2016. – Vol. 354. – i4428.
  24. Kleiner D.E., Brunt E.M. Nonalcoholic fatty liver disease: pathologic patterns and biopsy evaluation in clinical research // Semin. Liver Dis. – 2012. – Vol. 32, Iss. 1. – Р. 3–13.
  25. Kleiner D.E., Brunt E.M., Van Natta M. et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease // Hepatology. – 2005. – Vol. 41, Iss. 6. – Р. 1313–1321.
  26. Vernon G., Baranova A., Younossi Z.M. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults // Aliment. Pharmacol. Therapy. – 2011. – Vol. 34, Iss. 3. – Р. 274–285.
  27. World Gastroenterology Organisation Global Guidelines: Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis // J. Clin. Gastroenterol. – 2014. – Vol. 48, Iss. 6. – P. 467–473.
  28. Younossi Z., Anstee Q.M., Marietti M. et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention // Nat. Rev. Gastroenterol. Hepatol. – 2018. – Vol. 15, Iss. 1. – Р. 11–20.
  29. Younossi Z., Koenig A., Abdelatif D. et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes // Hepatology. – 2016. – Vol. 64, Iss. 1. – P. 73–84.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2022 Grinevich V.B., Datsko А.V., Kravchuk Y.А., Bakushkin I.А., Arapkhanova М.М., Petrova О.N., Koryakin S.V.


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: № 01975 от 30.12.1992.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies