Comorbid patient with rheumatoid arthritis: increasing the accuracy of diagnostics of non-alcoholic fatty liver disease with prediction of liver fibrosis


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Abstract

Background. Timely detection of non-alcoholic fatty liver disease (NAFLD) in patients with rheumatoid arthritis (RA) and metabolic syndrome (MS) remains an extremely relevant diagnostic position of clinical physicians, determining the management tactics for patient and their prognosis. Objective. Evaluation of the incidence of NAFLD and its clinical and morphological forms among patients with RA and MS, and conducting a mathematical search for a more accurate prediction model for assessing liver fibrosis. Methods. The study included 187 patients with RA and MS, of which 58 were diagnosed with NAFLD during ultrasound examination. All participants underwent anthropometric, laboratory examinations with the calculation of the indices of steatosis and fibrosis using calculation scales. We carried out a mathematical search for a discriminant model in the form of a scale for a more accurate assessment of fibrosis. Results. We obtained reliable data on the incidence of NAFLD in patients with RA and MS. Steatosis was detected in one third of cases, steatohepatitis - in two thirds; liver fibrosis, interpreted as probable, was diagnosed in every third patient. Conclusion. Close correlations were revealed between the components of MS and the parameters of liver transaminases, as well as steatosis and liver fibrosis. The proposed scale provides encouraging results for the diagnosis of fibrosis.

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About the authors

I. S Korolchuk

Kuban State Medical University

Email: ir.korolchuk@yandex.ru
Cand. Sci. (Med.), Associate Professor at the Department of Outpatient Therapy with Course of General Medical Practice (Family Medicine), Faculty of Advanced Training and Professional Retraining of Specialists 4, Mitrofan Sedin str., 350063 Krasnodar, Russian Federation

V. I Kucheryavy

Kuban State Medical University

Department of Outpatient Therapy with Course of General Medical Practice (Family Medicine), Faculty of Advanced Training and Professional Retraining of Specialists Krasnodar, Russia

R. V Kovalenko

Kuban State Medical University

Department of Outpatient Therapy with Course of General Medical Practice (Family Medicine), Faculty of Advanced Training and Professional Retraining of Specialists Krasnodar, Russia

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