Association of fibrosis with nutritional status in case of non-alcoholic fatty liver disease

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Resumo

Due to the epidemic growth of non-alcoholic fatty liver disease (NAFLD), significant progress has been made in its diagnosis: non-invasive indexes of fibrosis and imaging methods are quite accurate and comparable to histological examination in assessing the severity of the disease, and their correlation with nutritional status and clinical and molecular indexes allows even at the screening stage to make a more accurate prognosis.

The aim: to estimate some potential risk factors for fibrosis formation in NAFLD patients with different body mass index (BMI).

Material and methods. The study took place on the basis of Novosibirsk Regional Clinical Hospital of War Veterans No. 3 and Research Institute of Therapy and Preventive Medicine – a branch of Institute of Cytology and Genetics of Siberian branch of the Russian Academy of Sciences and included 349 patients: 113 of them with NAFLD without obesity according to BMI, 122 patients with NAFLD with obesity according to BMI and 114 apparently healthy persons. Nutritional status, levels of biochemical and hormonal indexes, as well as the degree of fibrosis in patients with NAFLD were assessed.

Results. As a part of the study it was found that the probability of detecting stage 2, 3 or 4 fibrosis in a patient with NAFLD in combination with obesity is 5.5 times higher comparatively to patients with NAFLD without obesity (95% confidence interval: 3.0–11.3; p < 0.001). Also, in general regression analysis, it was determined that for liver fibrosis according to the results of indirect elastometry (IEM) in patients with diagnosed NAFLD, both with and without obesity, significant markers are the results of bioimpedansometry (fat mass in kg: β = 0.268, T = 4.08), biochemical parameters (gamma-glutamyltransferase level: β = 0.251, T = 4.01) and hormonal profile (visfatin level: β = 0.125, T = 2.05) at p < 0.05.

Conclusion. Adipose tissue mass, gamma-glutamyltransferase and visfatin levels may be the markers of increased probability of developing fibrosis in case of NAFLD.

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Sobre autores

Elena Znakharenko

Novosibirsk State Medical University of the Ministry of Healthcare of Russia
Novosibirsk Regional Clinical Hospital of War Veterans No. 3

Autor responsável pela correspondência
Email: znaxarenko85@bk.ru
ORCID ID: 0000-0001-6408-6622

MD, postgraduate student of the Department of faculty therapy named after professor G.D. Zalessky, Novosibirsk State Medical University of the Ministry of Healthcare of Russia, nutritionist, gastroenterologist at Novosibirsk Regional Clinical Hospital of War Veterans No. 3

Rússia, 630091, Novosibirsk, 52 Krasny Avenue; 630005, Novosibirsk

Oksana Gerasimenko

Novosibirsk State Medical University of the Ministry of Healthcare of Russia
Novosibirsk Regional Clinical Hospital of War Veterans No. 3

Email: profgerasimenko@inbox.ru
ORCID ID: 0000-0002-9742-0479
Código SPIN: 7783-2977

MD, Dr. Sci. (Medicine), professor, head of the Department of faculty therapy named after professor G.D. Zalessky of the Faculty of general medicine, chief physician, chief external expert in therapy and general medical practice of the Ministry of Healthcare of Novosibirsk region, Honored Doctor of the Russian Federation, Outstanding Worker of Healthcare of the Russian Federation

Rússia, 630091, Novosibirsk, 52 Krasny Avenue; 630005, Novosibirsk

Vladimir Maksimov

Research Institute of Therapy and Preventive Medicine – a branch of Institute of Cytology and Genetics of Siberian branch of the Russian Academy of Sciences

Email: medik11@mail.ru
ORCID ID: 0000-0002-7165-4496
Código SPIN: 9953-7867

MD, Dr. Sci. (Medicine), professor, chief researcher, head of the Department of molecular genetic research work of therapeutic diseases

Rússia, 630089, Novosibirsk, 175/1 Borisa Bogatkova Str.

Alena Gorbunova

Novosibirsk State Medical University of the Ministry of Healthcare of Russia; Novosibirsk Regional Clinical Hospital of War Veterans No. 3

Email: belyaeva-alena@list.ru
ORCID ID: 0000-0002-1593-3984

MD, postgraduate student, assistant, head of the educational unit of the Department of faculty therapy named after Professor G.D. Zalessky, general practitioner, geriatrician

Rússia, 630091, Novosibirsk, 52 Krasny Avenue; 630005, Novosibirsk

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2. Fig. 1. Non-invasive diagnostic indicators of fibrosis (FIB-4 index) in the studied patients

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3. Fig. 2. Non-invasive assessment of fibrosis using transient elastometry in patients with non-alcoholic fatty liver disease

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