Age and gender features of non-alcoholic fatty liver disease
Author Affiliations1Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
2Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
3Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
4Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
5Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
6Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
7Novosibirsk State Medical University of Minzdrav of Russia, 630091 Novosibirsk, Krasny av., 52
Abstract
The purpose of the study. Evaluation of clinical course and metabolic disorders in men and women with non-alcoholic fatty liver disease (NAFLD) of different ages. Materials and methods. 113 patients (63 men and 50 women) have been examined. NAFLD has been verified in all patients for the first time. The clinical manifestations of NAFLD have been studied in comparative terms. The state of lipid and carbohydrate metabolism, insulin resistance have been investigated. Results. Dyslipidemia at NAFLD is characterized by the increase in triglyceride levels over 1.7 mmol/l and hypoalphaholesterolemia whereby the level of HDL-C in men is less 1.0 mmol/l and is less 1.2 mmol/l in women. So that is the diagnostic criterion for NAFLD. These abnormalities were more pronounced in men, indicating to more severe lipid metabolism disorders in men. The immunoreactive insulin concentration was significantly higher in men, indicating to the men hyperinsulinemia severity. Insulin resistance index HOMA-IR was also significantly higher. Higher hypertriglyceridemia and insulin resistance suggest that the combination of these disorders and their greater severity contribute to the formation of liver steatosis in men well before. These disorders dominated mostly in young people. Conclusion. NAFLD in examined patients is mainly formed in middle age. This is facilitated by the emergence of significant disturbances in carbohydrate and lipid metabolism. The main pathophysiological factors contributing to the formation of NAFLD, namely, IR and dyslipidemia were more significant in men. Probably this may be due to earlier development of hepatic steatosis in men and younger age compared to women.
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References
- Balabolkin M.I., Klebanova V.M., Kreminskay V.M. New classification, criterions diagnosis and compensation of diabetes mellitus / Therapeutic Archives=Terapevtichekiy arkhiv. 2000. (10) 5-10. [In Russian]
- Dedov I.I., Shestakova M.I. Algorithm of special medical help for patients with diabetes mellitus. M., 2015 105 р. [In Russian]
- Demidovа T.Y. Obesity and insulin resistance / Difficult patient=Trudny patsient. 2006. (7) 25-28. [In Russian]
- Denisova T.P., Tyultyaeva L.A. Geriatric Gastroenterology. M., 2011. 336 p. [In Russian]
- Drapkina O.M., Gazolaeva D.S., Ivashkin V.T. Nonalcoholic fatty liver disease is the component of metabolic syndrome / Russian Medical News=Russiyskie meditsinskie vesti. 2010. (2) 72-78. [In Russian]
- Zadionchenko B.S., Adasheva T.V., Demicheva О.Yu., Porevkina О.N. Mеtabolic syndrome: therapeuticpossibilitis and perspectives / Consilium Medicum. 2005.(9) 725-733. [In Russian]
- Ivashkin V.T., Drapkina O.M., Korneev О.N. Clinical variants of metabolic syndrome. M., 2011. 96 р. [In Russian]
- Ivashkin V.T., Mayevskaya M.V., Pavlov Ch.S. et al. Diagnostics and treatment of non-alcoholic fatty liver disease: clinical guidelines of the Russian Scientific Liver Society, and the Russian gastroenterogical association //Rus. J. Gastroenterol. Gepatol. Coloproctol.=Rossiiski zhurnal gastroenterologii, gepatologii, koloproktologii. 2016. (2) 1-20. [In Russian]
- Nedogoda S.V., Savina T.N., Pocheptsov D.A. Nonalcoholic fatty liver disease. Bulletin of Volgograd State Medical University=Vestnik Volgogradskogo gosudarstvennogo meditsinskogo universiteta. 2009. (3) 3-11. [In Russian]
- Osipenko M.F., Bikbulatova E.A., ZhukЕ.А., Skalinskaya M.A. Barrett's esophagus - the current state of the problem // Russian Journal of Gastroenterology, Hepatology, Coloproctology=Rossiiski zhurnal gastroenterologii, gepatologii, koloproktologii.. 2007. (4) 11-19 [In Russian]
- Radchenko V.G., Seliverstov P.V. Course of biliary sludge on the background non-alcoholic fatty liver disease //Experimental. Clin. Gastroenterol.=Eksperimentalnaya klinicheskaya gastroentologiya. 2015. (11) 4-9. [In Russian]
- Tsukanov V.V., Tonkikh J.L., Kasparov E.V. et al. Nonalcoholic fatty disease in adult Russia (prevalence and risk factors) of the urban population / Doctor=Vrach. 2010 (9) 2-6. [In Russian]
- Angulo P. Nonalcoholic fatty liver disease //N.Engl.J.Med. 2002. (16) 1221-1231.
- Cope M.B., Allison D.B. Obesity: person and population. Obesity. 2006. (Suppl. 4) 156-159.
- Bedogni G., Miglioli L., Masutti F., Tiribelli C. Prevalence and risk factors for non-alcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005. (1) 44-52.
- Belentani S., Scaglioni F., Marino M. еt al. Epidemiology of nonalcoholic fatty liver disease.-Dig. Dis. 2010. (28) 155-161.
- Browning J.D., Szczepaniak L.S., Dobbins R. et al. Prevalence of hepatic cteatosis in an urban population in the United States: Impact of ethnicity. Hepatology 2004. (6) 1387-1395.
- Frith J., Day C.P., Henderson E et al. Non-alcoholic fatty liver disease in older people //Gerontilogy. 2009. (6) 607-613.
- Hashimoto E., Tokushigie K. Prevalence, gender, ethnic, and prognosis of NASH //J. Gastroenterol. 2011. (1) 63-69.
- Kimura Y., Hyogo H., Ishitobi T. Postprandial insulin secretion pattern is associated with histological severity in nonalcoholic fatty liver disease patients without prior know diabetes mellirus //J. Gastroenteol. Hepatol. 2011. (4). 517-522.
- Lazo M., Clark J.M. The epidemiology of nonalcoholic fatty liver disease: A global perspective //Semin. Liver Dis. 2008. (28) 339-350.
- Leclereq I.A., Da Silv. M.A., Schroyen B. et al. Insulin resistance in hepatocytes and sinusoidal liver cells: mechanisms and consequences. J. Hepatol. 2007. (1) 142-156.
- Manchanayake J., Chitturi S., Nolan C. Postprandial hyperinsulinemia is universal in non-diabetic patients with nonalcoholic fatty liver disease //J. Gastroenterol. Hepatol. 2011. (4). 510–516.
- McLeay S.C., Morrish G.A., Ponnuswamy T.K. et al. Noninvasive Quantification of Hepatic Steatosis: Relationship Between Obesity Status and Liver Fat Content //Open Obesity Journal. 2014.(1) 16-24.
- Rhee EJ, Lee WY, Cho YK, Kim BI, Sung KC. Hyperinsulinemia and the development of nonalcoholic Fatty liver disease in nondiabetic adults //Am J Med. 2011. (1). 69-76.
- Targer G., Day P.D., Bonora E.N. Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease //Engl. J. Med. 2010. (363) 1341-1350.
- Tilg H., Hotamisligil C.S. Nonalcoholic fatty liver disease; Cytokine-adipokine interplay and regulation of insulin resistance. Gastroenterology, 2006. (3): 934-945.
- Younossi Z.M., Gramlich T., Matteoni C.A., et al. Nonalcoholic fatty liver disease in patients with type 2 diabetes. Clin. Gastroenterol. Hepatol. 2004. (3) 262-265.
- Vernon G., Baranova A., Younosi Z.M. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults //Aliment Pharmacol. Ther. 2011. (2) 274-285.
About Authors (Correspondence):
Kuimov A.D. – doctor of medical sciences, professor, head of the department of faculty therapy, honored physician of RF, honored scientist of RF, e-mail: terapia@mail.ru Krivosheev A.B. doctor of medical sciences, professor of the department of faculty therapy, e-mail: krivosheev-ab@narod.ru
Krivosheev A.B. – doctor of medical sciences, professor of the department of faculty therapy, e-mail: krivosheev-ab@narod.ru
Popov K.V. – professor of the department of faculty therapy, e-mail: kpopov54@mail.ru
Lozhkina N.G. – associate professor of faculty therapy, e-mail: terapia@mail.ru
Bogoryanova P.A. – assistant professor of faculty therapy, e-mail: terapia@mail.ru
Kondratova M.A. – student of faculty therapy, e-mail: terapia@mail.ru
Gubanova S.K. – clinical intern of the department of emergency treatment with endocrinology and pathology, e-mail: sofocka-mofocka@mail.ru