FEATURES OF ARTERIAL HYPERTENSION COMBINED WITH OBESITY ACCORDING TO NON-ALCOHOLIC FATTY LIVER DISEASE (STEATOSIS AND STEATOHEPATITIS)

Olesia Bochar; Volodymyr Bochar

doi:10.23856/4627

Olesia Bochar Danylo Halytsky Lviv National Medical University http://orcid.org/0000-0001-5000-9415
Volodymyr Bochar Danylo Halytsky Lviv National Medical University http://orcid.org/0000-0002-5100-8657

Słowa kluczowe: arterial hypertension, nonalcoholic fatty liver disease, metabolic syndrome, obesity

Abstrakt

This research was aimed to estimate the course of hypertension on the background of obesity and nonalcoholic fatty liver disease according to its stages (steatosis and steatohepatitis). Ninety patients were evaluated for anthropometric, general-clinical, laboratory, instrumental and immune-enzymatic research methods. With USG, the most characteristic features of fatty liver infiltration and the criteria for the distinction of steatosis from steatohepatitis were revealed, and on the basis of them 2 groups were formed. Thus, the progression of nonalcoholic fatty liver disease to the stage of steatohepatitis was accompanied by a more pronounced increase in blood pressure larger in comparison with steatosis of mass index of myocardium and anterior-posterior size of the left atrium, indicating the progression of structural myocardial disorders. Therefore, the presence of non-alcoholic steatohepatitis in patients with hypertension can be regarded as unfavorable prognostic criteria for the development of heart failure. In the presence of steatohepatitis, more marked changes in lipidograms were noticed for Low-Density Lipoprotein and Triglyceride values and a violation of the functional state of the liver with a cytolytic syndrome on the activity of AST and ALT and the total bilirubin, which may contribute to the progression of liver damage.

Wykaz bibliografii

1. Anstee Q.M., Reeves H.L., Kotsiliti E., Govaere O., Heikenwalder M. (2019). From NASH to HCC: current concepts and future challenges. Nature Reviews Gastroenterology&Hepatology, 16 (7), 411-428. doi: 10.1038/s41575-019-0145-7.
2. Bochar O.M., Sklyarova H.Y., Abrahamovych K.Y., Hromnats'ka N.M., Bochar V.T., Sklyarov E.Y. (2021). Metabolic syndrome, overweight, hyperleptinemia in children and adults. Wiadomości Lekarskie, 2, 313-316. DOI:10.36740/WLek202102126
3. Chalasani N., Younossi Z., Lavine J.E., Diehl A.M., Brunt E.M., Cusi K., Charlton M., Sanyal A.J. (2014). The «New Deadly Quartet» for cardiovascular disease in the 21st century: obesity, metabolic syndrome, inflammation and climate change: how does statin therapy fit into this equation? Current atherosclerosis reports abbreviation, 16 (1), 380. doi: 10.1007/s11883-013-0380-2.
4. Diehl A.M., Day C. (2017). Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis. The New England Journal of Medicine, 377, 2063-72. doi: 10.1056/NEJMra1503519
5. Fargion S., Porzio M., Fracanzani A.L. (2014). Nonalcoholic fatty liver disease and vascular disease: state-of-the-art. World Journal of Gastroenterology, 20 (37),13306-24. doi: 10.3748/wjg.v20.i37.13306
6. Festuccia W.T. (2017). Turning up the heat against metabolic syndrome and non-alcoholic fatty liver disease. Clinical science (London), 131 (4), 327-328. doi: 10.1042/CS20160855.
7. Katsimardou A., Imprialos K., Stavropoulos K., Sachinidis A., Doumas M., Athyros V. (2020). Hypertension in Metabolic Syndrome: Novel Insights. Current Hypertension Reviews, 16 (1), 12-18. DOI: 10.2174/1573402115666190415161813
8. O'Neil A., Scovelle A.J., Milner A.J., Kavanagh A. (2018). Gender/Sex as a Social Determinant of Cardiovascular Risk. Circulation, 137(8), 854-864. doi: 10.1161/CIRCULATIONAHA. 117.028595.
9. Schwabe R.F., Tabas I., Pajvani U.B. (2020). Mechanisms of Fibrosis Development in Nonalcoholic Steatohepatitis. Gastroenterology, 158 (7), 1913-1928. doi: 10.1053/j.gastro.2019.11.311.
10. Targher G., Byrne C.D., Lonardo A., Zoppini G., Barbui C. (2016). Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. Journal of Hepatology, 65 (3), 589-600. doi: 10.1016/j.jhep.2016.05.013.
11. Vakalyuk I.I., Virstyuk N.G., Kazmiruk V.M. (2016) Progresuvannya fibrozu pechinky u xvoryh na stabil’nu ishemichnu xvorobu sercya na tli nealkogol’noyi zhyrovoyi xvoroby pechinky [Progression of liver fibrosis in patients with stable coronary heart disease combined with non-alcoholic fatty liver disease (2016)]. Gastroenterologyja – Gastroenterology, 4, 27-31. DOI: https://doi.org/10.22141/2308-2097.4.62.2016.81088
12. VanWagner L.B., Khan S.S., Ning H. et al. (2017). Body mass index trajectories in young adulthood predict non-alcoholic fatty liver disease in middleage: The CARDIA cohortstudy. Liver International, 38(4), 706-714. doi: 10.1111/liv.13603.
13. Zhou Y.J., Zhou Y.F., Zheng J.N., Liu W.Y., Van Poucke S., Zou T.T., Zhang D.C., Shen S., Shi K.Q., Wang X.D., Zheng M.H. (2017). NAFL screening score: A basic score identifying ultrasound-diagnosed non-alcoholic fatty liver. Clinica Chimica Acta, 475, 44-50. doi: 10.1016/j.cca.2017.09.020.