Лабораторные предикторы неалкогольного стеатоза печени у пациентов с абдоминальным ожирением

Любовь Александровна Корноухова; Николай Львович Денисов; Владимир Леонидович Эмануэль

doi:10.21638/11701/spbu11.2018.405

Authors

Любовь Александровна Корноухова North-Western Centre of Evidence-based Medicine, 28A, Pulkovskoe sh., St. Petersburg, 196158, Russian Federation ;The First Saint Petersburg State Medical University n.a. I. P. Pavlov, 6-8, ul. Lva Tolstogo, St. Petersburg, 197022, Russian Federation
Николай Львович Денисов N. I. Pirogov Clinic for Advanced Medical Technologies, Saint Petersburg University, 154, nab. r. Fontanka, St. Petersburg, 190103, Russian Federation
Владимир Леонидович Эмануэль The First Saint Petersburg State Medical University n.a. I. P. Pavlov, 6-8, ul. Lva Tolstogo, St. Petersburg, 197022, Russian Federation

DOI:

https://doi.org/10.21638/11701/spbu11.2018.405

Abstract

The aim of the study: The study of the metabolic status of 74 clinically healthy patients with abdominal obesity was performed to determine the most significant predictors of steatosis.Materials and Methods: The study did not include patients with clinical signs of liver pathology,
manifestations of hypertension, decompensation of atherosclerosis. The diagnosis of the non-alcoholic fatty liver was established based on ultrasound examination of the liver, as well as on FibroMax and SteatoScreen indices (BioPredictive, France). Defined the following indicators: ALT, AST, GGT, total bilirubin, blood glucose, triglycerides, total cholesterol, apoB, apoA, HDL, LDL, fasting insulin were measured by standard laboratory methods after 12-hr fasting. In the course of studies, the following indices are obtained: the relationship of TG/ HDL; HOMA-IR according to the formula D. R. Matthews; QUICKI on A. Katz; CARO according to the formula F. Caro; Metabolic Index (MI). Lipid Accumulation Product (LAP) according to the formulas H. Kahn et al. The Visceral Adiposity Index (VAI) is obtained according to the formulas M. C. Amato et al. Results: The interdependence between the presence of pathological changes in the liver and early steatosis predictors is determined. The
optimal parameters for preventive diagnostics were selected and validated. The cutoff values for Index of steatosis in >32 % of hepatocytes (predictor HS32), Metabolic index, and Visceral adiposity index (VAI) are 0,69 (sensitivity 81 %, specificity 88), 3,0 (sensitivity 76 %, specificity
78 %), and 3,24 (sensitivity 72 %, specificity 82 %) (p < 0,001, respectively).The areas under the ROC curves (95 % CI) for the parameters are 0,910 (0,837–0,958), 0,843 (0,770–0,900), and 0,784 (0,705–0,851), respectively. The cutoff values for Triglyceride and Total cholesterol are 2,27 (sensitivity 58 %, specificity 96 %), and 6,4 (sensitivity 54 %, specificity 95 %) (p < 0,001, respectively). We suggest that the cutoff values of these simple methods can be applied to evaluate hepatic steatosis grade in adults with abdominal obesity.

Keywords:

obesity, non-alcoholic fatty liver (NAFL), рreventive medicine, biochemical markers, prenosological

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References

Литература

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