urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.25.3.34EZLPOYurmj-2229Research ArticleОригинальные статьи | Original articlesOriginal articlesСтруктура коморбидности, метаболический статус и возможности терапии пациентов амбулаторного профиля с неалкогольной жировой болезнью печени и нормальной массой телаComorbidity Structure, Metabolic Status and Treatment Options in Outpatients with Non-alcoholic Fatty Liver Disease and Normal Body Weighthttps://orcid.org/0000-0002-7802-4796БулатоваИ. А.BulatovaI. A.

Ирина Анатольевна Булатова — доктор медицинских наук, доцент, заведующий кафедрой нормальной физиологии, профессор кафедры факультетской терапии № 1 

Пермь 

Irina A. Bulatova — Doctor of Sciences (Medicine), Head of the Department of Normal Physiology, Profes‑ sor of the Department of Faculty Therapy No. 1 

Perm 

bula.1977@mail.ruЮсуповаА. А.YusupovaA. A.

Алёна Анатольевна Юсупова — соискатель кафедры факультетской терапии № 1, Пермский государственный медицинский университет имени академика Е. А. Вагнера; терапевт, Клиника «Альтернатива» 

Пермь 

Alena A. Yusupova — Applicant of the Department of Faculty Therapy No. 1, Perm State Medical University named after Academician E. A. Wagner; Therapist, “Alternative” Clinic 

Perm 

dr.alena2008@mail.ruПермский государственный медицинский университет имени академика Е. А. ВагнераРоссияPerm State Medical University named after Academician E. A. WagnerRussian FederationПермский государственный медицинский университет имени академика Е. А. Вагнера; Клиника «Альтернатива»РоссияPerm State Medical University named after Academician E. A. Wagner; “Alternative” ClinicRussian Federation20260207202625334–49Copyright © Булатова И.А., Юсупова А.А., 20262026Булатова И.А., Юсупова А.А.Bulatova I.A., Yusupova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/2229Введение

Введение. В последние годы стали выделять фенотип неалкогольной жировой болезни печени (НАЖБП) у лиц с нормальной массой тела (НМТ), клинические особенности которого мало изучены.

Цель — изучить структуру сопутствующей патологии, компонентный состав тела и метаболический профиль пациентов НАЖБП и НМТ, динамику этих показателей при комбинированной терапии глицирризиновой кислотой и фосфолипидами.

Материалы и методы

Материалы и методы. Обследовано 69 пациентов с НАЖБП и НМТ. Проводилось ультразвуковое исследование органов брюшной полости, транзиентная эластография печени, определение компонентного состава тела, параметров углеводного и липидного обмена, уровни инсулина, лептина, адипонектина, HbA1c.

Результаты

Результаты. Исследуемые пациенты имели стеатоз печени 1-й стадии в 72,5 % случаев, 2-й стадии — 27,5 %; фиброз печени 1–3-й стадий — 22,0 %. Сопутствующая патология органов желудочно-кишечного тракта регистрировалась у 48,0 % лиц, артериальная гипертензия — 25,0 %, дислипидемия — 51,0 %; нарушение толерантности к глюкозе в 30,7 % случаев, адипокинового статуса — 46,0 %. Индекс коморбидности составил (0,6±0,2) балла, риск развития острого коронарного синдрома по шкале PROCAM равнялся (29,2±2,6) %.

Заключение

Заключение. Большинство пациентов с НАЖБП и НМТ имело 1 или более факторов кардиометаболического риска. Прогрессирование НАЖБП ассоциировалось с неблагоприятным метаболическим профилем и повышением риска развития кардиоваскулярной патологии. В результате 3-месячной терапии препаратом «Фосфоглив» в комплексе с немедикаментозными методами достигнуты задачи по регрессу стеатоза, фиброза, улучшению компонентного состава тела и повышение протективных липопротеинов высокой плотности. 

Introduction

Introduction. In recent years, the phenotype of non-alcoholic fatty liver disease (NAFLD) has been identified in individuals with normal body weight (NBW), the clinical features of which have been little studied.

The purpose of the work is to study the structure of concomitant pathology, body composition and metabolic profile of patients with NAFLD and NBW, the dynamics of these indicators in combination therapy with glycyrrhizic acid and phospholipids.

Materials and methods

Materials and methods. 69 patients with NAFLD and NMT were examined. Ultrasound examination of abdominal organs, transient liver elastography, determination of body composition, parameters of carbohydrate and lipid metabolism, levels of insulin, leptin, adiponectin, HbA1c were performed.

Results

Results. The studied patients had liver steatosis of stage 1 in 72.5 %, stage 2 in 27.5 %, liver fibrosis of stages 1–3 in 22.0 % of cases. Concomitant pathology of the gastrointestinal tract was registered in 48.0 % of individuals, arterial hypertension in 25.0 %, dyslipidemia in 51.0 %, impaired glucose tolerance in 30.7 %, impaired adipokine status in 46.0 % of cases. The comorbidity index was (0.6±0.2) points, and the risk of developing acute coronary syndrome on the PROCAM scale was (29.2±2.6) %.

Conclusion

Conclusion. Most patients with NAFLD and NBW had 1 or more cardiometabolic risk factors. The progression of NAFLD was associated with an unfavorable metabolic profile and an increased risk of developing cardiovascular pathology. As a result of 3 months of therapy with Phosphogliv in combination with non-medicinal methods, the tasks of regressing steatosis, fibrosis, improving body component composition and increasing protective high-density lipoproteins were achieved. 

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The authors declare that there are no conflicts of interest present.