urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.25694/URMJ.2019.02.28urmj-487Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYНеалкогольная жировая болезнь печени у больных с артериальной гипертензиейNon-alcoholic fatty liver disease in patients with hypertensionБобылевЮ. М.BobylevY. M.bobylev.1950@mail.ruВладимирскийВ. Е.VladimirskyV. E.noemail@neicon.ruКатковаА. В.KatkovaA. A.noemail@neicon.ruФГБОУ ВО "Пермский государственный медицинский университет имени академика Е.А. Вагнера" Министерства здравоохранения Российской ФедерацииRussian Federation201914042021025863Copyright © Бобылев Ю.М., Владимирский В.Е., Каткова А.В., 20212021Бобылев Ю.М., Владимирский В.Е., Каткова А.В.Bobylev Y.M., Vladimirsky V.E., Katkova 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/487

Цель исследования. Изучить взаимосвязь неалкогольной жировой болезни печени (НАЖБП) у больных артериальной гипертензией (АГ) с кардиометаболическими факторами риска (ФР) сердечно-сосудистых заболеваний (ССЗ) и влияние НАЖБП на их развитие. для этого методом случайной выборки выбран 71 пациент с артериальной гипертензией I-III стадией (ВОЗ). Выделено две группы - 37 пациентов с НАЖБП и 34 пациента без НАЖБП преимущественно пожилого и старческого возраста. По результатам исследования можно сделать заключение. Наличие НАЖБП у больных с АГ пожилого и старческого возраста недостаточно для того, чтобы пациенты рассматривались как больные с более высоким риском сердечно-сосудистых заболеваний. основная причина - это наличие метаболического синдрома (МС) и его компонентов, которые повышают риск ССЗ в исследуемой группе, а не сама НАЖБП. Метаболический синдром по нашему мнению является общим знаменателем, фундаментом для всех факторов риска. Уровень трансаминаз в группе больных с АГ и НАЖБП с возрастом снижается, поэтому использовать АЛТ в качестве суррогата НАЖБП у больных пожилого и старческого возраста неуместно. Уровень трансаминаз у больных со стеатозом и стеатогепатитом не связан с риском сердечно-сосудистых заболеваний. При сочетании АГ и НАЖБП отсутствует связь НАЖБП с ИБС, ФП, ГЛЖ и перенесенным инсультом. Наличие АГ у пациента с НАЖБП и без НАЖБП по нашему мнению нивелирует влияние НАЖБП на риск ССЗ, так как сама АГ является мощным фактором риска сердечно-сосудистых заболеваний. По частоте ГЛЖ и по типу ремоделирования ЛЖ различия у больных с НАЖБП и без НАЖБП отсутствуют.

Purpose of research. To study the relationship of nonalcoholic fatty liver disease (NAFLD) in patients with hypertension (AH) with cardiometabolic risk factors (FR) of cardiovascular disease (CVD) and the effect of NAFLD on their development. 71 patients with stage I-III hypertension were randomly selected for this purpose. Two groups were identified - 37 patients with NAFLD and 34 patients without NAFLD, mainly elderly and senile age. The results of the study can be concluded. The presence of NAFLD in patients with hypertension in the elderly and senile age is not sufficient for patients to be considered as patients with a higher risk of cardiovascular disease. The main reason is the presence of metabolic syndrome and its components, which increase the risk of CVD in the study group, rather than NAFLD itself. Metabolic syndrome, in our opinion, is a common denominator, the Foundation for all risk factors. The level of transaminases in the group of patients with hypertension and NAFLD decreases with age, so it is inappropriate to use ALT as a NAFLD surrogate in elderly and senile patients. The level of transaminases in patients with steatosis and steatohepatitis is not associated with the risk of cardiovascular disease. With the combination of AH and NAFLD there is no connection of NAFLD with ischemic heart disease, AF, LVH and stroke. The presence of hypertension in a patient with NAFLD and without NAFLD, in our opinion, levels the impact of NAFLD on the risk of CVD, as the hypertension itself is a powerful risk factor for cardiovascular disease. There are no differences in the frequency of LVH and in the type of LV remodeling in patients with and without NAFLD.

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