CLINICAL AND LABORATORY INDICATORS IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE ON THE BACKGROUND OF ESSENTIAL ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i1.11992Keywords:
nonalcoholic fatty liver disease, arterial hypertension, daily monitoring of blood pressure, unloading-dietary therapyAbstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most difficult problems in modern medicine. It is often comorbid and is associated with hypertension and metabolic syndrome. It should be noted that in recent years there have been many studies on NAFLD, but questions remain about the mechanisms of NAFLD with essential hypertension, indicators of daily blood pressure monitoring and the choice of optimal treatment, especially given the chronobiological changes.
The aim – optimization of diagnosis and treatment of NAFLD on the background of arterial hypertension.
Material and Methods. 167 patients aged 28-69 years who were on outpatient and inpatient treatment in the State Institution "Departmental Clinical Hospital Art. Uzhhorod DTGO "Lviv Railway" during 2010-2019.
Results. Deterioration of lipid and carbohydrate metabolism with increasing intensity of laboratory syndromes of cytolysis and cholestasis, as well as changes in circadian rhythm of blood pressure in patients with NAFLD on the background of hypertension.
Conclusions. The use, along with lifestyle adjustments and basic therapy (atorvastatin, telmisartan and indapamide) of chronotherapeutic approaches, relief and dietary therapy, adamethionine, ursodeoxycholic acid in various subgroups of patients with NAFLD and hypertension, promotes the correction of.
References
Fadieienko, H.D., Hridniev, O., Nesen, A., Chernyshov, V., Hrunchenko, M., & Shkapo, V. (2013). Komorbidnist i vysokyi kardiovaskuliarnyi ryzyk – kliuchovi pytannia suchasnoi medytsyny [Comorbidity and high cardiovascular risk - key issues of modern medicine]. Ukrainskyi terapevtychnyi zhurnal – Ukrainian Therapeutic Journal, 1, 102-107 [in Ukrainian].
Stepanov, Yu.M. (2019). Rezultaty observatsiynoho perekhresnoho doslidzhennia PRELID 2 (2015–2016). Chastyna 1. Poshyrenist nealkoholnoi zhyrovoi khvoroby pechinky, kharakterystyka suputnoi patolohii, metabolichnoho syndromu ta yoho okremykh kryteriiv u patsiientiv, yaki zvertaiutsia do terapevtiv i hastroenterolohiv v Ukraini [Results of the observational cross-sectional study PRELID 2 (2015–2016). Part 1. Prevalence of non-alcoholic fatty liver disease, characteristics of concomitant pathology, metabolic syndrome and its individual criteria in patients who turn to therapists and gastroenterologists in Ukraine]. Hastroenterolohiya – Gastroenterology, 53 (1), 26-33 [in Russian].
Bellentani, S. (2017). The epidemiology of non-alcoholic fatty liver disease. Liver Int., 37, 81-84. DOI: 10.1111/liv.13299
Leung, J.C., Loong, T.C., Wei, J.L., Wong, G.L., Chan, A.W., Choi, P.C., & Wong, V.W. (2017). Histological severity and clinical outcomes of nonalcoholic fatty liver disease in nonobese patients. Hepatology, 65 (1), 54-64. DOI: 10.1002/hep.28697
Jennison, E., Patel, J., Scorletti, E., & Byrne, C.D. (2019). Diagnosis and management of non-alcoholic fatty liver disease. Postgrad. Med. J., 95 (1124), 314-322. DOI: 10.1136/postgradmedj-2018-136316
Munteanu, M., Tiniakos, D., Anstee, Q., Charlotte, F., Marchesini, G., Bugianesi, E., & Poynard, T. (2016). Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference. Aliment Pharmacol. Ther., 44 (8), 877-889. DOI: 10.1111/apt.13770
Vilar-Gomez, E., & Chalasani, N. (2018). Non-invasive assessment of non-alcoholic fatty liver disease: clinical prediction rules and blood-based biomarkers. J. Hepatol., 68 (2), 305-315. DOI: 10.1016/j.jhep.2017.11.013
Rajendra Acharya, U., Faust, O., Molinari, F., Sree, S.V., Junnarkar, S.P., & Sudarshan, V. (2015). Ultrasound-based tissue characterization and classification of fatty liver disease: A screening and diagnostic paradigm. Knowledge-Based Systems, 75, 66-77. DOI: https://doi.org/10.1016/j.knosys.2014.11.021
Lupşor-Platon, M., Stefănescu, H., Mureșan, D., Florea, M., Szász, M.E., Maniu, A., & Badea, R. (2014). Noninvasive assessment of liver steatosis using ultrasound methods. Med. Ultrason., 16 (3), 236-245. DOI: 10.11152/mu.2013.2066.163.1mlp
Zhuravleva, L.V., & Ogneva, Ye.V. (2014). Preimushchestva i nedostatki sovremennykh metodov diagnostiki nealkogolnoy zhirovoy bolezni pecheni [Advantages and disadvantages of modern methods of diagnostics of non-alcoholic fatty liver disease]. Ukrainskyi medychnii visnyk – Ukrainian Medical Bulletin, 10, 19-21 [in Russian].
Tarzamni, M.K., Khoshbaten, M., Sadrarhami, S., Daneshpajouhnejad, P., Jalili, J., Gholamian, M., & Shahmoradi, Z. (2014). Hepatic artery and portal vein doppler indexes in non-alcoholic fatty liver disease before and after treatment to prevent unnecessary health care costs. Int. J. Prev. Med., 5 (4), 472-427.
Balci, A., Karazincir, S., Sumbas, H., Oter, Y., Egilmez, E., & Inandi, T. (2008). Effects of diffuse fatty infiltration of the liver on portal vein flow hemodynamics. J. Clin. Ultrasound., 36 (3), 134-140. DOI: 10.1002/jcu.20440
Mohammadi, A., Ghasemi-rad, M., Zahedi, H., Toldi, G., & Alinia, T. (2011). Effect of severity of steatosis as assessed ultrasonographically on hepatic vascular indices in non-alcoholic fatty liver disease. Med. Ultrason., 13 (3), 200-206.
Wells, M.M., Li, Z., Addeman, B., McKenzie, C.A., Mujoomdar, A., Beaton, M., & Bird, J. (2016). Computed tomography measurement of hepatic steatosis: Prevalence of hepatic steatosis in a Canadian population. Can. J. Gastroenterol. Hepatol., 2016, 4930987. DOI: 10.1155/2016/4930987
Paredes, A.H., Torres, D.M., & Harrison, S.A. (2012). Nonalcoholic fatty liver disease. Clin. Liver Dis., 16 (2), 397-419. DOI: 10.1016/j.cld.2012.03.005
Qayyum, A., Nystrom, M., Noworolski, S.M., Chu, P., Mohanty, A., & Merriman, R. (2012). MRI steatosis grading: development and initial validation of a color mapping system. Am. J. Roentgenol., 198 (3), 582-588. DOI: 10.2214/AJR.11.6729
Adolph, T.E., Grander, C., Grabherr, F., & Tilg, H. (2017). Adipokines and non-alcoholic fatty liver disease: multiple interactions. Int. J. Mol. Sci., 18 (8), 1649. DOI: 10.3390/ijms18081649
Shah, A.M., & Pfeffer, M.A. (2014). Left ventricular size, mass, and shape: is the sum greater than the parts? JACC Heart Fail., 2 (5), 523-525. DOI: 10.1016/j.jchf.2014.05.010
Williams, B., Mancia, G., Spiering, W., Rosei, E.A., Azizi, M., Burnier, M., & Desormais, I. (2018). 2018 ESC/ESH guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J. Hypertens., 36 (10), 1953-2041. DOI: 10.1097/HJH.0000000000001940
(2016). European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Diabetologia, 59 (6), 1121-1140. DOI: 10.1007/s00125-016-3902-y
Romero-Gómez, M., Zelber-Sagi, S., & Trenell, M. (2017). Treatment of NAFLD with diet, physical activity and exercise. J. Hepatol., 67 (4), 829-846. DOI: 10.1016/j.jhep.2017.05.016
Kim, S.-H., Jo, S.-H., Lee, S.-C., Lee, S.-Y., Yoon, M.-H., Lee, H.-L., & Oh, B.-H. (2016). Blood pressure and cholesterol-lowering efficacy of a fixed-dose combination with irbesartan and atorvastatin in patients with hypertension and hypercholesterolemia: a randomized, double-blind, factorial, multicenter phase III study. Clin. Ther., 38 (10), 2171-2184. DOI: 10.1016/j.clinthera.2016.09.005
Mancini, G.B.J., Baker, S., Bergeron, J., Fitchett, D., Frohlich, J., Genest, J., & Tashakkor, A.Ya. (2016). Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Consensus Working Group update. Can. J. Cardiol., 32 (7), S35-65. DOI: 10.1016/j.cjca.2016.01.003
Ivashkin, V.T., Mayevskaya, M.V., Pavlov, Ch.S., Tikhonov, I.N., Shirokova, Ye.N., & Palgova, L.K. (2015). Klinicheskiye rekomendatsii po diagnostike i lecheniyu nealkogolnoy zhirovoy bolezni pecheni Rossiyskogo obshchestva po izucheniyu pecheni i Rossiyskoy gastroenterologicheskoy assotsiatsii [Diagnostics and treatment of non-alcoholic fatty liver disease: clinical guidelines of the Russian Scientific Liver Society and the Russian gastroenterological association]. Gepatologiya – Hepatology, 2 (16), 24-42 [in Russian].
Shcherbynyna, M.B., Dotsenko, N.Ya., & Herasymenko, L.V. (2011). Vozmozhnosti primeneniya ursodeoksykholevoy kysloty (Ursosan) v hipolypidemicheskoy terapii [Possibilities of application of ursodeoxycholic acid (Ursosan) in hypolipidemic therapy]. Ukrainskyi medychnyi visnyk – Ukrainian Medical Bulletin, 7-8, 2-4 [in Russian].
Durazzo, M., Belci, P., Collo, A., Grisoglio, E., & Bo, S. (2012). Focus on therapeutic strategies of nonalcoholic Fatty liver disease. Int. J. Hepatol., 2012, 464706. DOI: 10.1155/2012/464706
Khajehdehi, P. (2000). Lipid-lowering effect of polyunsaturated fatty acids in hemodialysis patients. J. Ren. Nutr., 10 (4), 191-195. DOI: 10.1053/jren.2000.16326
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