CHANGES IN HORMONAL REGULATION AND LIPID METABOLISM INDICATORS IN GALLSTONE DISEASE IN PATIENTS WITH METABOLIC-ASSOCIATED FATTY LIVER DISEASE
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i4.15784Keywords:
non-alcoholic fatty liver disease/metabolic-associated fatty liver disease, gallstone disease, obesity, insulin resistance, hormones (ghrelin, resistin, leptin), lipid metabolism, interleukin-6Abstract
SUMMARY. It is expected that the prevalence of obesity, metabolic syndrome and related conditions (insulin resistance (IR), type 2 diabetes mellitus (DM), non-alcoholic fatty liver disease (NAFLD), biliary tract disease, including gallstone disease (GSD)), as well as their consequences, will soon increase and become a serious burden on the healthcare system.
The aim – to determine the characteristics of lipid metabolism disorders and their dependence on changes in serum ghrelin, leptin, and resistin levels in patients with GSD and metabolically associated fatty liver disease (MAFLD).
Material and Methods. At the clinical base of the Department of Propaedeutics of Internal Medicine, 186 patients with MAFLD were examined. The patients were divided into two groups: group I (n=84) included patients with MAFLD combined with GSD; group II (n=102) consisted of patients with MAFLD without GSD. The levels of lipid metabolism, ghrelin, leptin, resistin and interleukin-6 (IL-6) in blood serum were determined.
Results. Patients with MAFLD were diagnosed with abnormal serum lipid metabolism, which was more pronounced in patients with combined liver damage in the form of steatohepatitis and GSD. Increased levels of resistin and leptin in serum were diagnosed, mainly in patients in group I. Leptin levels, regardless of the presence or absence of NAFLD in patients with GSD, are higher in females (6.7 times higher in patients in group I and 4.7 times higher in patients in group II compared to the same indicator in women in the control group – p<0.001). An increase in ghrelin levels was found in patients in group II and, conversely, a decrease in group I patients. Serum IL-6 levels were also significantly higher than normal in patients with MAFLD.
Conclusions. In patients with MAFLD and GSD, a decrease in serum ghrelin levels (to 72.16±2.14 ng/ml – p<0.05) was observed, which negatively correlates with the severity of obesity in these patients.
Patients with NAFLD and GSD have been diagnosed with increased levels of leptin and resistin in their blood serum, which directly correlates with increased levels of total cholesterol and triglycerides in the blood serum of these patients.
In patients with GSD and MAFLD, a significant increase in serum IL-6 levels (up to 89.55±2.78 pg/ml – p<0.001) was diagnosed, which correlates with the severity of IR in these patients.
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