Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in highly developed countries. The risk of developing NAFLD and associated complications varies greatly among people of different nationalities and is determined by environmental and genetic factors. Genome-wide studies have revealed strong and reproducible associations between gene variations such as PNPLA3, TM6SF2, MBOAT7, GCKR, HSD17B1, and NAFLD. In this article, we consider the influence of genes and environmental factors on the pathophysiological features of NAFLD. The use of a sufficient population sample with the analysis of SNP arrays and the use of sequencing methods (exome and genome as a whole) will lead to the discovery of additional genetic variants, will inevitably improve the understanding of the pathogenesis of NAFLD, and will allow the development of a technology for personalized risk in assessing the disease in a patient. The aim of our study was to study the genetic predictors of NAFLD based on literature data with the interpretation of the studies. There is now strong evidence that specific variants of genetic risk have a large effect on NAFLD, and their effect is comparable to that of major metabolic risk factors such as obesity and type 2 diabetes. The increased risk extends to the onset and progression of the entire spectrum of NAFLD manifestations, including overall mortality due to liver disease. Currently, individual genetic variants do not allow the creation of a personalized risk profile; therefore, the most expedient approach today is the development of polygenic risk assessments. The number of genetic loci associated with the prevalence and outcome of NAFLD remains limited. The use of a sufficient population sample with the analysis of SNP arrays and the use of sequencing methods (exome and genome as a whole) will lead to the discovery of additional genetic variants and will inevitably improve the understanding of the pathogenesis of NAFLD and will allow the development of a technology for personalized risk in the assessment of the disease.
Obesity and metabolic syndrome are one of the major public health problems in the 21st century due to their prevalence. Nonalcoholic fatty liver disease, dyslipidemia, type 2 diabetes mellitus, arterial hypertension, chronic inflammation and anemia are non-communicable diseases accompanying obesity. With obesity, there is a violation of iron metabolism, iron deficiency, which further contributes to the development of metabolic disorders. Iron is the second most abundant metal on Earth, and its bioavailability is reduced due to the formation of insoluble oxides, while iron deficiency is the most common nutritional disorder. Iron metabolism in the body is associated with the formation of reactive oxygen species involved in lipid peroxidation processes. Iron metabolism in the human body is regulated at all levels; dysregulation of any stage of metabolism can lead to iron deficiency and the development of anemia associated with obesity. This review article summarizes data on molecular and cellular abnormalities in iron metabolism in obesity and metabolic syndrome. The aim of our study was to study, according to the literature, pathophysiological disorders in iron metabolism in the development of obesity and metabolic syndrome. In the future, more research is required to study iron metabolism in obesity with the aim of their preventive and therapeutic effects. The role of oxidative stress in impaired iron metabolism in obesity has not been fully studied, while iron deficiency enhances lipid peroxidation processes in antioxidant deficiency. Under these conditions, oxidative stress can damage cells and destroy red blood cells. The question arises whether the restoration of iron homeostasis in obesity can improve metabolic, inflammatory disorders and reduce the manifestation of oxidative stress, becoming a new innovative approach to the treatment of concomitant metabolic diseases associated with obesity.
The article is devoted to the study of the psychological characteristics of the behavior of patients with non-alcoholic fatty liver disease (NAFLD). The manifestations of NAFLD are a powerful frustrating factor for patients, negatively affect the quality of life, hinder psychosocial adaptation and serve as the basis for the formation of chronic stress from the disease, which blocks the actual needs of the individual. Psychological factors are an important component in the clinical assessment of patients in connection with the individualization of the treatment process and secondary psychoprophylaxis, including methods of somato-centered and personality-centered psychotherapy.
Rationale. The article examines the assessment of the quality of life, psychological state (anxiety-depressive disorders, neurosis-like states) in patients with metabolic syndrome. The prevalence of metabolic syndrome in different countries is 25-30% and varies depending on the criteria used. The severity of the clinical manifestations of the metabolic syndrome affects the quality of life of patients, while the indicators of physical and mental health decrease. The problem of the quality of life of patients suffering from overweight and obesity is relevant and socially significant. Obesity leads to anxiety-depressive disorders, neurosis-like states, which contributes to a worsening of the prognosis of the underlying disease. The number of patients with chronic metabolic disorders (obesity, type 2 diabetes mellitus, non-alcoholic fatty liver disease) is increasing in the world every year. The aim of our work was to assess the quality of life, the level of anxiety and depression in patients with metabolic syndrome. Materials and methods. The authors presented the results of a study of 60 patients with metabolic syndrome and 45 apparently healthy volunteers. Examination of patients, determination of anthropometric indicators with an assessment of the quality of life (questionnaire SF-36) were carried out. The level of anxiety and depression was determined according to the hospital scale of anxiety and depression HADS. Statistical processing of the obtained data was carried out using the application package "STATISTICA 8.0". Results. Most of the quality of life indicators were statistically significantly different in patients with metabolic syndrome relative to the control group. There was a decrease in the average level of the parameters "physical functioning" by 17.3%, "role functioning" by 31%, "general health" by 11.3%, "vitality" by 13%, "emotional functioning" by 50.1%. ... The level of anxiety and depression in patients with metabolic syndrome corresponded to the subclinical level, the level of depression exceeded the value of the control group by 18%. Conclusion. The study shows that patients with metabolic syndrome are characterized by a decrease in quality of life indicators, subclinically severe anxiety / depression. The goal of any treatment, according to MAPI Research Institute specialists, is to improve the quality of life of patients to the level of healthy individuals, therefore, for patients with metabolic syndrome, along with pathogenetic therapy aimed at reducing body weight, correction of psychological disorders is required, which will reduce the level of anxiety-depressive disorders and will improve quality of life indicators.
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