Introduction: Small intestinal bacterial overgrowth may cause the hyperlipidemia appearance by enterohepatic circulation disturbance which evolves on the background of the early bile acids deconjugation with further endotoxin production and oxidative stress in the liver with hyperproduction of cholesterol and atherogenic lipoproteins. The aim: the determination of prevalence and features of SIBO in a series of patients with hyperlipidemia and in control subjects. Materials and methods: Nineteen patients with hyperlipidemia and ten control subjects were studied. Small intestinal bacterial overgrowth was assessed by a lactulose breath test. Such biochemical markers as CRP, ALT, AST, GGTP, apolipoprotein B, bilirubin, cholesterol and lipid profile were determined. Except the routine interpretation of lactulose breath test, which contains the SIBO detection, small intestinal transit time and hydrogen level evaluation with next comparison between groups of patients was realized. Results: Small intestinal bacterial overgrowth was present in 78.9% of patients with hyperlipidemia and 40% in control subjects. The maximal dose of H2 was particularly higher in patients with hyperlipidemia in comparison with control group (94,7±13,69 vs. 36,13±5,4). There was a strong correlation between AST level and SIBO existence in both groups (r=1). Positive connection between LDL, TG, VLDL and the dose of exhaled hydrogen on 120 minute (r=0.6, r= 0.62, r=0.7 respectively) and strong negative correlation between HDL and 120 minute dose (r=-0.74) in main group was marked. Conclusions: Patients with hyperlipidemia have a higher prevalence of small intestinal bacterial overgrowth and there is a relationship between H2 rate and LDL, TG, VLDL.
Researchers have studied the connection between cholesterol and microbiota for a long time. The results of widely published data demonstrate that the relationship between the lipid balance of the blood and the composition of the intestinal microbiota is apparent. The oblective of this study was, we tried to find the path through which this connection is carried out. Furthermore, the aim was to analyze the studies, which demonstrate the decrease of blood lipids as the result of different prebiotics and probiotics prescribtion. Also, the screening of different data from previous years was done for comparing the changes in the pathogenesis.
Abstract. Non-alcoholic fatty liver disease (NAFLD) is the most common kind of liver injury in the world and its prevalence is due to the lack of "in-time" diagnosis and, as a consequence, treatment. A lot of different diseases are complicated by the fatty liver infiltration, the most often is obesity. The progress of the disease could depend on the environmental factors and the genetic disabilities. The aim of the review article was to analyze the latest data about the factors which impact on the NAFLD development in obese patients, including the gut microbiota, genetic predictors and environmental components, to find the new ways of pathogenesis, diagnosis and treatment. Non-alcoholic liver steatosis is diagnosed in 70% of obese patients (although some authors report a significantly higher (up to 95%) incidence of cases) and 35% of thin patients, and non-alcoholic steatohepatitis (NASH) -in 18.5% of obese patients and 2.7% -with insufficient body weight. Among patients with severe obesity and BMI more than 35 kg/m2, the prevalence of NAFLD and NASH is 91% and 37%, respectively. The combination of facts, available at the moment, suggests that one of the central role in the NAFLD development plays disturbance of intestinal microbiota and its permeability. Intestinal microflora can affect the NAFLD due to three mechanisms: 1) an increase in ethanol production in the intestinal cavity; 2) metabolic disorders of food choline (necessary for the synthesis of very low-density lipoproteins and elimination of liver lipids); 3) the release of bacterial lipopolysaccharides. The diagnostic methods, which allow investigation of fatty liver infiltration in the early stages, are considered. Despite the lower sensitivity and specificity compared with CT, ultrasound is considered as an acceptable first-line procedure for diagnostic NAFLD in clinical practice. The waist cir-
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