Clinical and laboratory features of the course of non-alcoholic liver steatosis in women in the early postmenopausal period living on the territory of an industrial megapolis

Abstract

The aim. To study risk factors, clinical features, anthropometric, biochemical and metabolic parameters, parameters of the functional state of the endothelium, the level of interleukin-6 (IL-6) and markers of hemostasis in patients with non-alcoholic liver steatosis in the early postmenopausal period living in Perm. Materials and methods. 100 women in the early postmenopausal period were examined: 70 patients with the clinical form non-alcoholic liver steatosis and overweight or obesity of varying severity (49.9±1.1 years) and 30 practically healthy women without obesity and liver pathology (47.3±2.6 years). Biochemical parameters, lipid spectrum, insulin, leptin, leptin receptors, interleukin-6 (IL-6), markers of endothelial dysfunction, hemostasis parameters were determined in the blood of all subjects, body mass index (BMI), free leptin index, NOMA-IR and Caro were calculated. Liver steatosis was determined by ultrasound examination. Results. General weakness (35%), severity (35%) and pain (15%) in the right hypochondrium (35%), dyspepsia - belching (25%), nausea (15%), heartburn (10%), flatulence (10%). Hypertension was observed in 60% of women, type 2 diabetes mellitus - in 24%. All patients had a genoid type of obesity. 34% of women with non-alcoholic liver steatosis were overweight, 29% were obese of the 1st degree, 23% were obese of the 2nd degree, and 14% of patients were obese of the 3rd degree. Conclusion: In the examined women with non-alcoholic liver steatosis in the early postmenopausal period living in Perm, risk factors for the development of obesity were identified: consumption of high-calorie foods with high fat and sugar content and hypokinesia, and the course of the disease was accompanied by the development of dyslipidemia, insulin and leptin resistance, inflammatory syndrome with activation of proinflammatory cytokine IL-6 and hyperfibrinogenemia, and also endothelial dysfunction, the severity of which increased during the transition from 1 to 2-3 degrees of obesity.

Dynamics of the functional state of the liver and endothelium in patients with metabolic syndrome on the background of menopausal hormone therapy

“…У женщин пострепродуктивного возраста установлена высокая частота встречаемости метаболических факторов риска: более половины имеют ожирение, у 30% наблюдается дислипидемия, у 58-88% регистрируется артериальная гипертензия, нарушение толерантности к глюкозе и инсулинорезистентность [14,15,16]. Женщины в этот период относятся к группе риска по развитию стеатоза печени, а пациентки со стеатогепатитом подвергаются повышенному риску фиброза печени по сравнению с женщинами в пременопаузе, что обусловлено дефицитом эстрогенов [17].…”

“…По данным УЗИ у 76% пациенток с МС имелись признаки стеатоза печени, а по расчетному индексу HSI жировое поражение печени верифицировалось у всех женщин с ММС, у которых данный индекс составил 43,0 (41,5-44,0), что было значимо выше группы контроля 27,8 (26,1-30,0) (р< 0,001). Оценка гормонального статуса женщин с МС показала повышение уровня ФСГ 68,9 (54,0-82,7) мМЕ/мл и снижение эстрадиола 20,8 (11,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)6) пг/мл в группе женщин с ММС, что соответствует периоду менопаузы и свидетельствует о состоянии гипоэстрогении.…”