Clinical and molecular characteristics and peculiarities of nutritional status in non-alcoholic fatty liver disease
Abstract. Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, the prognosis of which directly depends on the patient’s lifestyle. Therefore, a comprehensive assessment of nutritional status and a detailed study of the clinical and molecular peculiarities of the disease allow to choose optimal therapeutic approaches.Znakharenko E.A., Gerasimenko O.N., Maksimov V.N.
The aim: to develop diagnostic criteria for nutritional status and additional markers for the prognosis of NAFLD basing on the study of clinical, functional, nutritional, metabolic and hormonal criteria of this disease.
Material and methods. During one-stage, open, non-randomized study, all participants (n = 349) underwent a multi-level comprehensive estimation of nutritional status. In patients with NAFLD (113 patients with non-obese NAFLD, 122 patients with obese NAFLD), the degree of fibrosis was additionally estimated using a set of non-invasive diagnostic methods.
Results. In the course of linear regression intersystem analysis of nutritional and molecular parameters, predictors of fibrosis development in case of NAFLD were identified: waist circumference, active cell and fat mass percentage in body composition, prealbumin, visfatin and 25(OH) vitamin D levels. Using the logistic regression method, models were built to determine significant factors associated with the chance of having this disease: for patients with NAFLD without obesity, these factors were the waist-to-hip ratio, adipokine levels and 25(OH) vitamin D, and for patients with NAFLD and obesity they were a combination of percentage of active cell mass, prealbumin and 25(OH) vitamin D levels (p < 0.05).
Conclusion. The results of the study allowed us to identify diagnostic combinations of parameters of nutritional-metabolic status and determine additional prognostic markers of fibrosis development in patients with NAFLD.
Keywords
non-alcoholic fatty liver disease
nutritional status
fibrosis
prealbumin
adipokines
25(OH) vitamin D
active cell mass
estimation of actual nutrition
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About the Authors
Elena A. Znakharenko, MD, postgraduate student of the Department of faculty therapy named after professor G.D. Zalessky of the Faculty of general medicine, Novosibirsk State Medical University of the Ministry of Healthcare of Russia, nutritionist, gastroenterologist at Novosibirsk Regional Clinical Hospital for War Veterans No. 3. Address: 630091, Novosibirsk, 52 Krasny Avenue.E-mail: znaxarenko85@bk.ru
ORCID: https://orcid.org/0000-0001-6408-6622
Oksana N. Gerasimenko, MD, Dr. Sci. (Medicine), professor, head of the Department of faculty therapy named after Professor G.D. Zalessky of the Faculty of general medicine, Novosibirsk State Medical University of the Ministry of Healthcare of Russia, chief physician of Novosibirsk Regional Clinical Hospital for War Veterans No. 3, chief specialist in therapy and general medical practice of the Ministry of Healthcare of the Novosibirsk region, Honored Doctor of the Russian Federation, Outstanding Healthcare Worker of the Russian Federation. Address: 630091, Novosibirsk, 52 Krasny Avenue.
E-mail: profgerasimenko@inbox.ru
ORCID: https://orcid.org/0000-0002-9742-0479. Scopus ID: 12763759000. eLibrary SPIN: 7783-2977
Vladimir N. Maksimov, MD, Dr. Sci. (Medicine), professor, professor of the Department of medical genetics and biology of the Faculty of general medicine, Novosibirsk State Medical University of the Ministry of Healthcare of Russia, chief researcher, head of the Department of molecular genetic testing of therapeutic diseases, Research Institute of Therapy and Preventive Medicine – a branch of the Federal Research Center Institute of Cytology and Genetics of the Siberian branch of the Russian Academy of Sciences. Address: 630089, Novosibirsk, 175/1 Borisa Bogatkova St.
E-mail: medik11@mail.ru
ORCID: https://orcid.org/0000-0002-7165-4496. Scopus ID: 720254327. eLibrary SPIN: 9953-7867
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