Clinical features of the comorbid course of non-alcoholic fatty liver disease and gallstone disease

Cherkashchenko, N. A.; Livzan, M. А.; Кролевец, Т. С.

doi:10.26442/00403660.2020.08.000764

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…https://doi.org/10.31146/1682-8658-ecg-223-3-57-64 Введение В последнее время важное значение в развитии желчнокаменной болезни (ЖКБ) придают неалкогольной жировой болезни печени (НАЖБП). По сравнению с общей популяцией у больных НАЖБП конкременты в желчном пузыре выявляются в 5 раз чаще [1,2]. По некоторым данным, камни в желчном пузыре выявлялись у 18,2% и 31,1% пациентов соответственно при стеатозе и стеатогепатите, тогда как при развитии цирроза печени холелитиаз был выявлен у 41,7% пациентов [3].…”

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Biochemical and structural changes in bile in non-alcoholic fatty liver disease

Vakhrushev,

Kosareva,

Suchkova

et al. 2024

ECG

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The purpose of the work is to diagnose the early stage of cholelithiasis through a comprehensive study of bile in patients with NAFLD. Materials and methods. We examined 210 patients with NAFLD at the steatosis stage. The diagnosis was confirmed based on general clinical indicators, ultrasound and liver elastography data, and assessment of blood enzyme levels. All patients underwent ultrasound examination of the gallbladder, study of the microscopic and physicochemical properties of bile (specific gravity, acidity, surface tension, viscosity, lithogenicity indices, cholesterol content, bile acids, phospholipids) obtained as a result of multifractional duodenal intubation, and crystallography. Results: Ultrasound examination revealed biliary sludge in 72% of patients. Microscopic examination of bile revealed crystals of cholesterol and calcium bilirubinate in 75.4% of patients. Biochemical analysis of bile revealed significant changes, expressed in increased cholesterol, decreased bile acids, phospholipids, cholate-cholesterol and phospholipid-cholesterol ratios. A study of the physical properties revealed thickening of bile and an increase in its viscosity. Crystallography revealed elements with high optical activity, which became the basis for the formation of gallstones. Conclusions: In patients in the steatosis stage of NAFLD, a decrease in lithogenicity indices, an increase in acidity and thickening of bile are determined, indicating the tendency of bile to stone formation. Signs of biliary sludge (putty-like bile, microlithiasis), characteristic of stage I cholelithiasis, are detected by ultrasound of the gallbladder in 72% of patients in the steatosis stage of NAFLD. Bile crystallography made it possible to identify crystal optical markers indicating changes in the microstructure of gallbladder bile in patients in the steatosis stage of NAFLD. When conducting an examination of patients with NAFLD in the steatosis stage, to diagnose the early stage of cholelithiasis, it is recommended to conduct multifractional duodenal intubation with subsequent study of the physicochemical properties and structural changes of bile.

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Biochemical and structural changes in bile in non-alcoholic fatty liver disease

Vakhrushev,

Kosareva,

Suchkova

et al. 2024

ECG

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Liver Fibrosis in Some Patients with Non-Alcoholic Fatty Liver Disease: from Diagnosis to Prognosis

Krolevets,

Livzan,

Syrovenko

2024

Annals RAMS

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The purpose of this publication was to update knowledge about non-alcoholic fatty liver disease (NAFLD) and fibrogenesis, as well as factors that have a positive or negative prognostic value in relation to the formation and progression of liver fibrosis. This review article contains the current literature dates about pathogenetic factors of the development of liver fibrosis in NAFLD and conceptual ideas about its diagnosis at this moment. Obviously, along with genetic and epigenetic factors, hyper- and disproduction of organokines affect to the progression of the disease. Evaluation of the quantitative and qualitative composition of the microbiota, the integrity of the epithelial intestinal barrier are perceptual fields for research this problem. Non-invasive proprietary and non-proprietary scales for assessing the risk of steatosis and fibrosis, transient elastometry are suitable for routine assessment of individual risk of disease development and progression. This scientific review demonstrates proofs of necessity to develop individual strategies for the management of patients with NAFLD in relation to its metabolic activity and the stage of liver fibrosis.

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Prevalence of comorbidity in chronic HCV‑infection

Эсауленко

Basina

Dzemova

et al. 2021

Medicinskij alfavit

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The effect of the comorbid background on the course of the infectious process in chronic HCV infection requires study due to the existence of a risk of progression of liver fibrosis even after the eradication of the virus against the background of concomitant diseases.Material and methods. The article analyzes the prevalence of various comorbid conditions in 700 patients with chronic HCV infection, who were observed in the hospital of the Botkin in St. Petersburg, an assessment of the mutual influence of the comorbid background and the progression of liver fibrosis in HCV infection was given. To determine the contribution of comorbidity to the course of HCV infection, the odds ratio (OR) parameters were calculated.Results. HCV-infected individuals have higher prevalence of comorbidity (63 %) and multimorbidity (50 %). In patients with severe fibrosis or cirrhosis, the presence of the comorbidity factor increased to 85 %. In the examined group of patients, diseases of the biliary tract and pancreas prevailed (30.0 %), occult Hepatitis B Infection was revealed in 19.0 %, in 15.4 % – cardiovascular diseases, in 13.7 % – diseases of the upper gastrointestinal tract. Diabetes mellitus was found in 4.6 % of patients, and obesity – in 5.9 %, kidney disease – 3.0 %. The remaining concomitant diseases occurred in less than 2.0 % of the observed patients. It has been established that diseases of the biliary tract and pancreas, gastrointestinal tract, diabetes mellitus, obesity, cardiovascular diseases are risk factors for the development of liver fibrosis in chronic HCV infection.Conclusions. The data obtained indicate the need for a more personalized approach to monitoring patients and the need to create integrated models of medical care for patients with chronic hepatitis C.

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Clinical features of the comorbid course of non-alcoholic fatty liver disease and gallstone disease

Cited by 3 publications

References 42 publications

Biochemical and structural changes in bile in non-alcoholic fatty liver disease

Biochemical and structural changes in bile in non-alcoholic fatty liver disease

Liver Fibrosis in Some Patients with Non-Alcoholic Fatty Liver Disease: from Diagnosis to Prognosis

Prevalence of comorbidity in chronic HCV‑infection

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