Filippova A. Yu., Gubar I. A.

CRITERIA FOR THE PREDICTING THE DISEASE OF NONALCOHOLIC STEATO-HEPATITIS IN PATIENTS WITH OBESITY AND PATHOLOGY OF THE BILIARY TRACT

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About the author:	Filippova A. Yu., Gubar I. A.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	Objective – to investigate the main laboratory factors that correlate with the progredient course of steatohepatitis and determine the optimal criteria for assessing the risk of progression of non-alcoholic steatohepatitis (NASH) in patients with obesity (OB) and pathology of the biliary tract (BT). Materials and methods. To create mathematical models for predicting the course of nonalcoholic fatty liver disease, the data of 100 patients with NASH in combination with OB and pathology of BT were analyzed. The main group consisted of 62 patients with rapidly progressive course of steatohepatitis, control group - 38 patients with a slow course of the disease. The activity of alanine aminotransferase (ALT), triglycerides (TG), oxyproline protein-bound (OPB), malonic dialdehyde (MDA) in plasma was determined. Results and discussion. Based on the results of the correlation analysis, 4 main factors were selected that directly correlated with the progredient course of NASH-the ALT level (rs = 0.509, p<0.001), TG (rs = 0.555, p <0.001), OPB (rs = 0.477, p<0.001), MDA of the plasma (rs = 0.307, p<0.002). With the help of ROC- and logit-analysis, optimal criteria for assessing the risk of the progression rate of NASH in patients with OB and pathology of BT were determined. The critical value by which the progression`s relative risk of NASH is significantly increased (p<0.001) was defined: the serum ALT level is more than 1.03 mmol /l (OR = 12.9, 95% CI 4.33-38.4), TG more than 1.99 mmol/l (OR = 14.9; 95% CI 4.98-44.8), OPB more than 218.9 μmol/l (OR = 14.6; 95% CI 5,35-39 7), MDA of the blood plasma more than 3.01 nmol/ml (OR = 4.9; 95% CI 2.04-11.9). Conclusions. Predicting the course of NASH in patients with OB and pathology of BT at the onset of the disease or while dynamic observation by constructed mathematical models based on using the critical or actual values of the allocated laboratory indicators substantially raises the validity of the conclusions (prediction accuracy from 89% to 92%). It allows to direct therapeutic measures for preventing the unfavorable course of the disease.
Tags	nonalcoholic steatohepatitis, obesity, biliary tract, mathematical modeling
Bibliography	Gubler E.V. Informatika v patologii, klinicheskoy meditsine i pediatrii / E.V. Gubler // – L.: Meditsina, - 1990. – 175 s. Vinnitskaya E. V. Diagnosticheskaya znachimost syivorotochnyih markerov fibroza pri hronicheskih zabolevaniyah pecheni / E. V. Vinnitskaya, V. N. Drozdov, Yu. M. Yunusova [i dr.] // Terapevticheskiy arhiv. – 2013. – No.2. – S.27-31. Kamyishnikov V. S. Kliniko-laboratornaya diagnostika zabolevaniy pecheni / V.S. Kamyishnikov // Moskva: MEDpress-inform. – 2-e izd. – 2014. – 96 s. Rebrova O. Yu. Statisticheskiy analiz meditsinskih dannyih. Primenenie paketa prikladnyih programm STATISTICA / O. Yu. Rebrova // – M.: Media Sfera, - 2002. – 312 s. Filippova O. Yu. Porushennia oksydatyvnoho metabolizmu ta aktyvnosti fermentatyvnykh antyoksydantiv u patsiientiv z nealkoholnym steatohepatytom v poiednanni z ozhyrinniam i patolohiieiu biliarnoho traktu / O. Yu. Filippova // Ukrainskyi terapevtychnyi zhurnal. – 2016. – No.3. – S.19-26. Chesnokova L. V. Insulinorezistentnost, aterogennyie narusheniya i fibroz pecheni u bolnyih s metabolicheskim sindromom / L. V. Chesnokova, I. M. Petrov, I. A. Troshina // Ozhirenie i metabolizm. – 2014. – No.2. – S. 17-23. Argo C.K. Systematic review of risk factors for fibrosis progression in non-alcoholic steatohepatitis / C. K. Argo, P. G. Northup, A. M. Al-Osaimi [et. al.] // J. Hepatol. – 2009. – Vol. 51. – P.371–379. Dietrich P. Non-alcoholic fatty liver disease, obesity and the metabolic syndrome / P. Dietrich, C. Hellerbrand // Best Pract Res Clin Gastroenterol. – 2014. – Vol.28(4). – P.637-653. Obesity World Gastroenterology Organisation Global Guideline / James Toouli, Michael Fried, Aamir Ghafoor Khan // - 2009. – 30p. Sowa J.P. Novel Algorithm for Non-Invasive Assessment of Fibrosis in NAFLD / J.P. Sowa, D. Heider, L.P. Bechmann [et. al.] // PLoS One. – 2013. – Vol. 8(4). – e62439.
Publication of the article	«World of Medicine and Biology» №4(62), 2017 year, 099-103 pages, index UDK 616-36-002.003.826:613.25:616.361/.366]-036-037
DOI	10.26724/2079-8334-2017-4-62-99-103