Specific indicators of endogenous intoxication syndrome under the conditions of concomitant steatosis of the liver

Abstract

The basic aspects of the endogenous intoxication syndrome (EIS) in the pathogenesis of many diseases are still poorly understood - an increase in the content of a wide variety of compounds, most of which belong to middle mass molecules (MMM) with a mass of 500-2000 D, the content of which under the conditions of metabolically associated steatosis of the liver (MASL) as the initial stage of the fatty disease has not been yet established. In order to determine the content of molecules of average mass of total and their fractions in the blood and urine in patients with MASL, 25 patients were examined (14 men, 11 women; average age 63,8 years) with coronary artery disease (CAD), atherosclerotic cardiosclerosis, heart failure of I-II FC and sonographically diagnosed fatty liver disease (19 with MACL and 6 with steatohepatitis (SH)), in which MMMs were additionally determined at 238, 254, 266 and 282 nm in blood and urine at 238, 254, 266, 280, 288, 310 nm; coefficients of aromaticity were calculated, peptide-nucleotide, distributive; de Ritis indices and hepato-steatosis, AST/platelet ratio. The results were calculated statistically. The level of significance is p<0,05. The results. In patients with chronic forms of coronary artery disease, under the conditions of concomitant MASL, the content of total MMM was significantly higher (0,63±0,06 vs 0,34±0,02; p<0,05), which correlated with the level of high-sensitivity C-reactive protein (r=0,86; p<0,05). It was accompanied by the elevation of MMM at all wavelengths in the blood (238, 254, 266, and 280 nm) and hydrophilic chain MMM238 in urine and was associated by significantly higher values of aromaticity coefficients (2,14±0,23 vs 1,60±0,05) and peptide-nucleotide (2,65±0,37 vs 1,38±0,05), all p<0,05. The group with concomitant MASL differed from patients with comorbid SH significantly only in the lower content of hydrophilic MMM238 in urine (1,92±0,18 vs 2,30±0,03; p<0,05). Conclusion. Metabolic-associated steatosis of the liver is accompanied by the activation of the endogenous intoxication syndrome with an increase of the content of MMM in the blood and urine, which occurs in parallel with the syndrome of systemic inflammation.

Keywords

• endogenous intoxication syndrome
• medium mass molecules
• steatohepatosis
• steatohepatitis
• de ritis index
• hepato-steatosis index