Features of indicators of the functional state of the liver, immune link, cytokine regulation and carbohydrate metabolism in patients with toxic chronic diffuse liver diseases

Abstract

Background. The problem of the development and progression of chronic diffuse liver diseases is currently one of the most important in modern gastroenterology, it has general medical and social significance. The purpose was to determine the features of indicators of the functional state of the liver, immune link, cytokine regulation and carbohydrate metabolism in patients with alcohol-related and drug-induced chronic diffuse liver diseases. Materials and methods. There were 50 patients with chronic diffuse liver diseases under the supervision: 27 patients with alcoholic liver disease — 16 (59.3 %) men and 11 (40.7 %) women with the ave­rage age of (37.6 ± 2.4) years; and 23 individuals with toxic drug-induced hepatitis — 6 (26.1 %) men and 17 (73.9 %) women aged (49.2 ± 3.1) years. All patients underwent biochemical and immunological blood tests. The levels of interleukin 6 (IL-6), IL-10, tumor necrosis factor α (TNF-α), and the HOMA-IR were also determined. Results. Most patients with alcoholic liver disease and toxic drug-induced hepatitis are characterized by the presence of cytolytic and cholestatic syndromes, mainly of a minimal degree of activity. Signs of hypercoagulation were found 2 times more often among patients with alcoholic liver disease than among those with toxic drug-induced hepatitis (χ2 = 4.43; p < 0.05). In drug-induced liver injury, an increase in the level of prothrombin index was observed 6.5 times more often (χ2 = 10.87; p < 0.01). A significant 1.8-fold decrease in the number of T-killers (p < 0.05) was found in patients with drug-induced liver injury compared to the control group, while in patients with alcoholic liver disease, the activation of the humoral immunity was determined. There was a significant increase in IL-6, TNF-α, the ratio of pro-inflammatory and anti-inflammatory cytokines, the development of insulin resistance in persons with alcohol-related liver damage, while a significant decrease in IL-10 was typical for patients with toxic drug-induced hepatitis. Conclusions. The analysis of the features of the functional state of the liver, immune link, cytokine regulation and carbohydrate metabolism in the examined patients revealed indicators that can be considered laboratory markers for the development and progression of toxic liver lesions.

Keywords

• alcoholic liver disease
• toxic drug-induced hepatitis
• laboratory diagnosis