Arta Medica (Aug 2023)
THE IMPORTANCE OF ASSESSING INDICATORS OF LIPID METABOLISM IN CHRONIC VIRAL HEPATITIS
Abstract
Introduction. A disorder of lipid metabolism is very often observed in patients with chronic viral hepatitis B and C, which can lead to the progressive damage of the liver parenchyma with future severe evolution of chronic liver pathology. The disturbance of cholesterol metabolism under the action of viral, metabolic and other factors leads to the pathological accumulation of free cholesterol in hepatocytes, and the development of nonalcoholic fatty liver disease with steatosis or steatohepatitis and liver fibrosis. The aim of the study was to study certain indices of lipid metabolism in patients with chronic viral hepatitis HBV, HCV and mixed viral etiology HBV+HCV in reference to cytolysis syndrome. Material and methods. In the study participated 138 patients with chronic viral hepatitis of chronic viral etiology HBV, HCV and HBV+HCV. Patients were divided into 3 groups according to the etiology of viral etiology: group I consisted of patients (n = 58) with chronic viral hepatitis of HBV etiology. Group II presented patients (n = 69) with chronic viral hepatitis, of HCV etiology. Group III consisted of patients with chronic viral hepatitis mixed form: HBV+HCV (n = 11). The comparison group consisted of 30 practically healthy people. Results. The study revealed a significant increase in cytolysis syndrome indicator enzymes, alanine aminotransferase and aspartate aminotransferase, with a significant increase depending on the viral etiology, being high in group II (p<0.01). The highest indices were appreciated in patients from group III (HBV+HCV) (p<0.001), compared to the data of the control group (p˂0.001). The Ritis index constituted in gr. I – 0.88, in gr. II – 0.47, in gr. III – 0.5. At the same time, the cholesterol level showed an increasing tendency in all evaluated groups (p<0.05), compared to the parameters of healthy patients. Conclusions. Processes at the liver parenchyma level with the appearance of cytolysis syndrome in chronic viral infection significantly affect cholesterol metabolism in patients with chronic viral hepatitis. Evaluation of the levels of cytolysis syndrome enzymes, alanine aminotransferase and aspartate aminotransferase, simultaneously with the indicator of lipid metabolism, cholesterol, can efficiently and easily accessible monitor the metabolic state of the patients with chronic viral hepatitis. In patients with chronic viral hepatitis, it is necessary to monitor the cytolysis syndrome with indicators of lipid metabolism with a concomitant change in patient management.
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