Features of the connective tissue metabolism, the content of adipokines and cytokeratin-18 in patients with non-alcoholic steatohepatitis combined with osteoarthritis and obesity

Abstract

Aim. To determine the indices of connective tissue metabolism, adipokines and cytokeratin-18 in non-alcoholic steatohepatitis patients with osteoarthritis and obesity comorbidities. Materials and methods. 90 patients were examined and divided into three groups: group 1 (n = 30) included patients suffering from OA grade II–III according to Kellgren and Lawrence classification with normal body mass (BMI = 21–25 kg/m2), group 2 (n = 30) – patients with NASH and OB without OA (BMI > 30 kg/m2), group 3 (n = 30) – patients with OA with NASH and OB (BMI more than 30 kg/m2). The control group consisted of 30 age-matched practically healthy persons (PHP). The average age of patients was 62.3 ± 5.7 years. Results. In NASH patients with OB and OA, there is a significant increase in the synthesis of collagen and glycosaminoglycans which is accompanied by ineffective resorption of newly formed collagen due to inhibition of the collagenolytic activity of blood plasma in NASH arising from activation of proteinase inhibitors (α2-MG), a significant imbalance in the metabolic system of connective tissue, which, particularly in OA and OB comorbidities, leads to progressive fibrosis of the liver and its functions impairment. It has been established that blood adipokines level not only depends on body weight, but also reflects the risk for occurrence of nosologies associated withOB. Conclusions. In patients with NASH and morbidOB, a significant increase in collagen and glycosaminoglycans synthesis was observed. Adipokine deficiency, found in the work, can play a significant pathogenetic role in the development and progression of NASH as well asOB and OA. Adipokines leptin and adiponectin and also cytokeratin-18 may serve as sensitive risk markers for comorbid diseases development and could be candidates for their measurements inclusion in the diagnostic algorithm for NASH, OA,OB and their combination.

Keywords

• nonalcoholic steatohepatitis
• connective tissue
• adipokines
• cytokeratin-18