CLINICAL AND LABORATORY FEATURES OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

The article presents the results of studying the clinical and laboratory features of non-alcoholic fatty liver disease in patients with chronic obstructive pulmonary disease (COPD). The study included 142 patients with a confirmed diagnosis of COPD. All patients underwent ultrasound of the abdominal cavity and used a non-invasive method of diagnosis – FibroMax, which includes: FibroTest, ActiTest, SteatoTest, AshTest, NashTest to determine the degree of hepatic steatosis. The study is based on a comprehensive analysis of 10 biochemical parameters: alpha-2-macroglobulin, haptoglobin, Apo-A1, GGTP, total bilirubin, ALT, AST, blood glucose, TG, ZH. Two groups were formed depending on the body weight of patients: 1 group – n=52 patients with COPD with overweight (PMT) and 2 group, n=90 patients with COPD with normal body weight (BMI). According to clinical and laboratory studies, liver dysfunction was found in 35.2% (50/142) of patients with COPD, with a significant predominance of those in the overweight group of 65.4% vs. 17.8% (p <0.05) in patients with normal weight. Dyspeptic complaints were reported by 42.2% of patients with COPD. The patients were complained of bitterness in the mouth, intermittent discomfort in the right hypochondrium and bloating. Asthenovegetative syndrome was found in 83.8% of patients, and also 70.4% had general weakness. Levels of total bilirubin, alkaline phosphatase, gamma-glutamyl-transpeptidase were significantly higher in patients with COPD with BMI compared with patients with BMD (p <0.05), indicating a predominance of cholestasis syndrome. Liver steatosis of 1-2 degrees was registered in 34.6% of patients with COPD. Also, patients with COPD with BMI were found to have elevated levels of total cholesterol and low-density lipoproteins, indicating impaired lipid metabolism in these patients. It should be noted that 25.0% of patients with BMI had only changes in laboratory and instrumental parameters without complaints. It was found that in patients with COPD non-alcoholic fatty liver disease is registered 3.7 times more often in overweight people than in patients with normal body weight and is accompanied by cytolysis and cholestasis syndromes. In every fourth patient with COPD and overweight, there are changes in laboratory and instrumental parameters without complaints, which confirms the frequent latent course of non-alcoholic fatty liver disease at the stage of steatosis.

Keywords

• chronic obstructive pulmonary disease
• nonalcoholic fatty liver disease
• steatosis
• overweight.