Patologìâ (Aug 2016)
The peculiarities of the indexes of endogenous intoxication depending on concomitant pathology of the biliary tract in patients with obesity and non-alcoholic fatty liver disease
Abstract
Аim – to study the features of indicators of endogenous intoxication (EI) as a function of the presence of various pathology of the biliary tract (BT) in patients with comorbid course of the obesity (OB) in combination with non-alcoholic hepatic steatosis (NAHS) or nonalcoholic steatohepatitis (NASH). Materials and methods. The study involved 200 patients with OB in conjunction with non-alcoholic fatty liver disease (NAFLD) and BT pathology, who at the time of sonographic and morphological study of liver biopsy revealed signs of hepatic steatosis: 100 patients with OB and NAHS, 100 – with OB and NASH. Depending on BT pathology patients with OB and NAHS and OB and NASH were divided into three subgroups: OB and NAHS or OB and NASH with chronic non-calculous cholecystitis (CNC); OB and NAHS or OB and NASH with chronic calculous cholecystitis (CCC); OB and NAHS or OB and NASH in patients with postcholecystectomical syndrome (PCES). The control group consisted of 20 practically healthy persons (PHP). Indicators of EI were determined by the content of middle weight molecules (MWM), their fractional composition: MWM-λ-210, MWM-λ-254, MWM-λ-280, concentration of copper (Cu) in blood serum. Results. It was revealed that high levels of MWM, MWM-λ-210, MWM-λ-254, MWM-λ-280, and Cu were observed in patients with the OB and NAHS or NASH with concomitant CNC and often with CCC, and lowest with concomitant PCES in relation to PHP (p<0.05 to p<0.001) and when compared with CCC. Conclusion. OB in combination with NAFLD on the background pathology of BT is accompanied by clinical symptoms of EI, which manifest itself in reliable laboratory growth of MWM, their fractional composition, and Сu compared to PHP (p<0.05 to p<0.001) and depend on the existence of various pathologies on the part of BT.
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