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Abstract
CYTOKERATIN-18 FRAGMENTS FOR PREDICTING STEATOHEPATITIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE
Babak O., Zhelezniakova N., Molodan V., Prosolenko K., Lapshyna K., Vizir M.
The aim of the study was to investigate metabolic parameters, cytokeratin 18 (CK-18) levels in blood plasma and the state of the liver parenchyma of patients with non-alcoholic fatty liver disease (NAFLD) in non-alcoholic steatohepatitis (NASH) stage. Materials and methods: Fasting serum CK-18 was measured in 30 NASH patients (mean age (49.3±3.6). The control group consisted of 20 practically healthy volunteers. The diagnosis of NADH was established on the basis of clinical, biochemical and instrumental data. In addition to basic laboratory tests and ultrasonographic examination, the Fibromax test (Biopredective, France) was performed. Results: In patients with NAFLD, the lipid profile showed a tendency to hyper- and dyslipidemia. The obtained data showed a significant increase in the parameters of enzymatic activity of the liver, the average level of aspartate aminotransferase (AST) exceeded the control group 2.5 times, the alanine aminotransferase (ALT) – 2.9 times, respectively (˂ 0.05). In NAFLD in NASH stage CK-18 levels in blood plasma were significantly increased, exceeded the results of the control group 3 and more times, and allowed to establish NASH in patients of the main group. Conclusions: Increased levels of CK-18 in NASH patients as well as its association with atherogenic dyslipidemia and increasing of liver enzymatic activity were revealed. The obtained data showed the possibility of using biomarker for non‑invasive diagnostics of NASH and represent the prospect of further research.
Key words: nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, noninvasive diagnosis, cytokeratin-18.
Резюме.
ФРАГМЕНТИ ЦИТОКЕРАТИНУ-18 ДЛЯ ПРОГНОЗУВАННЯ СТЕАТОГЕПАТИТУ У ПАЦІЄНТІВ З НЕАЛКОГОЛЬНОЮ ЖИРОВОЮ ХВОРОБОЮ ПЕЧІНКИ
Бабак О.Я., Железнякова Н.М., Молодан В.І., Просоленко К.О., Лапшина К.А., Візір М.О.
Мета дослідження: вивчити метаболічні показники, рівні цитокератину 18 (СК-18) у плазмі крові та стан паренхіми печінки у хворих на неалкогольну жирову хворобу печінки (НАЖХП) y стадії неалкогольного стеатогепатиту (НАСГ). Матеріали і методи: Обстежено 30 хворих з НАЖХП в стадії НАСГ, у віці від 30 до 60 років (середній вік (49.3 ± 3.6) років). Групу контролю склали 20 практично здорових добровольців. Діагноз НАЖХП був встановлений на підставі клініко-біохімічних та інструментальних даних. Всім пацієнтам, окрім основних лабораторних і ультрасонографічних досліджень, було проведено тест Fibromax (Biopredective, Франція). Визначення цитокератину-18 (СК-18) в плазмі крові проводилось імуноферментним методом з використанням наборів ELISA. Результати дослідження: У пацієнтів з НАЖХП ліпідний профіль показав тенденцію до гіпер- і дисліпідемії. Отримані дані свідчили про достовірне підвищення показників ферментативної активності печінки, середній рівень аспартатамінотрансферази (АСТ) перевищував показник контрольної групи у 2,5 рази, аланінамінотрансферази (АлАТ) - в 2,9 рази, відповідно (˂ 0,05). У хворих НАЖХП в стадії НАСГ рівні СК-18 в плазмі крові були достовірно підвищені, перевищували результати групи контрою в 3 та більше разів, і дозволяли встановити НАСГ у пацієнтів основної групи. Висновки: Виявлено підвищені рівні СК-18 у пацієнтів з НАСГ, а також його асоціація з атерогенною дисліпідемією і порушенням ферментативної активності печінки. Отримані дані свідчать про можливість використання біомаркеру для неінвазивної діагностики НАСГ і представляють перспективу подальших досліджень.
Ключові слова: неалкогольна жирова хвороба печінки, неалкогольний стеатогепатит, неінвазивна діагностика, цитокератин-18.
Резюме.
ФРАГМЕНТЫ ЦИТОКЕРАТИНА-18 ДЛЯ ПРОГНОЗИРОВАНИЯ СТЕАТОГЕПАТИТА У ПАЦИЕНТОВ С НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНЬЮ ПЕЧЕНИ
Бабак О.Я., Железнякова Н.М., Молодан В.И., Просоленко К.А., Лапшина Е.А., Визир М.А.
Цель исследования: изучить метаболические показатели, уровни цитокератина 18 (СК-18) в плазме крови и состояния паренхимы печени у больных неалкогольной жировой болезнью печени (НАЖБП) в стадии неалкогольного стеатогепатита (НАСГ). Материалы и методы: Обследовано 30 больных с НАЖБП в стадии НАСГ, в возрасте от 30 до 60 лет (средний возраст (49.3 ± 3.6) лет). Группу контроля составили 20 практически здоровых добровольцев. Диагноз НАЖБП был установлен на основании клинико-биохимических и инструментальных данных. Всем пациентам, помимо основных лабораторных и ультрасонографических исследований, был проведен тест Fibromax (Biopredective, Франция). Определение цитокератина-18 (СК-18) в плазме крови проводилось иммуноферментным методом с использованием наборов ELISA.
Результаты. У пациентов с НАЖБП липидный профиль показал тенденцию к гипер- и дислипидемии. Полученные данные свидетельствовали о достоверном повышении показателей ферментативной активности печени, средний уровень АсАТ (АСТ) превышал показатель контрольной группы в 2,5 раза, аланинаминотрансферазы (АЛТ) - в 2,9 раза, соответственно (˂ 0,05). У больных НАЖБП в стадии НАСГ уровни СК-18 в плазме крови были достоверно повышены, превышали результаты группы контроля в 3 и более раз, и позволяли установить НАСГ у пациентов основной группы. Выводы. Выявлены повышенные уровни СК-18 у пациентов с НАСГ, а также его ассоциация с атерогенной дислипидемией и нарушением ферментативной активности печени. Полученные данные свидетельствуют о возможности использования биомаркера для неинвазивной диагностики НАСГ и представляют перспективу дальнейших исследований.
Ключевые слова: неалкогольная жировая болезнь печени, неалкогольный стеатогепатит, неинвазивная диагностика, цитокератин-18.
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