Журнал "Гастроэнтерология" Том 54, №4, 2020
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The pathogenetic features of nonalcoholic steatohepatitis course with obesity and chronic kidney disease
Авторы: A.A. Antoniv, O.S. Khukhlina
Bukovinian State Medical University, Chernivtsi, Ukraine
Рубрики: Гастроэнтерология
Разделы: Медицинские форумы
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The purpose of the study was to determine the pathogenetic role of the bacterial endotoxin content in the blood on the hepatocytes damage markers, the degree of steatosis and liver fibrosis in patients with NASH with obesity, depending on the form and stage of CKD and their progression.
Materials and methods. To realize this goal 170 patients with NASH aged 40–55 years were examined. All patients were distributed as follows. Group 1 consisted of 70 patients with NASH with concomitant obesity 1st degree. Group 2 consisted of 100 patients with NASH and obesity 1st degree with a comorbid CKD of І–ІІ st. (chronic pyelonephritis). We examined 30 practically healthy persons (PHPs), which by age and sex were not statistically significantly different from the main group and the comparison group.
Results. The article presents the theoretical generalization of the features of the microbial state of the colon cavity (MSCC) during the comorbid flow of non-alcoholic steatohepatitis (NASH) with obesity and chronic kidney disease (CKD) of the I–III stages, which is characterized by the development of deep dysbiosis (II–III st.) with the appearance and prevalence of pathogenic microflora, an increase in the number of opportunistic bacteria and yeast fungi of the genus Candida, a probable deficiency of representatives of normal microbiota: lactobacilli, bifidobacteria, bacteroids.
Conclusions. As a result of the study, it was found that the bacterial endotoxin content in the blood has a high predictive value as a marker for the progression of NASH on the background of CKD and obesity with a growth above 0.23 EO/ml (sensitivity 87.1 %, specificity 91.6 %).