Наукові праці. Кафедра внутрішньої медицини № 1
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Item Analysis of pathogenetic relations between clinical and metabolic parameters in patients with nonalcoholic fatty liver disease on the background of hypertension(2019-09) Bashkirova, AnnaThe article presents the factor analysis of pathogenetic relationships between metabolic parameters, EL levels and clinical parameters in patients with liver steatosis on the background of hypertension. The study have found that the most significant factor load on the severity of liver steatosis is reproduced by the concentration of insulin, triglycerides, HDL, and proatherogenic hyperdyslipidemia is closely associated with diet and alcohol intake.Item Cluster analysis of the pathogenetic relationships of metabolic parameters in patients with non-alcoholic fatty liver disease on the background of hypertension(2019) Babak, Oleg; Bashkirova, AnnaThe aim of the study was to conduct a cluster analysis of pathogenetic relationships between metabolic parameters, endothelial lipase levels, the severity of steatosis, and clinical parameters in patients with non-alcoholic fatty liver disease with hypertension. To analyze pathogenetic relationships, a cluster analysis was performed with the distribution of parameters into 4 clusters using the Ward's method. The most dense metabolic link by cluster analysis endothelial lipase forms with NAFLD liver fat score (2.639 cu), HbA1C (2.084 cu), total cholesterol (2.272 cu), and alcohol units (2.797 cu).Item Endothelial Lipase as a New Diagnostic Marker in Patients with Nonalcoholic Fatty Liver Disease and Metabolic Syndrome(2019) Bashkirova, AnnaThe concentration of EL is lowest in patients of the control group and increases progressively with steatosis and metabolic syndrome compared with those suffering from hypertension without steatosis and metabolic syndrome. In ad- dition, an increase in EL is associated with the presence of met- abolic disorders, which, in aggregate, makes it possible to at- tribute it to independent markers of the atherosclerotic process and cardiovascular risk.Item Parameters of lipid metabolism and severity of liver steatosis in patients with non-alcoholic fatty liver disease on the background of hypertension depending on the status of carbohydrate metabolism(2018-12) Babak, Oleg; Bashkirova, AnnaThe aim of the study was to establish relationships between the parameters of lipid metabolism, the severity of liver steatosis and the concentration of endothelial lipase (EL) serum levels depending on the state of carbohydrate metabolism and the presence of type 2 diabetes . 60 patients with non-alcoholic fatty liver disease (NAFLD) on the background of hypertension and overweight have been examined. The distribution of the examined patients was carried out in the following groups: group 1 - patients with hypertension without an increase in NAFLD liver fat score normal weight (n = 8); Group 2 - with hypertension without increse in NAFLD liver fat score with overweight (n = 8); group 3 - with liver steatosis without type 2 diabetes (n = 10); group 4 - with liver steatosis and type 2 diabetes (n = 10); group 5 - with laboratory signs of steatohepatitis without type 2 diabetes (n = 16); group 6 - with laboratory signs of steatohepatitis and type 2 diabetes (n = 8). All patients were divided with accordance of age and sex. The control group consisted of 20 healthy individuals. All patients with NAFLD on the background of hypertension and the presence of type 2 diabetes had significantly (p <0.001) higher hyperinsulinism (32.27 + 4.71 vs. 20.75 + 9.5 mkU/ml) and significantly (p <0.001) increased values of insulin resistance index HOMA-IR (9.52 + 4.21 against 4.76 + 2.23 U), which testifies in favour of type 2 diabetes. In all patients with NAFLD on the background of hypertension, there are proatherogenic changes in lipid status, the presence of which is exacerbated with obesity and the severity of steatosis. It is most evident in patients with steatohepatitis in combination with type 2 diabetes. The level of EL is significantly higher in patients with steatosis, regardless of the presence of diabetes and with steatohepatitis without diabetes compared with controls and patients with hypertension and normal weight. Significantly high levels of endothelial lipase were found in patients with steatohepatitis and diabetes. Correlation analysis between the HbA1c and EL levels showed a reliable direct relationship between the parameters. So the level of EL in patients with hypertension in combination with the severity of liver steatosis is significant relative to atherosclerotic vascular lesions and prognostic as the occurrence of cardiovascular complications.Item Results of correction of the hepatic steatosis on the background of hypertension and overweight with help of essential phospholipid complex(2019-03) Babak, Oleg; Bashkirova, AnnaOne of the unfavorable factors contributing to the forma- tion of cardiovascular risk in non-alcoholic fatty liver disease (NAFLD) on the background of hypertension is the low level of HDL cholesterol, in the metabolism of which the activity of endothelial lipase (EL) plays a leading role. The liver plays an important role in the formation of dyslipidemia and is a target for lipid metabolism disorders, representing one of the pathoge- netic stages of NAFLD formation, which dictates the search for ways of drug “support” of hepatocytes. The aim of the research was to study the effectiveness of es- sential phospholipids in the complex therapy of patients with NAFLD, hypertension and overweight, taking into account the ynamics of laboratory and instrumental examinations and EL blood level. 52 patients with NAFLD on the background of hypertension and overweight have been examined. The control group con- sisted of 20 practically healthy people. All patients were divided with accordance of age and sex. Dietary nutrition with reduction of simple carbohydrates and fats was recommended for patients and treatment with essential phospholipids for 6 months at a dose of 2 capsules 3 times a day was prescribed. 16 patients of the main group showed complete compliance till the end of the course of treatment. The concen- tration of EL was determined by the ELISA using the Aviscera Bioscience INC reagents kit (USA). The complex of essential phospholipids as additional com- ponent for diet showed an effective decrease in the severity of hepatic steatosis in combination with the reduction of insulin re- sistance, as well as the restoration of normal pathogenetic func- tional links between HDL and endothelial lipase in patients with NAFLD on background of hypertension. Thus essential phospholipids can be recommended to reduce CVD and comorbidity for all patient`s with these diseases, which was mentioned above, despite the range of steatosis.Item The role endothelial lipase in patients with non-alcoholic fatty liver disease and hypertension depending on the performance of the lipid profile(2019-09) Bashkirova, AnnaIt turns out that in patients with more pronounced non-alcoholic liver steatosis there is a proatherogenic type dislipidemia with high levels of triglycerides and low levels of protective HDL. The concentration of EL did not show a direct relationship with the level of HDL. However EL was found to depend on LDL and total cholesterol levels, which can determine its complementary role in LDL metabolism in conditions of liver steatosis.Item The role of endothelial lipase in the diagnosis of cardiovascular risk in patients with non-alcoholic fatty liver disease in hypertension and insulin resistance subjects(2018-09) Bashkirova, Anna; Babak, OlegNon-alcoholic fatty liver disease (NAFLD) is now recognized as the most common disease in hepatology, and is also often accompanied by hypertension. Insulin resistance(IR) and endothelial dysfunction, in which metabolism endothelial lipase (EL) plays a leading role, are links in a chain and play an important role in the development of cardiovascular risk (CVR). Therefore, our aim was to determine the blood levels of EL for the early detection of CVR in patients with NAFLD in hypertension and IR subjects. Increased levels of EL is inherent in all patients with NAFLD and hypertension. However, in patients with NASH and hypertension formed an additional association between the level of EL and HbA1С, which allows to consider EL as an additional predictor of CVR.