Наукові праці. Кафедра внутрішньої медицини № 1
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Item Comparison of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension(2023) Molodan, Volodymyr; Panchenko, Galyna; Prosolenko, Kostyantyn; Lapshyna, Kateryna; Shalimova, AnnaBackground: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups: patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries.Item Comparison of structural and functional vascular disorders in patients with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension(2023) Prosolenko, Kostyantyn; Molodan, Volodymyr; Panchenko, Galyna; Lapshyna, Kateryna; Shalimova, AnnaBackground: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups: patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries.Item Comparison of structural and functional vascular disorders in patients with comorbidity of non-alcoholic fatty liver disease and two types of arterial hypertension(2023) Prosolenko, Kostyantyn; Molodan, Volodymyr; Panchenko, Galyna; Lapshyna, Kateryna; Shalimova, AnnaBackground: The aim was to conduct a comparative assessment of structural and functional vascular disorders in patiets with comorbidity of non-alcoholic fatty liver disease (NAFLD) and two types of arterial hypertension (HTN). Material and methods: The study included 329 patients 18–66 years old. All patients were divided into five groups:patients with comorbidity of NAFLD and primary HTN (121 subjects), patients with comorbidity of NAFLD and renal parenchymal HTN (88 subjects), patients with NAFLD (60 subjects), patients with primary HTN (30 subjects), patients with renal parenchymal HTN (30 people). The control group consisted of 20 healthy individuals of similar age and gender categories. Results: In the comparative analysis of the structural and functional ultrasonographic parameters of vessels, no significant differences between two comorbidity groups NAFLD + primary HTN and NAFLD + renal parenchymal HTN were found. The influence of AH and degree of liver steatosis on ultrasound indicators of arteries in examined patients with comorbidity was evaluated by MANOVA analysis. The influence of the HTN factor and the influence of the liver steatosis factor were evaluated separately, after which the influence of the comorbidity factor, i.e., the combined influence of these factors and one or another indicator, was evaluated. The additive effect of the factors of AH and liver steatosis was identified according to the parameters: intima media thickness, pulse wave velocity in the carotid artery, pulse wave velocity in the abdominal aorta and endothelial-related vasodilation, which indicates an important comorbid effect of NAFLD and primary/renal parenchymal HTN on the structural and functional state of arteries. Conclusions: There are no differences between the structural and functional indicators of arteries in patients with comorbidity of NAFLD + primary HTN and NAFLD + renal parenchymal HTN. The factor of the presence of HTN and the degree of liver steatosis significantly affect structural and functional indicators of the studied arteries. Key words: structural and functional vascular alterations; non-alcoholic fatty liver disease; hypertensionItem Effectiveness of treatment of patients with nonalcoholic fatty liver disease and hypertension with use of complex therapy(2017-06-29) Babak, Oleg; Myasoedov, V.; Prosolenko, Kostyantyn; Molodan, Volodymyr; Lapshyna, KaterynaThe aim: to investigate the basic level and dynamics of lipid, carbohydrate metabolism, adiponectin, fetuin A, pro-inflammatory cytokines (TNF-alpha and IL-6) and ultrasound parameters of carotid arteries in patients with NAFLD and hypertension using complex therapy. Materials and methods. The study involved 88 patients with NAFLD with hypertension stage II, 2 degree, undergoing treatment in National Institute of Therapy named LT Malaya NAMS of Ukraine. Among 88 patients were 49 men (55.68%) and 39 females (44.32%). The median age was (51,3 ± 6,2) years. The control group consisted of 30 healthy volunteers of similar age category, male and female. We studied the lipid and carbohydrate metabolism, blood pressure, ultrasound of the liver, adiponectin, fetuin A and pro-inflammatory cytokines (TNF-alpha and IL-6) by conventional methods. The study of vascular endothelial motor function was conducted by determining the dynamics of blood flow in the brachial artery during reactive hyperemia as described by D. Celermajer. Determines the pulse wave velocity and endothelium-dependent vasodilation. Patients with NAFLD and hypertension (n = 88) were divided into two groups. Patients group I (n = 44) received lisinopril 10 mg / day, atorvastatin 10-20 mg / day. Group II patients (n = 44) received lisinopril 10 mg / day atorvastatin and 10-20 mg / day in combination with PUFA 2 g / d and UDCA 10 mg / kg / day. Duration of treatment was 12 months. All were given recommendations for a balanced diet and exercises. Results. In patients with NAFLD and hypertension abnormalitis of lipid and carbohydrate metabolism, increasing pro-inflammatory cytokines (TNF-alpha and IL-6), fetuin A and a decreasing of adiponectin were indicated. Also indicators of pulse wave velocity and endothelium-dependent vasodilation were violated. In our study, significantly better result was achieved when assigning complex therapy using UDCA and PUFA - group 2. Significantly better results than were achieved in group 2 in triglycerides, TNF-α and IL-6. In group 2 was possible to increase the level of adiponectin of 47.57% compared with 20.67% in group 1 (p <0.001). Significantly improved indices of endothelial function. Conclusions. Combination therapy comprising atorvastatin, lisinopril, UDCA and PUFA in combination with non-drug therapy in patients with NAFLD and hypertension compared with taking lisinopril and atorvastatin combination with non-drug therapy is more effective for the treatment and correction associated with NAFLD metabolic disorders that can help reduce the overall cardiometabolic risk and improving life prognosis in patients with NAFLD and hypertension.