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

The 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.