Changes in Extracellular Matrix Components Metabolism in Patients with Nonalcoholic Steatohepatitis on the Background of Obesity and Comorbidity with Chronic Kidney Disease

The purpose of the study was to find out the features of the state of carbohydrate-protein components of the connective tissue of the liver and kidneys extracellular matrix in non-alcoholic steatohepatitis in patients with obesity of the 1st degree and chronic kidney disease of the І-ІІ stages. We examined 140 patients with non-alcoholic steatohepatitis with comorbid obesity of the 1st degree and chronic kidney disease of the I-II stages. Patients were divided into 2 groups that were randomized according to age, sex, degree of obesity, and stage of chronic kidney disease (chronic uncomplicated pyelonephritis with latent course in the phase of retinal exacerbation). The control group consisted of 30 practically healthy persons of the corresponding age and sex. As a result of studies, it was found out that a significant increase in the synthesis of collagen and glycosaminoglycans was observed in patients with non-alcoholic steatohepatitis that arose on the background of obesity. It was accompanied by ineffective resorption of newly formed collagen due to inhibition of the collagenolytic activity of blood plasma, due to significant activation of proteinase inhibitors, significant imbalance in the system metabolism of connective tissue. Under the conditions of comorbidity of non-alcoholic steatohepatitis and chronic kidney disease, the synthesis and resorption of collagen are activated. In spite of compensatory activation of collagenolysis, the anabolism processes predominated with a significant hyperproduction of actinic-phase proteins, fibronectin, glycosaminoglycans, fibroblast growth factor, and led to progressive fibrosis of the liver and disturbance of its functions.