FEATURES OF THE COMBINED COURSE OF NON-ALCOHOLIC FATTY LIVER DISEASE AND CHOLELITHIASIS

Ufimtseva Irina Vladimirovna, Pirogova Irina Yurievna, Vereina Natalia Konstantinovna

Introduction: Pathogenetic therapy of NAFLD and cholelithiasis is determined by a number of predictors that improve the effectiveness of treatment and prognosis. Aim: to identify predictors that affect the effectiveness of treatment of NAFLD and GI and to create a mathematical model for predicting successful therapy. Materials and Methods:114 people with housing and communal services aged from 18 to 65 years were included, 75 of them were women (65.7%), and the number of men was 39 people (34.3%). The average age of the patients was 48.4±13.3 years. The groups are divided by the presence of NAFLD into 2 subgroups (housing with NAFLD - 65 people and housing without NAFLD-49 people). All patients underwent general clinical, biochemical blood tests, abdominal ultrasound, abdominal MSCT, liver elastometry on a fibroscan device with an XL sensor, fibrosis indices (FIB4, APRI) and liver steatosis (FLI) were calculated. All patients were prescribed UDCA 15 mg/kg for 12 months. Results and discussion: in the group with a combination of GI and NAFLD, the indices of OHS, TG, LDL, NOME index, GGTP were statistically higher, BMI, waist circumference and comorbidity index CIRS-G were higher, gallstones of large density and size prevailed. Against the background of UDCA therapy, effective litholysiswas achieved in the GI group without NAFLD in 69.4% of people, as opposed to 33.8% of people with NAFLD. The outcome of litholysisis most influenced by the eye. The regression of steatosiswas most influenced by BMI, waist circumference, blood glucose and FLI index. Regression of steatosis was achieved in 62%.These predictors are included in the mathematical model of therapy prediction. Conclusions: Therapy with ursodeoxycholic acid is pathogenetically justified in the combined course of NAFLD and GI, taking into account the predictors will allow for regression of steatosis, improve blood metabolic parameters and conduct litholysis of gallstones.

Keywords:NAFLD, comorbidity, litholysis, gallstone disease