E.A. PYLAEVA¹, A.E. BAGRIY¹, E.S. MYKHAILICHENKO¹, E.A. ANDREEVA²

 ¹M. Gorky Donetsk National Medical University, Donetsk, DPR

²Railway Clinical Hospital of Donetsk station, Donetsk, DPR

Contact details:

Mykhailichenko E.S. — PhD (medicine), Assistant Lecturer of the Department of Internal Diseases No. 2

Address: 16 Illicha Ave., Donetsk, Donetsk People’s Republic, 283003, tel.: +38 (071) 470-68-08; e-mail: klassiki@inbox.ru

Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (DM2) are often combined and often burden each other.

The purpose was to compare demographic, clinical, laboratory and ultrasound characteristics of patients with NAFLD and the presence or absence of type 2 diabetes mellitus during prospective follow-up.

Material and methods. 56 patients with NAFLD (18 men and 37 women) aged 57.7 (6.2) years were under observation. Patients were divided into 2 groups: group 1 (31 patients with NAFLD and DM2) and group 2 (32 patients with NAFLD without DM2). General clinical and biochemical blood tests and ultrasound examinations of the liver were performed at baseline and after 6 and 12 months of follow-up in all patients (ultrasound device Aplio 500 (TOSHIBA, Japan). The liver structure was evaluated using the recommendations of R.V. Eifler (2013); S. Saadeh (2002). The program MedStat 4.0 was used for statistical processing of the material.

Results. Overweight, arterial hypertension, coronary heart disease, dyslipidemia, hyperuricemia, elevated levels of AST and ALT were detected in group 1 more often than in group 2 (p < 0.05). There were no significant differences between the groups in the frequency and severity of clinical manifestations of NAFLD, in the average values of alkaline phosphatase and GGT concentrations (all p > 0.05). There was a statistically significant relationship between the increase in aminotransferase levels by 2 or more times and the glycosylated hemoglobin levels (χ² = 8.53, p < 0.01), the DM2 duration (χ² = 6.71, p < 0.05), the presence of retinopathy and/or nephropathy (χ² = 5.92, p < 0.05). Among the patients of the group 1, the ultrasound examination significantly more often revealed an increased liver echogenicity, multiple drain hyperechoic changes and its diffuse lesion (all p < 0.05).

Conclusions. NAFLD in patients with DM2 has a number of clinical, laboratory and ultrasound features compared with patients with NAFLD without diabetes.

Key words: non-alcoholic fatty liver disease, diabetes mellitus, obesity, glycosylated hemoglobin.

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