M.G. TUKHBATULLIN¹, A.E. YANGURAZOVA^1,2, Z.M. GALEEVA¹

¹Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012

²Medical Sanitary Unit of Kazan State University, 1A Chekhov Str., Kazan, Russian Federation, 420012

Tukhbatullin M.G. — D. Med. Sc., Professor, Head of the Department of Ultrasound Diagnostics, tel. +7-843-231-20-09, e-mail: munir.tuhbatullin@tatar.ru

Yangurazova A.E. — post-graduate student of the Department of Ultrasound Diagnostics, doctor, tel. +7-987-413-67-23, e-mail: aleksandra7891@bk.ru

Galeeva Z.M. — Cand. Med. Sc., Associate Professor of the Department Hospital and Policlinic Therapy, tel. (843) 236-87-86, e-mail: zarina26@bk.ru

The diagnosis of diffuse liver diseases, in particular the nonalcoholic fatty liver disease (NAFLD), is largely determined by methods that are informative, safe, non-invasive and can be used for all patients. One of these methods is shear wave elastography. To study these issues, a literature review was carried out; data on NAFLD risk factors, pathogenesis, and clinic are presented; the possible options for invasive and non-invasive diagnosing of NAFLD are described. Based on the results of own research in age-gender groups in patients with NAFLD, biochemical parameters and shear wave elastography data were evaluated. A direct correlation was found between the indicators of liver stiffness and age, presence of diabetes mellitus type 2, biochemical parameters, NAFLD and AST/ALT indices. The use of shear wave elastography, in combination with laboratory parameters and risk assessment by indices, enables to improve the diagnosing and efficiency evaluation of NAFLD treatment.

Key words: nonalcoholic fatty liver disease, steatosis, steatohepatitis, fibroscan, shear wave elastography.

References

1. Ermolova T.V., Ermolov S.Yu., Belyaeva E.L. Non-alcoholic fatty liver disease: a modern view of the problem. Effective pharmacotherapy, 2016, 5, pp. 26-35. (in Russ.).
2. Fadi K., Glushchenkov D.V., Usanova A.A., Pavlov C.S. Modern diagnostics of non-alcoholic fatty liver disease in the clinic of internal diseases. Bulletin of the DSEA, 2016, vol. 21, no. 4, pp. 77-82. (in Russ.).
3. Drapkina O.M., Ivashkin V.T. Epidemiological features of non-alcoholic fatty liver disease in Russia (results of an open multicenter prospective study-observation DIREG L 01903). RZHGK, 2014, no. 4, pp. 32-38. (in Russ.).
4. Ermolova T.V., Ermolov S.Yu. Nonalcoholic steatohepatitis: treatment from the perspective of evidence-based medicine. Effective pharmacotherapy, 2011, no. 2, pp. 32-34. (in Russ.).
5. Lazebnik L.B., Radchenko V.G., Golovanova E.V. et al. Non-alcoholic fatty liver disease: a clinic, diagnosis, treatment (recommendations for therapists, 2nd version). Therapy, 2017, vol. 13, no. 3, pp. 6-23. (in Russ.).
6. Mekhtiev S.N., Zinovieva E.N., Mekhtieva O.A., Sokolovsky S.V. Contemporary view on the pathogenesis, diagnosis and treatment of non-alcoholic fatty liver disease. Preventive and Clinical Medicine, 2010, no 3-4, pp. 113-116. (in Russ.).
7. Ivashkin V.T., Maevskaya M.V., Pavlov C.H. et al. Clinical recommendations for the diagnosis and treatment of non-alcoholic fatty liver disease of the Russian Society for the Study of the Liver and the Russian Gastroenterological Association. Russian Journal of Gastroenterology, Hepatology, Coloproctology, 2016, vol. 26, no. 2, pp. 24-42. (in Russ.).
8. Zvenigorodskaya L.A. Nonalcoholic fatty liver disease: the evolution of representations. Effective pharmacotherapy, 2015, vol. 2, no. 1, pp. 16-22. (in Russ.).
9. Klyaritskaya I.L., Stilidi E.I., Maksimova E.V., Shahbazidi G. Extraintestinal manifestations of inflammatory bowel diseases. Crimean therapeutic journal, 2017, no. 1, pp. 47-51. (in Russ.).
10. Ratziu V., Giral P., Charlotte F. et al. Liver fibrosis in overweight patients. Gastroenterology, 2000; no. 6, pp. 1117-1123.
11. Lee J.-H., Kim D., Kim H.J. et al. NAFLD index: a simple screening tool reflecting nonalcoholic fatty liver disease in the Korean population. J. Hepatol, 2009, no. 50, pp. S25-S26.
12. Alkhouri N., McCullough A. J. Noninvasive diagnosis of NASH and liver fibrosis within the spectrum of NAFLD. Gastroenterol. Hepatol, 2012, vol. 10, no. 8, pp. 661-668.
13. Alkhouri N., McCullough A. J. Noninvasive diagnosis of NASH and liver fibrosis within the spectrum of NAFLD. Gastroenterol. Hepatol, 2012, vol. 10, no. 8, pp. 661-668.
14. McPherson S., Stewart S.F., Henderson [et al.] Simple non-invasive fibrosis scoring systems can reliably exclude advanced fibrosis in patients with non-alcoholic fatty liver disease. Gut, 2010, vol. 59, no. 9, pp. 1265-1269.
15. Chalasani N., Deeg M.A., Crabb D.W. Systemic levels of lipid peroxidation and its metabolic and dietary correlates in patients with nonalcoholic steatohepatitis. Am. J. Gastroenterol, 2004, no. 99, pp. 1497-1502.
16. Kowdley K.V., Belt P., Wilson A. et al. NASH Clinical Research Network. Serum ferritin is an independent predictor of histologic severity and advanced fibrosis in patients with nonalcoholic fatty liver disease. Hepatology, 2012, no. 55, pp. 77-85.
17. Başkol M., Başkol G., Deniz K., Ozbakir O., Yücesoy M. A new marker for lipid peroxidation: serum paraoxonase activity in non-alcoholic steatohepatitis. Turk. J. Gastroenterol, 2005, no. 16, pp. 119-123.
18. Tukhbatullin M.G., Safiullina, L.R., Galeeva Z.M. et al. Echography in the diagnosis of diseases of the internal and superficial organs. Kazan, 2016, 208 p. (in Russ.).
19. Yangurazova A.E., Tukhbatullin M.G., Galeeva Z.M. Complex ultrasound diagnostics in assessing the liver status in patients with non-alcoholic fatty liver disease on the background of treatment. Practical medicine, 2016, vol. 101, no. 9, pp. 74-77. (in Russ.).
20. Ermolitsky N.M. Sonography in low-symptom diffuse liver diseases: current state (literature review). Problems of health and ecology, 2011, vol. 53, no. 3, pp. 24-28. (in Russ.).
21. Bastrakova A.E., Galeeva Z.M., Tukhbatullin M.G. Complex ultrasound in early diagnosis of liver steatosis. Practical medicine, 2016, vol. 94, vol. 2-2, pp. 48-50. (in Russ.).
22. .Zykin B.I., Postnova N.A., Medvedev M.E. Elastography: anatomy of the method. Promeneva Diagnostics, Promeneva therapy, 2012, no 2-3, pp. 107-113. (in Russ.).
23. Zykin B.I., Postnova N.A. The importance of color mapping of hepatic tissue stiffness in studies with shear wave elastography in patients with hepatitis C. Ultrasonic and functional diagnostics, 2013, no. 5, pp. 24-29. (in Russ.).
24. Morozova T.G., Borsukov A.V., Pleshkov V.G. Multiparametric ultrasound in diseases of the liver and pancreas in modern conditions. Clinical practice, 2016, vol. 26, no. 2, pp. 40-44. (in Russ.).
25. Diomidova V.N., Petrova O.V. Comparative analysis of the results of shear wave elastography and transient elastography in the diagnosis of diffuse liver diseases. Ultrasonic and functional diagnostics, 2013, no. 5, p. 17. (in Russ.).