[Non-alcoholic fatty liver disease in dyslipidemia and insulin resistance: similarities and differences; differential approach to therapy].
OBJECTIVE
to study the clinical, functional and morphological features of the liver damage in patients with nonalcoholic fatty liver disease in combination with the atherogenic dyslipidemia and/or insulin resistance, and treatment of these changes according to violations.


METHODS
240 patients with clinical signs of non-alcoholic fatty liver disease, who were gathering medical history, blood chemistry, lipid spectrum estimation blood, an oral glucose tolerance test, determination of Noma-test, transabdominal ultrasonography of abdominal organs, morphological study of liver with followed morphometric evaluation of the material.


RESULTS
The patients with non-alcoholic fat liver disease transaminase levels were ranged from 1.5 to 5. Degree of morphological ethical changes depends on the non-alcoholic fat liver disease etiology, in patients with impaired carbohydrate metabolism was increased dyslipidemia. At patients with IR there were identified morphological changes such as presence of "vacyolelike" nuclei and anisocarosis. In patients with atherogenic dyslipidemia most characteristic histological change is the polymorphism of the nuclei.


CONCLUSIONS
The clinical picture of non-alcoholic fat liver disease is unspecific, without reliable clinical distinction between groups of patients with dyslipidemia, impaired glucose tolerance and patients with diabetes mellitus 2-nd type. Biochemical and morphological changes in the liver are most pronounced in patients with diabetes mellitus 2-nd type. Treatment of the non-alcoholic fat liver disease should be taking into account of the disease etiology (the presence of dyslipidemia or insulin resistance).
Lazebnik
L B
LB
Zvenigorodskaia
L A
LA
Egorova
E G
EG
Mel'nikova
N V
NV
Khomeriki
S G
SG
D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D005234:Fatty Liver / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007333:Insulin Resistance; D050356:Lipid Metabolism / Q000187:drug effects; D008055:Lipids / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D008055:Lipids