[Hepatic parenchimatous damage and perfusion disturbance in the progression of nonalcoholic fatty liver disease].
OBJECTIVE
To detect early diagnostic criterions of hepatocellular inflammation and portal hypertension for revealing the progressive course of nonalcoholic fatty liver disease (NAFLD).


METHODS
We have studied 58 patients with NAFLD: 6 with steatosis, 47 with steatohepatitis (SH), 5 with class A liver cirrhosis (LG). Liver biopsy was performed in 24 (41.4%) patients with estimation of histological activity index (HAI) and fibrosis by Brunt method. Abdominal sonography and dopplerography of portal and spleen venous bloodflow with estimation of portal vein congestive index (CI) were performed in all patients.


RESULTS
Among conventional laboratory markers of parenchimatous damage gammaglutamiltransferase (GGTF) was increased more frequently--in 77.6% of patients, then alaninaminotransferase (ALAT)--in 62.0% and aspartataminotransferase (ASAT)--in 51.7% of patients. GGTF correlated more closely with HAI: with fatty cellular degeneratic r = 0.82 (p < 0.01), bottled cellular degeneration--r = 0.65 (p < 0.05), lobular inflammation--0.58 (p < 0.05), fibrosis r = 0.67 (p < 0.05), than ALAT--0.51 (p < 0.05), 0.48 (p < 0.05), 0.42 (p < 0.05), 0.51 (p < 0.05) accordingly. Liver venous perfusion worsening was revealed already in moderate SH, when clinical symptoms of portal hypertension were absent. CI in portal vein correlated closely with HAI r = 0.78 (p < 0.05) and fibrosis r = 0.69 (p < 0.05) in NAFLD, that confirmed its diagnostic role in detection of parenchimatous and vascular liver architectonics deterioration and portal hypertension development.


CONCLUSIONS
GGTF is more sensitive parenchimatous damage marker in NAFLD than ALAT and ASAT. Liver venous perfusion study with estimation portal vein congestive index permits to reveal the portal hypertension long before clinical symptoms of this syndrome appearance. Liver parenchimatous damage and its perfusion disturbance confirm the NAFLD progressive course.
O P
OP
Dudanova
I A
IA
Belavina
D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D005723:gamma-Glutamyltransferase