Diagnostic significance of the newest biomarkers of steatosis progression in patients with stable coronary heart disease, combined with nonalcoholic fatty liver disease

Authors

  • I. I. Vakalyuk Ivano-Frankivsk National Medical University, Ukraine,
  • N. G. Virstyuk Ivano-Frankivsk National Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2409-2932.2018.1.123648

Keywords:

liver steatosis, biomarkers, coronary heart disease, non-alcoholic fatty liver disease

Abstract

The purpose was to determine the diagnostic value of selenoprotein P and M30 fragments of cytokeratin 18 in conjunction with proinflammatory cytokines for early diagnosis and progression of non-alcoholic fatty liver disease (NAFLD) in patients with stable coronary heart disease (CHD).

Materials and methods. 140 patients with NAFLD and stable CHD of II-III functional classes were examined: 89 patients with non-alcoholic steatosis (Group I); 51 patients with non-alcoholic steatohepatitis (Group II). General-clinical examination, electrocardiography, coronary angiography, echocardiography, liver ultrasound, determination of cytokeratin 18 M30, selenoprotein P, TNF-alpha, interleukin-6, high-sensitivity C-reactive protein serum levels were performed to all patients.

Results. The presence of liver steatosis of different degrees was established in all examined patients. However, the majority of the patients of Group I had steatosis of 1 and 2 degrees; in group 2 – steatosis of 3 degree prevailed. Selenoprotein P level in patients with steatosis of 1 degree was on 39.6 % higher compared with 0 degree; at 2 degree – it was by 2.8 times higher vs. its level in the control group and by 1.9 times vs. its level at steatosis of 1 degree (P < 0.05). Cytokeratin 18 M30 level at steatosis of 1 degree was by 1.8 times higher than its value in the control group; at 2 degree – it exceed this value by 2.3 times; at 3 degree – it reached its highest value (P < 0.05). TNF-alpha level at 1 degree of steatosis was by 2.5 times higher than its value in the control group; at 2 degree – it exceed this value by 3.7 times; at 3 degree – it was by 5.4; 2.2 and 1.5 times higher vs. its value at steatosis 0, 1 and 2 degrees (P < 0.05). Similar patterns were observed by IL-6 and hsCRP levels. Positive correlation relationships between serum selenoprotein P, cytokeratin 18 M30 and proinflammatory cytokines levels were revealed.

Conclusion. Increasing of serum selenoprotein P and cytokeratin 18 M30 levels next to proinflammatory cytokines at liver steatosis of 1 degree indicates their independent diagnostic and prognostic value at the early stages of NAFLD development in patients with stable CHD.

References

Kharchenko, N. V., Lishchyshyna, O. M., & Anokhina, H. A. (2014). Adaptovana klinichna nastanova, zasnovana na dokazakh «Nealkoholna zhyrova khvoroba pechinky» [Adapted clinical guidance, based on the evidence «Non-alcoholic fatty liver disease»]. Retrieved from http://www.moz.gov.ua/docfiles/dod_akn_dn_20140616_2.pdf. [in Ukrainian].

Stepanov, Yu. M (2014). Steatoz pecheni i steatogepatit – neizbezhnost' smeshannogo geneza [Hepatic steatosis and steatohepatitis is the inevitability of mixed genesis]. Gastroe'nterologiya, 4, 136–142. [in Russian].

Khobzei, M. K, Kharchenko, N. V., & Lishchyshyna, O. M. (2014). Unifikovanyi klinichnyi protokol «Nealkoholnyi steatohepatyt» [Unified clinical protocol «Nonalcoholic steatohepatitis»]. Nakaz MOZ Ukrainy vid 06 lystopada 2014 roku №826. Retrieved from http://moz.gov.ua/docfiles/dn_20141106_0826_dod_ukp_nsg.pdf. [in Ukrainian].

Kravchenko, V. V., Sokolov, M. Yu., & Talaieva, T. V. (2016). Unifikovanyi klinichnyi protokol «Stabilna ishemichna khvoroba sertsia» [Unified Clinical Protocol «Stable coronary heart disease»] Nakaz MOZ Ukrainy vid 02 bereznia 2016 roku №152. Retrieved from http://www.moz.gov.ua/docfiles/dn_20150716_1dod.pdf. [in Ukrainian].

Fadieienko, G. D., & Chernyshov, V. A. (2014). Komorbidna patolohiia, shcho vplyvaie na sertsevo-sudynnyi ryzyk u postinfarktnykh khvorykh [Comorbid pathology influenced on cardiovascular risk in patients survived myokardial infarction]. Ukrainskyi terapevtychnyi zhurnal, 2, 10–20. [in Ukrainian].

European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). (2016) EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. Journal of Hepatology, 64(6), 1388–1402. doi: 10.1016/j.jhep.2015.11.004.

Fitzpatrick, E., & Dhawan, A. (2014). Noninvasive biomarkers in non-alcoholic fatty liver disease: Current status and a glimpse of the future. World Journal of Gastroenterology, 20(31), 10851–10863. doi: 10.3748/wjg.v20.i31.10851.

Nascimbeni, F., Pais, R., Bellentani, S., Day, C. P., Ratziu, V., Loria, P., & Lonardo, A. (2013). From NAFLD in clinical practice to answers from guidelines. Journal of Hepatology, 59, 859–871. doi: 10.1016/j.jhep.2013.05.044.

Marianthi, P., Areti, S., & Konstantinos, T. (2015). Non-invasive methods for the diagnosis of nonalcoholic fatty liver disease. World Journal of Hepatology, 7(4), 638–648. doi: 10.4254/wjh.v7.i4.638.

Sven, M., van der Graaff, D., & Kwanten, W. (2016). Non-alcoholic fatty liver disease and cardiovascular risk: Pathophysiological mechanisms and implications. Journal of Hepatology, 65, 425–443. doi: 10.1016/j.jhep.2016.04.005.

How to Cite

1.
Vakalyuk II, Virstyuk NG. Diagnostic significance of the newest biomarkers of steatosis progression in patients with stable coronary heart disease, combined with nonalcoholic fatty liver disease. Current issues in pharmacy and medicine: science and practice [Internet]. 2018Feb.16 [cited 2024Apr.23];(1). Available from: http://pharmed.zsmu.edu.ua/article/view/123648

Issue

Section

Experimental and clinical pharmacology