Diagnostic significance of the newest biomarkers of steatosis progression in patients with stable coronary heart disease, combined with nonalcoholic fatty liver disease
DOI:
https://doi.org/10.14739/2409-2932.2018.1.123648Keywords:
liver steatosis, biomarkers, coronary heart disease, non-alcoholic fatty liver diseaseAbstract
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.
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