ADVANTAGES OF BIOCHEMICAL METHODS OF DIAGNOSING FIBROSIS IN NON-ALCOHOLIC FATTY LIVER DISEASE IN ADOLESCENTS WITH OBESITY

Abstract

Non-alcoholic fatty liver disease occurs in most obese people, the main pathway of which is the process of fibrogenesis. This disorder is currently classified into two types: hepatic steatosis and nonalcoholic steatohepatitis. Hepatic steatosis is a reversible condition in which large vacuoles of triglyceride fat accumulate in the liver cells, causing nonspecific inflammation. Most people with this condition experience few, if any, symptoms, and it does not usually lead to scarring or serious liver damage. The majority of patients with nonalcoholic fatty liver disease have this type. Nonalcoholic steatohepatitis is the more severe, progressive form that involves not only fat accumulation (steatosis) in the liver but also inflammation. Steatohepatitis can lead to fibrosis and eventually to cirrhosis, which is severe scarring that can lead to liver failure. The real frequency of the prevalence of the disease is difficult to establish, due to the insufficient use of non-invasive screening diagnostic methods, through which it is possible to detect the initial forms of the disease. The aim: to study the diagnostic significance of the serum biomarkers of liver fibrogenesis in adolescents with obesity. Methods. On the base of the Department of Endocrinology, SI “Institute of children and adolescence health care of NAMS” (Kharkov) 226 patients with obesity aged 8–18 years were examined. Investigation of liver fibrosis consisted of measurement in blood the levels of fibronectin, collagen type IV, N-terminal propeptides and C-terminal telopeptides of type I collagen by IFA method. Results. The study of liver fibrogenesis revealed a significant increase in levels of type IV collagen and fibronectin in children with obesity (p<0.05). As diagnostic criteria for two physiologically diverse processes – fibrogenesis and fibrolysis, the levels of N-terminal propeptides and C-terminal telopeptides of type I collagen, respectively, were determined. The serum level of N-terminal propeptides of type I collagen significantly exceeds the normal values in all children with obesity, in contrast to the children of the control group (p<0.05). Conclusion. It has been established that a biochemical method for determining the level of type IV collagen, fibronectin, N-terminal propeptides and C-terminal telopeptides of type I collagen has a high sensitivity for the diagnosis of liver fibrogenesis.