Terapevticheskii Arkhiv最新文献

{"title":"[Stage I cholelithiasis. Approaches to diagnosis and treatment. Results of the Machaon study].","authors":"S N Mekhtiev, O A Mekhtieva, I G Nikitin, S V Okovityy, C S Pavlov, A O Bueverov, M F Osipenko, S V Turkina, L G Vologzhanina, E V Beloborodova, V V Tsukanov, V G Morozov, V A Akhmedov","doi":"10.26442/00403660.2025.02.203160","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203160","url":null,"abstract":"<p><strong>Aim: </strong>To review the results of the open observational study Makhaon on the use of a fixed combination of glycyrrhizic acid (GA) and ursodeoxycholic acid (UDCA) (Phosphogliv Urso) for the treatment of abdominal pain, assessment of contractile function of the gallbladder and bile rheology in patients with stage I cholelithiasis.</p><p><strong>Materials and methods: </strong>The study included 330 subjects, 44.5% males and 55.5% females. The study participants were 18-70 years old, with a mean age of 43.8±0.6 years. In 2021-2022, patients were treated in 14 clinical centers in 10 cities of the Russian Federation: Moscow, St. Petersburg, Stavropol, Volgograd, Perm, Samara, Ufa, Omsk, Novosibirsk, Tomsk. All patients received Phosphogliv Urso (UDCA 250 mg + sodium glycyrrhizinate 35 mg), 1 capsule 3 times daily with food for 6 months.</p><p><strong>Results: </strong>Based on the clear improvement, therapy with a combination of GA and UDCA has demonstrated high efficacy and safety and appears to be optimal for the treatment of abdominal pain, improvement of the contractile function of the gallbladder, and physicochemical properties of bile in patients with stage I cholelithiasis.</p><p><strong>Conclusion: </strong>Treating all variants of baseline changes in the bile rheology is an urgent task of modern biliology. Universal drugs for stage I cholelithiasis are UDCA and its fixed combination with GA.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"137-144"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of dynapenia and excess body weight in patients with ulcerative colitis].","authors":"G R Bicbavova, O M Drapkina, M Livzan, N Lisyutenko, A E Romanyuk","doi":"10.26442/00403660.2025.02.203118","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203118","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the associated effects of dynapenia and overweight in patients with ulcerative colitis (UC).</p><p><strong>Materials and methods: </strong>Single-center observational cross-sectional case-control study. 80 patients with UC were divided into groups: 14 UC patients with dinapenia and overweight/obesity; UC and dinapenia patients with normal body weight/body weight deficiency (<i>n</i>=12); overweight/obese UC patients (<i>n</i>=24); UC patients with normal body weight/weight deficiency bodies (<i>n</i>=30). The protocol included: the study of nutrition, physical activity, the risk of nutritional insufficiency, measurement of body mass index, blood pressure, dynamometry, duplex scanning of extracranial vessels, determination of the insulin resistance index (HOMA-IR). The assessment of blood composition parameters included studies of blood lipid composition, C-reactive protein, TNF-α, glucose, insulin, C-peptide, leptin, adiponectin, leptin receptors. Zonulin has been studied in feces.</p><p><strong>Statistical methods: </strong>median (<i>Me</i>), upper and lower quartiles (<i>Q</i>₂₅, <i>Q</i>₇₅); fraction and standard error of the fraction; Mann-Whitney criterion; Kruskal-Wallis criterion; Pearson's χ². To identify the statistical relationship, Spearman's correlation coefficient was calculated. Statistical indicators are calculated using Statistica 10.01.1011.</p><p><strong>Results: </strong>Dinapenia in combination with obesity/overweight is observed in 17.5% of patients with UC, most of them patients with low physical activity. Dinapenic obesity is associated with metainflammation and increased permeability of the epithelial barrier, as evidenced by significantly higher rates of C-reactive protein, TNF-α, HOMA-IR and fecal zonulin. In patients with dinapenia in combination with overweight/obesity, higher leptin levels were determined, and the leptin receptors level was lower than in participants of other groups.</p><p><strong>Conclusion: </strong>The mechanisms of dinapenia in overweight/obese UC patients include a synergistic effect of inflammation, insulin resistance and increased epithelial permeability.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"121-127"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Therapy for irritable bowel syndrome: focus on butylbromide hyoscine. A review].","authors":"A I Goncharenko, F V Gorbovskoi, E A Kargina, N M Kondrat'eva","doi":"10.26442/00403660.2025.02.203191","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203191","url":null,"abstract":"<p><p>Irritable bowel syndrome (IBS) is a widespread bowel disease, associated with a significant decrease in patients' quality of life. The etiology, pathogenesis, clinical symptoms and treatment strategies of IBS have not been studied sufficiently. Current clinical guidelines list antispasmodics as medications for abdominal pain management, the main symptom of IBS. Both in Russian and foreign clinical guidelines of IBS, among the antispasmodic drugs, hyoscine butylbromide is regarded as an effective and safe medicine for abdominal pain management. Hyoscine butylbromide has a broad spectrum of applications in gastroenterology. This fact determines its advantages in terms of drug choice for treating patients with comorbidities involving digestive system pathologies. The use of hyoscine butylbromide is especially relevant in light of the frequent occurrence of a combination of IBS and functional disorders of the biliary tract, since the antispasmodic is also recommended for biliary pain management.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"176-184"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chronic small bowel obstruction in a patient with post-radiation enteropathy. Case report].","authors":"A V Leontiev, L K Indejkina, M A Danilov, E A Sabelnikova, M A Orlyuk, K O Abramov, A A Makarova, A I Parfenov","doi":"10.26442/00403660.2025.02.203119","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203119","url":null,"abstract":"<p><p>Сase report of late radiation damage to the small intestine in a patient who underwent laparoscopic extirpation of uterine cancer and radiation therapy is presented. The article shows the clinical manifestations of chronic post-radiation enteritis with a long progressive course and the development of partial intestinal obstruction, demonstrating the importance of timely diagnosis and the implementation of a multidisciplinary approach in the treatment of patients with late radiation damage to the intestine.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"193-197"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevalence and risk of malnutrition in patients with chronic pancreatitis: A systematic review and meta-analysis].","authors":"D N Andreev, A R Khurmatullina, Y A Kucheryavyy, I V Maev","doi":"10.26442/00403660.2025.02.203192","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203192","url":null,"abstract":"<p><strong>Aim: </strong>To systematize data on the prevalence and risk of malnutrition in patients with chronic pancreatitis (CP).</p><p><strong>Materials and methods: </strong>MEDLINE/PubMed, EMBASE, Cochrane, Google Scholar, Scopus, and the Russian Science Citation Index were searched for studies published between January 1, 1985, and October 23, 2024 (inclusive) based on an analysis of the titles and abstracts of articles in these databases. The study included relevant publications in peer-reviewed periodicals in English or Russian, publications with data on the prevalence of malnutrition in patients with CP and control subjects (if any), studies on adult patients with CP, and publications with detailed descriptive statistics that allow using the data in the meta-analysis.</p><p><strong>Results: </strong>The final analysis included 13 studies involving 3,812 subjects (3,401 patients with CP and 411 controls). The overall prevalence of malnutrition in patients with CP was 43.43% (95% confidence interval [CI] 32.419-54.780), whereas in controls, it was 10.843% (95% CI 1.360-27.698). When analyzing the association in the overall pool of studies, a significant risk of malnutrition in CP patients compared to controls was shown (relative risk [RR] 3.635, 95% CI 1.409-9.373; <i>p</i>=0.008). The analysis used a random effect model, as there was high heterogeneity between the groups (<i>I</i>²=88.09%, 95% CI 74.76-94.38). A review of studies that used only validated instrumental methods for the diagnosis of malnutrition (criteria of the Global Leadership Initiative on Malnutrition) showed a total prevalence of malnutrition of 38.348% (95% CI 14.975-65.047) in patients with CP and 12.22% (95% CI 5.985-67.238) in control subjects.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrated that malnutrition is a common complication of CP and occurs in approximately 40% of CP patients. A modern clinician should promptly assess malnutrition markers in a CP patient and correct them using enzyme replacement therapy if detected.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"185-192"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Russian Cross-disciplinary Consensus on the diagnosis and treatment of spondyloarthritis associated with inflammatory bowel diseases].","authors":"G V Lukina, O V Knyazev, E A Belousova, D I Abdulganieva, E N Aleksandrova, I G Bakulin, O I Barysheva, M А Borisova, B А Vykova, A А Godzenko, I V Gubonina, T V Dubinina, T N Zhigalova, E V Zhilyaev, A V Kagramanova, T V Korotaeva, A V Kuzin, M A Livzan, A M Lila, V I Mazurov, E L Nasonov, A A Novikov, M F Osipenko, A I Parfenov, L V Tarasova, O V Khlynova, M V Shapina, O B Shchukina, S F Erdes, A A Iakovlev","doi":"10.26442/00403660.2025.02.203117","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203117","url":null,"abstract":"<p><p>The Russian Cross-disciplinary Consensus on the diagnositic and treatment of spondyloarthritis (SpA) in inflammatory bowel diseases (IBD) was prepared on the initiative of the Loginov Moscow Clinical Scientific Center, using the Delphic system. Its purpose was to consolidate the opinions of experts on the most actual issues of diagnosis and treatment of concomitant immuno-inflammatory diseases (SpA and IBD). An interdisciplinary approach is provided by the participation of leading gastroenterologists and rheumatologists. The working group analyzed domestic and foreign publications on the problem of curation of patients with SpA and IBD. There have been 17 statements and 2 treatment algorithms formulated. Statements 1-3 reflect the fundamental principles of management of patients with SpA and IBD. The principles of early diagnosis of SpA and IBD, including the diagnosis of complications of therapy, are described below. Eleven statements are devoted to current methods of treatment, on the basis of which 2 treatment algorithms have been developed. The statements of the Consensus were submitted to the Expert Council for consideration, edits were made, after which an online vote took place. This paper presents current recommendations for the management, diagnosis and treatment of patients with SpA and IBD.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"198-213"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Inflammatory cytokines, soluble interleukin-6 receptors, and fragmented cytokeratin-18 as indicators of non-alcoholic steatohepatitis].","authors":"A A Shipovskaya, O P Dudanova, I V Kurbatova","doi":"10.26442/00403660.2025.02.203123","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203123","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin (IL)-1β, 8, 6, soluble IL-6 receptors (sIL-6R) and fragmented cytokeratin-18 (FCK-18) as indicators of non-alcoholic steatohepatitis (NASH).</p><p><strong>Materials and methods: </strong>173 NASH patients aged 47.0±10.8 years were examined: 118 (68.2%) - men, 55 (31.8%) - women. The following markers were determined: TNF-α (Human TNFα Platinum ELISA, eBioscience, Austria), IL-1β, 8, 6 (Vector-Best, Russia), sIL-6R (Human sIL-6R ELISA, eBioscience, Austria), FCK-18 (TPS ELISA, Biotech, Sweden), insulin (Insulin TEST System, USA), HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) and NAFLD fibrosis score (NFS) were calculated.</p><p><strong>Results: </strong>The highest level in NASH patients compared with healthy individuals was observed for IL-6 - 8.4±1.6 pg/ml versus 2.8±0.9 pg/ml (<i>p=</i>0.001), FCK-18 - 295.3±56.3 U/l versus 110.5±30.2 U/l (<i>p=</i>0.0001), then IL-8 - 17.3±6.7 pg/ml vs 7.6±1.9 pg/ml (<i>p=</i>0.003), TNF-α - 6.3±0.4 pg/ml versus 4.1±0.8 pg/ml (<i>p=</i>0.0001), sIL-6R - 151.5±21.2 ng/ml vs 95.9±12.5 ng/ml (<i>p</i><0.05); IL-1β did not change - 5.3±1.4 pg/ml versus 4.7±1.5 pg/ml (<i>p=</i>0.3) respectively. FCK-18 showed the highest correlations with TNF-α (r=0.73), HOMA-IR (r=0.73), alanine aminotransferase (r=0.71), erythrocyte sedimentation rate (r=0.23), IL-6 (r=0.22); <i>p<</i>0.05. TNF-α correlated with FCK-18 (r=0.73), cholesterol (r=0.61), albumin (r=-0.42), fibrinogen (r=0.21), leukocyte count (r=0.21); <i>p<</i>0.05. IL-8 correlated with triglycerides (r=0.79) and HDL (r=-0.77), IL-6 - with NFS (r=0.63) and FCK-18 (r=0.22), rIL-6R - with aspartate aminotransferase (r=0.62); <i>p<</i>0.05.</p><p><strong>Conclusion: </strong>TNF-α, IL-8, 6, sIL-6R and FCK-18 should be used as non-invasive biomarkers of NASH.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"115-120"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ultrasound of muscles for the diagnosis of sarcopenia in patients with inflammatory bowel diseases].","authors":"O E Akchurina, D D Mukhametova, A K Odintsova, D I Abdulganieva","doi":"10.26442/00403660.2025.02.203204","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203204","url":null,"abstract":"<p><strong>Aim: </strong>To assess the muscle mass of patients with inflammatory bowel disease (IBD) using ultrasound.</p><p><strong>Materials and methods: </strong>102 IBD patients hospitalized in gastroenterology department of Republican Clinical Hospital (Kazan) were involved in the study. Among them, 49% of patients with ulcerative colitis, 51% with Crohn's disease, 10 people made up the control group (CG). The median age in the IBD group was 39.5 [28.5; 50] years, in the CG - 37 [26; 38] years. There were 52 (51%) women in the IBD group and 5 (50%) in the CG group. Patients were examined to assess body mass index (BMI), mid-upper arm circumference (MUAC, cm) and mid-thigh circumference (MTC, cm) of the dominant side; bioimpedance analysis of body composition using the ABC-02 \"MEDASS\" device; ultrasound examination of muscle thickness at two points on the leading side: ultrasound thickness of the middle of the shoulder (US-MUAC), ultrasound thickness of the middle of the thigh (US-MTC), dynamometry using a wrist dynamometer, assessment of nutritional status.</p><p><strong>Results: </strong>According to BMI, patients were distributed as follows: normal in 57 (55.9%) patients; deficiency - in 12 (11.8%); overweight - 25 (24.5%); obesity - 8 (7.8%). Median MUAC in women with IBD was 28 [24.9; 31] cm, in CG - 28 [27; 28.5] cm (<i>p</i>>0.05); in men with IBD 29.8 [27; 32] cm, in CG - 33 [31; 34] cm (<i>p</i><0.05). The median MTC in women with IBD was 54.25 [48.15; 58.10] cm, in CG - 61.5 [56; 67] cm (<i>p</i><0.05); in men with IBD 48 [46; 51.4] cm, in GC - 54 [53; 54] cm (<i>p</i><0.05). The median US-MUAC in women with IBD was 19.60 [18.23; 22.84] mm, CG 22.49 [20.41; 22.66] (<i>p</i>>0.05); in men with IBD 26.45 [22.87; 29.24] mm, in CG 21.54 [21.18; 25.13] mm (<i>p</i>>0.05). Median US-MTC in women with IBD was 31.05 [23.21; 37.11] mm, CG 41.30 [35.55; 41.74] mm (<i>p</i><0.05), in men with IBD 30.90 [25.64; 39.99] mm, in CG 40.67 [39.10; 41.84] (<i>p</i><0.05). According to the results of bioimpedansometry, the skeletal muscle mass index (SMI) was low in 32% of patients, normal in 65%, and above normal in 3%. US-MUAC correlated with MUAC (<i>r</i>=0.557; <i>p</i><0.05), with BMI (<i>r</i>=0.448; <i>p</i><0.05), with SMI (<i>r</i>=0.666; <i>p</i><0.05). US-MTC correlated with MTC (<i>r</i>=0.505; <i>p</i><0.05), with BMI (<i>r</i>=0.376; <i>p</i><0.05), with SMI (<i>r</i>=0.373; <i>p</i><0.05).</p><p><strong>Conclusion: </strong>In patients with IBD, MTC was lower than in CG. US-MTC in women and men with IBD was lower than in CG, which correlated with MTC, BMI, skeletal muscle mass according to bioimpedance measurements and grip strength according to dynamometry.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"157-162"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Trends of antibiotic resistance of Helicobacter pylori in Moscow].","authors":"I V Maev, D N Andreev, A K Fomenko, M S Podporin, S V Lyamina, A V Zaborovsky, I N Khimina, S V Cheremushkin, A S Bagdasarian, N V Cheremushkina, E G Lobanova, V N Tsarev, O V Zayratyants","doi":"10.26442/00403660.2025.02.203193","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203193","url":null,"abstract":"<p><strong>Aim: </strong>To determine the trends of primary antibiotic resistance of <i>Helicobacter pylori </i>strains isolated from patients living in Moscow.</p><p><strong>Materials and methods: </strong>As part of a clinical and laboratory study, 123 gastric biopsy specimens from <i>H. pylori</i>-infected patients were analyzed from 2015 to 2024. <i>H. pylori</i> infection was verified by a rapid urease test and a ¹³C-urease breath test. The anaerobic culture technique was used. After identifying a pure culture, its susceptibility to four antibacterial agents (amoxicillin - AMC, clarithromycin - CLR, metronidazole - MET, tetracycline - TET) was determined by the disc diffusion method.</p><p><strong>Results: </strong>According to the data, the resistance in the overall pool (<i>n</i>=123) of the test samples to AMC was 4.88%, CLR 16.26%, TET 3.25%, and MET 46.34%. Dual resistance to CLR and MET was detected in 4.06% of strains. Among strains collected from 2015 to 2019 (<i>n</i>=28), resistance to AMC was 0.0%, CLR 10.71%, TET 0.0%, and MET 50.0%. The structure of antibiotic resistance of strains collected from 2020 to 2024 (<i>n</i>=95) was as follows: AMC - 6.32%, CLR - 17.89%, TET - 4.21%, MET - 45.26%.</p><p><strong>Conclusion: </strong>There is a gradual tendency to increase the resistance of <i>H. pylori</i> to antibacterial agents such as AMC, CLR, and TET in Moscow, which is consistent with the data of other studies. This negative trend may eventually lead to decreased effectiveness of currently used eradication therapy regimens in Russia.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"163-168"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cardiometabolic and genetic factors in the progression of metabolic dysfunction-associated steatotic liver disease].","authors":"V P Gomonova, K L Raikhelson","doi":"10.26442/00403660.2025.02.203203","DOIUrl":"https://doi.org/10.26442/00403660.2025.02.203203","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the contribution of cardiometabolicfactors and <i>PNPLA3</i> I148M (rs738409 C>G) gene polymorphism to the development of compensated advanced chronic liver disease (cACLD) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Materials and methods: </strong>108 patients with MASLD were enrolled and formed the internal validation group; 30 patients with MASLD were selected for external validation. Anamnestic data, anthropometric and laboratory parameters and the presence of <i>PNPLA3</i> gene polymorphism I148M (rs738409 C>G) were assessed. Steatosis was detected by assessing the controlled attenuation parameter. Liver elasticity was assessed by transient elastography. cACLD was detected when the liver stiffness was ≥8 kPa.</p><p><strong>Results: </strong>Statistically significant difference was observed in the internal validation group during comparison of the incidence of cACLD depending on the presence of arterial hypertension (odds ratio - OR 5.58; 95% confidence interval - CI 1.21-25.71), type 2 diabetes mellitus - T2DM (OR 4.58; 95% CI 1.59-13.21), obesity (OR 3.13; 95% CI 1.1-8.9), dyslipidemia (OR 6.12; 95% CI 1.33-28.19) and the mutant G allele of the <i>PNPLA3</i> gene (OR 3.9; 95% CI 1.28-11.88). Patients with cACLD had significantly higher mean values of waist circumference (WC), alanine aminotransaminase, aspartate aminotransaminase, gamma-glutamyl transferase and triglycerides, non-invasive markers of steatosis and fibrosis. The compiled prognostic model demonstrated a direct relationship between the likelihood of developing cACLD and the presence of T2DM (adjusted odds ratio - AOR 3.28; 95% CI 0.62-17.33), dyslipidemia (AOR 5.89; 95% CI 1.21-28.67) and WC value (AOR 1.05; 95% CI 1.01-1.11). <i>PNPLA3</i> I148M gene polymorphism did not significantly affect the development of late stages of the disease. External validation of the model showed its moderate diagnostic ability.</p><p><strong>Conclusion: </strong>T2DM, dyslipidemia and WC values are the determining factors in the development of cACLD in patients with MASLD. The <i>PNPLA3</i> I148M gene polymorphism has no leading importance for the development of the progressive course of MASLD in the studied cohort.</p>","PeriodicalId":22209,"journal":{"name":"Terapevticheskii Arkhiv","volume":"97 2","pages":"149-156"},"PeriodicalIF":0.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}