| Popis: |
The aim of the work was to study the compositional features of fatty acids of erythrocyte membranes and blood serum in patients with fatty liver disease of alcoholic (AFLD) and nonalcoholic (NAFLD) genesis for possible use for differential diagnosis. A total of 80 men (51.8±3.9 years) with AFLD (n = 28) and NAFLD (n = 52), as well as 20 conditionally healthy individuals were examined. The composition of erythrocyte membrane and serum fatty acids (FA) was studied using a chromatography mass spectrometry system based on three Agilent 7000B quadrupoles (USA). Differences in levels and ratios of FA in blood serum and erythrocyte membranes were revealed in patients with alcoholic and nonalcoholic fatty liver disease. Increased esterification of FA, increased synthesis of polyunsaturated (PUFA), enhancing liver damage caused by ethanol, a significant role of oleic and linoleic acids are associated with AFLD. Patients with NAFLD showed elevated levels of potentially lipotoxic saturated FA (margarine, stearic, arachinic, pentadecanoic) with a decrease in monounsaturated (palmitoleic, elaidic, oleic). A decrease in the content of docosahexaenoic n-3 PUFAs against the background of a compensatory increase in the level of docosapentaenoic FA n-6 with an omega-3 deficiency, increased consumption of omega-6 PUFAs suggest defective desaturation of unsaturated fatty acids and increased longchain PUFA peroxidation followed by oxidative stress, especially insulin resistance. The synthesis of triglycerides provides a protective mechanism against toxic accumulation of free FA in the liver. Correlation was established between the levels of FA erythrocyte phospholipids and components of the metabolic syndrome, markers of alcohol consumption. Pilot diagnostic models have been obtained that make it possible to distinguish patients with NAFLD and AFLD from healthy patients (AUC 0.892, sensitivity 0.82, specificity 0.88 for NAFLD; AUC 0.811, sensitivity 0.74, specificity 0.80 for ASFLD), as well as NAFLD from AFLD (AUC 0.790, sensitivity 0.73, specificity 0.78). FA profiles of erythrocyte membranes and blood serum are reliable biomarkers of disorders in lipid metabolism in patients with fatty liver disease of various genesis and are promising from the point of view of differential diagnosis. |
