Object of the research: diabetes mellitus (DM), fatty degen-eration of liver (FDL) and their combination. Purpose of the research: revealing of the basic pathogenetic mechanisms in the development and progressing of FDL, its influ-ence on the peculiarities in the course of DM, on whose basis to reveal its main diagnostic criteria and devise schemes of correct-ing therapy. Methods of the research: clinical-laboratory, biochemical, im-munoenzyme and instrumental methods. Theoretical and practical results: the obtained results extend the knowledge about the homocysteine (Hc) balance in blood plasma, changes in the indices of carbohydrate, protein, enzyme, pigment, lipid metabolism, choleretic function of the liver, disclose their part in the pathogenesis of the disease and substantiate the neces-sity to study their content in steatohepatitis in patients with DM, FDL and DM combined with FDL in order to improve the diagno-sis of FDL. A relationship was revealed between the activity of the pathogenic process in the liver and the immunoresistancy level, thereby making it possible to regard these processes as pathogenic factors in patients with DM, FDL and DM combined with FDL. A revealed high level of Hc in patients with DM, FDL and in cases of DM combined with FDL gives grounds to consider this index (an amino acid) as a marker of remote DM complica-tions. The results of the conducted research demonstrate a positive effect of therapeutic complexes (Espa-Lipon – Ursochol and Espa-Lipon – Thiotriazoline) on the functional state of the hepa-tobiliary system in FDL in DM patients. The elimination of the general process in the liver contributes to achieving a stable meta-bolic control in patients with DM, FDL and DM combined with FDL Novelty: it was found out that FDL was more common for pa-tients with DM type 2 and an increased body weight (22/16 %) and manifested in them with the dyspeptic (10/45 %), pain (12/54 %), asthenic (20/91 %), hepatomegalic (13/59 %) syn-dromes, increasing chronic hyperglycaemia, high level of glycoslulated haemoglobin (> 11,1 %), increase in the extent of immunoresistency. It was revealed that the presence of FDL in patients with DM types 1 and 2 was often accompanied by a dis-turbance in protein metabolism with the presence of dysproteinaemia, development of the protein-energy deficiency syndrome, a higher activity of indicating enzymes (asparagine aminotransferase, alanine aminotransferase) and formation of the cytolysis syndrome, as well as development of hyperbilirubinaemia with the presence of the cholectasis syndrome. In increased concentration of Hc in blood serum gave rise to the intoxication syndrome and metabolic disturbances, which could be related with the formation of steatohepatosis, the latter producing its negative effect on the course of DM. It was proved that the presence of FDL in patients with DM types 1 and 2 passed with a disruption of the bilipoetic function of the liver. It manifested in changes of the biochemical properties of bile with a reliable decrease in the levels of bilirubin, cholesterol, bile acids, a reliable increase of C-reactive protein and sialic acids in the hepatic bile; at the same time, there was a disruption of the choleretic function of the liver with higher levels of the free, conjugated and the sum of bile acids in blood serum, which could be markers of steatohepatosis development. It was found out that DM types 1 and 2, FDL and their combination in patients with the normal and increased body weight passed with the development of dyslipidaemia, as well as are accompanied by a disturbance in the state of lipid peroxidation and antioxidant defence system, which predominate with the accompanying obesity and produce their negative effect on the metabolic state and the course of the diseases. The conducted histopathological study of liver biopsies in 15 examined patients with DM types 1 and 2 combined with FDL made it possible to reveal peculiarities in the structural-morphological changes of the liver (steatosis, inflammation, fibrosis) depending uponnosological forms, steatosis type, extent of histological activity and manifestation rate of fibrosis. A positive correlation effect was revealed between glycosulated haemoglobin and total cholesterol (r = +0.86 ? +0.88), triglycerides (r = +0.87), cholesterol of low density lipoproteins (r = +0.85 ? +0.83), cholesterol of very low density lipoproteins (r = +0.87 ? +0.72) and other biochemical criteria, which prevail in patients with DM types 1 and 2 in combination with FDL and confirm the key part of immunoresistency in the pathogenesis of steatosis and steatohepatosis. A positive effect of the suggested therapeutic schemes on the functional state of the hepatobiliary system in patients with DM, FDL and DM combined with FDL was proved. It was found out that such therapeutic complexes as Ursochol – Espa-Lipon in combination with traditional schemes in patients with DM types 1 and 2 together with FDL and the normal body weight and Thiotriazoline – Espa-Lipon with traditional therapeutic schemes in patients withDM type 2 together with FDL and an increased body weight produced a marked correcting effect. Degree of introduction: results of the research were introduced into clinical practice of the gastroenterological, endocrinological and therapeutic departments of the Kharkiv Regional Clinical Hospital, Blizniuki, Dergachi, Krasnograd, Izium, Nova Vodolaga, Lozova, Zolochev and Merefa Central District Hospitals of the Kharkiv Region, into the pedagogical process of the departments of the therapeutic type at Kharkiv National Medical University. Sphere of application: medicine, therapy departments.
