Aksentiychuk K. Nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: prevalence, risk factors, methods of noninvasive diagnosis

3. The object of investigation - nonalcoholic fatty liver disease in combination with type 2 diabetes. The aim is to improve the diagnosis and improve the prevention of NAFLD patients with type 2 diabetes based on a study of prevalence of comorbid disease, risk factors, clinical and pathogenetic and functional characteristics of the disease. It was established that the prevalence of NAFLD was 69.47%, among patients with type 2 diabetes and 65.6% among those who died during the lifetime of hurt this pathology. According to the analysis of clinical data, the frequency of NAFLD and its clinical forms among patients with type 2 diabetes were more than twice as high in the intervention group than in the control group, which, respectively, was 69.47% and 30.19% (P <0.05 ). Steatosis in patients of the main group met at 34.35%, the control group - only 13.2% (p <0.05). NASH was diagnosed in 29.01% of patients with type 2 diabetes, and 15.09% in the control group, fibrosis in 6.11% of the main and in 1.9% of the control group. According to the autopsy reports of deaths with type 2 diabetes, NAFLD was detected in 181 (65.6%). But in the control group only 23 (23.0%). The share of steatosis was 24.6%, steatohepatitis - 37.3% of liver fibrosis - 3.6%, NAFLD were not found 13.4% of patients. Among the control group was 14% steatosis, steatohepatitis - 16% and 2% of fibrosis. Liver disease wasn’t found in 74%. It was proved for the first time that NAFLD risk factors in patients with type 2 diabetes is hypertriglyceridemia (more than 1.82 mmol /l) and the duration of diabetes. A risk factor for steatosis identified female sex, and hypertriglyceridemia, to steatohepatitis - ALT levels> 0.68 mmol / l and hypertriglyceridemia. It was proved that steatosis develops in an average 9,38 ± 1,26 years from the onset of type 2 diabetes, steatohepatitis - for 6,58 ± 1,2 years, and fibrosis of the liver - a 13,83 ± 4,17 years. NAFLD diagnostic algorithm in patients with type 2 diabetes involves biochemical parameters, formula Forns, liver ultrasound and 13С-MBT was compiled. The results were inserted in the hospital practice, scientific and teaching-methodological process. The branch of science is medicine.There is also a certain period of time from the time of diagnosis of type 2 diabetes, in which the violation of the liver were not noted - 5,76 ± 1,34 years. NAFLD diagnostic algorithm in patients with type 2 diabetes involves biochemical parameters, formula Forns, liver ultrasound and 13С-MBT was compiled. The results were inserted in the hospital practice, scientific and teaching-methodological process. The branch of science is medicine.