The object of study: dyslipidemia, hypothyroidism, nonalcoholic fatty liver disease (NAFLD). The aim of the study: to improve the efficiency of treatment dyslipidemia in patients with hypothyroidism combined with nonalcoholic fatty liver disease by establishing features of their developing according to polymorphic varianrs -204А > С (rs 3808607) gene CYP7A1 and optimization drug and non-drug correction of lipid metabolism disorders. Methods: general clinical examination of patients (collection of complaints, history of disease and life, objective review of all organs and systems), anthropometric data (body weight, waist circumference, body mass index); biochemical blood test with the definition of the lipid spectrum; immunoassay case study with determination of thyroid stimulating hormone, free thyroxine, thyroid globulin antibodies, thyroperoxidase antibodies; alanine aminotransferase, aspartate aminotransferase, gammaglutamyltransferase, alkaline phosphatase; the molecular genetic testing with the identification of polymorphic variants -204А > С (rs 3808607) of CYP7A1 gene; test "FibroMaks"; ultrasonographic examination of the thyroid gland, liver and gall bladder; software package "Statistica-Stat-Soft" (USA). Scientific novelty of the results: the thesis contains a new approach to solving a scientific problem, which involves studying the peculiarities of the clinical course, the development of dyslipidemia and the biochemical parameters of the hepatobiliary system at the comorbid flow of hypothyroidism and NAFLD. The heterogeneity of dyslipidemia in patients with hypothyroidism in combination with NAFLD is determined not only by phenotype, but also by genotype. It is proved that dyslipidemia with hypothyroidism combined with NADH is not only related to the deficiency of thyroid hormones, but also has a genetic component. The method of combined treatment of dyslipidemia in this category of patients with the use of statins, omega-3 fatty acids and intravenous laser therapy on the background of the administration of L-thyroxine has been developed, which has shown the high efficiency of hypolipidemic effect. Based on the molecular genetic analysis, polymorphic variants of rs 38088607 of the CYP7A1 gene were first established, which made it possible to determine the effect on them of statins, omega-3 fatty acids and intravenous laser therapy, and also cases resistant to these methods, which substantiate the personified approach to treatment dyslipidemia in patients with hypothyroidism combined with nonalcoholic fatty liver disease, and in the long term - the need to determine this genetic marker for primary prevention of dyslipidemia.
