Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver diseases in developed countries. An increase in NAFLD incidence is associated with a global obesity epidemic and metabolic complications, including hypertension, diabetes, and dyslipidemia. According to the recommendations of the American Association for the Study of Liver Diseases (AASLD) and EASL-EASD-EASO guidelines for the diagnosis and treatment of NAFLD, the diagnosis of NAFLD prefers non-invasive methods, and the treatment is determined individually depending on the severity of steatosis and concomitant metabolic disorders. At the same time, clinical role of endothelial lipase (EL) in patients with NAFLD on the background of hypertension and excess body weight and further determination of therapeutic tactics is unknown. 80 people were surveyed (average age was 52.12 + 5.24 years), of which 32 men (53.33%) and 28 women (46.66%) made up the main group. Group 1 included 44 patients with NAFLD on the background of GC and overweight. Group 2 consisted of 16 individuals with III stage GC without NAFLD. The main group has been divided into subgroups according to the presence of liver steatosis. There were no statistically significant differences in age, gender representation and height between groups. All of them were subjected to collection of complaints, medical history of disease and life, objective study, determination of anthropometric parameters (BMI, RT, RT / height), measurement of blood pressure, ECG, biochemical analysis of 7 blood with determination of liver dysfunction markers (ASAT, ALAT, general
bilirubin, LF), studies of carbohydrate metabolism disorders (blood glucose, blood insulin, NOMA-IR, glycated hemoglobin) and lipid profile (total blood cholesterol,
HDL, LDL, VLDL, triglycerides), determination of EL in blood plasma by immuneenzyme method. Liver ultrasound and NAFLD liver fat score have been performed
to detect steatosis, including metabolic syndrome and type 2 diabetes (DM2), serum insulin levels, AST, and AST / ALT ratios. The severity of steatosis was assessed
using the Fib-4 index, which included such indicators as AST, ALT, and platelet levels. All patients for the exclusion of NAFLD alcohol genesis were interviewed
for alcohol units according to UK Chief Medical Officers' Low Risk Drinking Guidelines 2016 - a test that has international standardization and identifies alcohol
abuse. The diagnosis of NAFLD was established in accordance with Order No. 826 of the Ministry of Health of Ukraine dated 06.11.2014 on the basis of criteria of the
American Association for the Study of Liver Diseases, 2012 and European guidelines for NAFLD [1] the diagnosis and treatment. The diagnosis of GC was established in accordance with Order # 384 of the Ministry of Health of Ukraine dated 24.05.2012, the stage and degree of GC were determined according to the clinical guidelines for hypertension (2017) of the European Society of Hypertension (ESH) and the European Society of Cardiologists (ESC) [2]. All patients received recommendations for diet modification and exercise. Patients with NAFLD with pronounced steatosis were prescribed Essentiale forte H (RP No. UA / 8682/01/01) at a dose of 2 capsules 2 times a day for 6 months. 6 months later, patients were monitored for clinical and biochemical parameters and endothelial lipase. GC patients were treated according to clinical protocol No. 384 of the Ministry of Health of Ukraine. The study was approved by the KhNMU Commission on Bioethics (protocol No. 7 dated 06.11.2019). Statistical data processing was performed using standard methods. 8 A significant difference in the NAFLD liver fat score (p = 0.002) groups in which insulin sensitivity was considered has been demonstrated. The liver fibrosis index Fib-4 has diagnostic values for marked steatosis (F1-F2 fibrosis on the METAVIR scale). Index increase in patients with GC without steatosis was not significant, but with an increased BMI relative to the control group proves the prognostic role of the indicator regarding the pathogenetically possible steatosis occurrence in this contingent of subjects. Significantly higher EL concentration (p = 0.01) was established in the groups with moderate and distinct liver steatosis relative to the control group and the group without liver steatosis. In this case, the increase EL level is associated with the presence of metabolic disorders.
