To achieve this goal, 102 patients with nonalcoholic fatty liver disease (NAFLD) were examined and divided into three groups. The first group included patients with type 2 diabetes mellitus (type 2 diabetes) (51 patients), the second group included patients without type 2 diabetes mellitus and with a HOMA index of 2,5 to 5,0 (51 patients). During the work of the two above groups, an additional third group of patients with dyslipidemia (20 patients) was formed. The average age of patients of the first and second groups was 54.3 ± 7.2 years, the age of patients of the third group was 64.9 ± 1.4 years. In the first group, the ratio of men and women was 52,9 % (27) and 47,1 % (24), in the second group 54,9 % (28) and 45,1 % (23), in the group of patients with dyslipidemia 60% (12) and 40 % (8), respectively. The control group included 20 healthy people – 55 % (11) men and 45 % (9) women.
The design of this study was approved by the Commission on Bioethical Expertise and Ethics of Scientific Research at the National Medical University named after O.O. Bogomolets 116 dated 29.11.2018.
The scope of research was carried out in accordance with the purpose of the work and included history taking, physical and anthropometric examination (measurement of height, body weight, BMI calculation, OT/OS ratio). In addition, biochemical analysis of blood (ALT, AST, bilirubin, AF, GGTP), lipid profile, plasma glucose level, HOMA index and glycated hemoglobin (HbA1c) were determined. The fractions of ceramides C16:0, C18:0, C24:0, C24:1 and their ratios С16:0/С24:0, С18:0/С24:0, С24:1/С24:0, С18:0/С16:0 were determined by liquid chromatography with mass spectrometry. Instrumental studies (ultrasound: steatometry, elastometry) were performed to assess steatosis, non-alcoholic steatohepatitis (NASH) activity and fibrotic changes of the liver.
When analyzing the results of six months of treatment, a significant decrease in the ratio of C16:0/24:0 in three groups (p < 0,01). In the group of patients with NAFLD and type 2 diabetes who received metformin C16:0/24:0, it was halved compared to other patients. When comparing the results of patients with dyslipidemia with the second group, the decrease in the ratio of C18:0/24:0 in them after 6 months was statistically insignificant (p > 0,05). However, in patients with dyslipidemia compared with other groups, there was a significant decrease in C18:0/24:0 (p < 0,05, p <0,01). When comparing the data, it was found that against the background of six months of treatment, the ratio of C24:1/24:0, significantly decreased in three groups (p < 0,01). The greatest changes were observed in patients with type 2 diabetes in whom the ratio of C24:1/24:0 decreased by 1,7 times. Analysis of the results of the ratio C18:0/16:0 showed a significant increase in all groups at the end of the sixth month of treatment (p < 0,01). However, the difference between C18:0/16:0 in patients from the second group and patients from the first group was not statistically significant (p > 0,01).
