In recent years, there has been increasing interest in the "gut-liver axis", the dysfunction of which leads to intestinal dysbiosis, bacterial overgrowth syndrome (BBG) and increased intestinal permeability [1,2]. The results of experimental and clinical studies revealed an increase in the number of gram-negative bacteria of the type Bacteroidetes compared to the number of gram-positive bacteria of the type Firmicutes in patients with metabolically-associated fatty liver disease (MAFLD) and diabetes mellitus (DM) type 2 [3]. Violations of intestinal bacterial homeostasis and changes in the content and distribution of bacteria in the intestine and their metabolic functions in patients with MAFLD and type 2 diabetes lead to an increase in the permeability of the intestinal barrier, bacterial translocation and endotoxemia, which is a trigger for increased synthesis of zonulin, a protein that is one from regulators of intestinal permeability [4].
Modulation of intestinal microbiota using antibiotics, probiotics, and prebiotics is a modern, promising therapeutic direction for correcting intestinal dysbiosis and intestinal barrier permeability [4].
The purpose of the study is to optimize the diagnosis and treatment of patients with metabolic-associated fatty liver disease in combination with type 2 diabetes mellitus based on the study of the state of intestinal permeability, its effect on the level of pro-inflammatory cytokines and the effectiveness of its therapeutic correction.
The Bioethical Committee of Scientific Research of Bogomolets National Medical
Universitу was approved the protocol № 150/18.10.2021. The study was conducted at the clinical base of the Department of Internal Medicine №1 from 2020 to 2024 and was performed in accordance with the requirements of the Helsinki Declaration of the World
Medical Association «Ethical principles of medical research involving a person as a research object» 1964, (2008 Revision). Informed consent for participation in the study was signed by the patients.
To solve the aim and objectives of the dissertation work, a prospective interventional randomized study was conducted, which included 108 patients with MAS in combination with type 2 diabetes, who were divided into 2 groups. The first group included 52 patients with the absence of intestinal bacterial overgrowth syndrome (IBS). The second group includes 56 patients with SIBO. The control group consisted of 20 practically healthy people. In the first group, the ratio of men and women is 37% (19) and 63% (33), the average age of men - 53.42±1.62 and women - 57.56±2.58, in the second group of men 36% (20 ), women 64% (36), the average age of men - 56.21±2.13 and women - 55.54±3.77. Control group men 50% (10), women 50% (10), average age of men - 51.91±3.69 and women -
52.64±2.32.
