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Background. The purpose of the study was to investigate the biochemical blood peculiarities and cytokine profile in non-alcoholic fatty liver disease (NAFLD) patients depending on the form of hypothyroidism. Material and methods. The study involved 188 NAFLD patients (average age 53.60 ± 12.34 years). Among the examined individuals 44 of them had diagnosed hypothyroidism in addition to NAFLD (20 patients had subclinical form and 24 patients had manifest hypothyroidism). A comparison group consisted of 144 NAFLD patients with thyroid normal functional activity. The control group consisted of 45 healthy individuals represented by their age and gender similar to the patients of the studied groups. Biochemical blood parameters, tumor necrosis factor α, interleukin-10, leptin, adiponectin blood levels were investigated in the observed patients and healthy individuals. Results. Total lactate dehydrogenase blood activity in NAFLD patients with subclinical and manifest hypothyroidism was found to be 13.5 % increased compared to the NAFLD patients with normal functional activity of the thyroid gland (p = 0.02 and p = 0.01, respectively). Higher alkaline phosphatase blood activity by 12.0 % (p = 0.03) was recorded in NAFLD and manifest hypothyroidism patients as compared to the patients with intact thyroid gland. Leptin blood concentration in NAFLD patients with subclinical as well as manifest hypothyroidism was 35.7 % and 72.1 % increased compared to NAFLD patients with normal thyroid functional activity (p = 0.04 and p = 0.009, respectively). Adiponectin blood level in NAFLD patients with manifest hypothyroidism was 2.1 lower (p = 0.004) in comparison with NAFLD patients with thyroid normal functional activity and 50.0 % lower (p = 0.009) as compared to the NAFLD patients with subclinical hypothyroidism. NAFLD and manifest hypothyroidism patients showed greater vertical size of the liver measured by midclavicular line on average by 9.1 mm (p = 0.004) as compared to NAFLD patients with unchanged thyroid gland functional activity and by 8.6 mm (p = 0.04) in comparison with the NAFLD patients with subclinical hypothyroidism. Conclusions. There were found higher total lactate dehydrogenase activity and leptin blood level in NAFLD patients with subclinical and manifest hypothyroidism and higher alkaline phosphatase activity and lower adiponectin blood level in NAFLD patients with manifested hypothyroidism as compared
to NAFLD patients with normal functional activity of the thyroid gland. A significant increase in liver vertical size measured by midclavicular line was observed in NAFLD patients with manifest hypothyroidism as compared to the patients with normal thyroid function or subclinical hypothyroidism.
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Nakaz MOZ Ukraїni vіd 06.11.2014 № 826 ‘Pro zatverdzhennja ta vprovadzhennja mediko-tehnologіchnih dokumentіv zі standartizacії medichnoї dopomogi pri hronіchnih neіnfekcіjnih gepatitah’ [Order of Health Ministry of Ukraine N 826 dated 06.11.2014 ‘About a statement and introduction of medical and technological documents from standardization of medicare at chronic uninfectious hepatitis’]. Kyiv, 2014. (In Ukrainian).
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