medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-310medsovet-7806Research ArticleКОМОРБИДНЫЙ ПАЦИЕНТCOMORBID PATIENTМочевая кислота как предиктор развития неалкогольной жировой болезни печени у пациентов с артериальной гипертензиейUric acid as a predictor of the development of non-alcoholic fatty liver disease in patients with arterial hypertensionhttps://orcid.org/0000-0002-3306-0312СтаценкоМ. Е.StatsenkoM. Е.

Cтаценко Михаил Евгеньевич - доктор медицинских наук, профессор, проректор по научной работе, заведующий кафедрой внутренних болезней.

400131, Волгоград, площадь Павших Борцов, д. 1

Mikhail Е. Statsenko - Dr. Sci. (Med.), Professor, Vice-Rector for Scientific Work, Head of the Department of Internal Diseases.

1, Pavshikh Bortsov Square, Volgograd, 400131

mestatsenko@rambler.ruhttps://orcid.org/0000-0001-9016-3011СтрельцоваА. М.StreltsovaA. M.

Стрельцова Анастасия Михайловна - кандидат медицинских наук, ассистент кафедры внутренних болезней.

400131, Волгоград, площадь Павших Борцов, д. 1

Anastasia М. Streltsova - Cand. Sci. (Med.), Assistant of the Department of Internal Diseases.

1, Pavshikh Bortsov Square, Volgograd, 400131

nastyc03@mail.ruВолгоградский государственный медицинский университетРоссияVolgograd State Medical UniversityRussian Federation202321102023016101107Copyright © Стаценко М.Е., Стрельцова А.М., 20232023Стаценко М.Е., Стрельцова А.М.Statsenko M.Е., Streltsova A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7806Введение

Введение. В настоящее время повышение уровня мочевой кислоты (МК) рассматривается как независимый фактор риска развития неалкогольной жировой болезни печени. Оксидативный стресс, хроническое системное воспаление, инсулинорезистентность, характерные для неалкогольной жировой болезни печени (НАЖБП), могут представлять собой возможные механизмы связи между развитием гиперурикемии и НАЖБП.

Цель

Цель. Уточнить значение и характер связи между увеличением уровня концентрации мочевой кислоты и развитием НАЖБП, а также оценить связь МК и риска сердечно-сосудистых осложнений (ССО) у пациентов с артериальной гипертензией (АГ) и НАЖБП.

Материалы и методы

Материалы и методы. Проведено поперечное сравнительное исследование, в котором приняли участие 120 пациентов, в возрасте от 45 до 65 лет с АГ 1–2-й ст., 1–2-й стадии (с НАЖБП (FLI > 60) и без нее). При осмотре осуществляли клиническое обследование: анализ данных анамнеза, антропометрия. Также анализировали липиды, мочевую кислоту в плазме крови. Результаты. В группе коморбидных пациентов было значимо больше больных с превышением референсных значений уровня МК в плазме крови (ОШ = 2,25: 95% ДИ 1,08–4,71). ROC-анализ показал, что при МК, равной 369,5 мкмоль/л, прогнозируется высокий риск развития НАЖБП. Индекс МК/Кр у пациентов с АГ и НАЖБП был статистически значимо выше, чем у пациентов контрольной группы. Увеличение индекса МК/Кр на 1 у.е. увеличивает шансы развития НАЖБП в 1,54 раза (95% ДИ: 1,11–2,13). Также рост концентрации уровня МК на 1 мкмоль/л повышают шансы увеличения 10-летнего риска ССО до 5,0% и более на 0,6%.

Выводы

Выводы. При МК, равной 369,5 мкмоль/л, прогнозируется высокий риск развития НАЖБП в изучаемой группе. Рост индекса МК/креатинин на 1 у.е. увеличивает шансы развития НАЖБП в 1,54 раза. Кроме того, увеличение концентрации МК в плазме крови на 1 мкмоль/л повышают шансы роста 10-летнего риска ССО до 5,0% и более на 0,6% у пациентов с АГ и НАЖБП.

Introduction

Introduction. Currently, increased uric acid (UA) levels are considered an independent risk factor for the development of non-alcoholic fatty liver disease. Oxidative stress, chronic systemic inflammation, and insulin resistance characteristic of non-alcoholic fatty liver disease (NAFLD) may represent possible mechanisms for the association between the development of hyperuricemia and NAFLD.

Aim

Aim. To clarify the meaning and nature of the relationship between an increase in the level of UA concentration and the development of NAFLD, as well as to evaluate the relationship between uric acid and the risk of cardiovascular complications in patients with hypertension and NAFLD.

Materials and methods

Materials and methods. A cross-sectional comparative study was conducted, which involved 120 patients aged from 45 to 65 with hypertension of 1–2 degrees, 1–2 stages (with and without NAFLD (FLI > 60). During the examination, a clinical examination was carried out: analysis of anamnesis data, anthropometry. Lipids and uric acid in blood plasma were also analyzed.

Results

Results. In the group of comorbid patients, there were significantly more patients with excess of the reference values of UA levels in the blood plasma (OR = 2.25: 95% CI 1.08–4.71). ROC analysis showed that with an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD is predicted. The UA/Cr index in patients with hypertension and NAFLD was statistically significantly higher than in patients in the control group. Increase in the MK/Kr index by 1 USD increases the chances of developing NAFLD by 1.54 times (95% CI: 1.11–2.13). Also, an increase in the concentration of sUA level by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6%.

Conclusions

Conclusions. With an uric acid level of 369.5 µmol/l, a high risk of developing NAFLD in the study group is predicted. Increase in UA/creatinine index by 1 USD increases the chances of developing NAFLD by 1.54 times. In addition, an increase in the concentration of sUA in the blood plasma by 1 µmol/l increases the chances of an increase in the 10-year risk of cardiovascular events to 5.0% or more by 0.6% in patients with hypertension and NAFLD.

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The authors declare that there are no conflicts of interest present.