Clinical and metabolic determinants of liver fibrosis in patients with metabolic syndrome
https://doi.org/10.34215/1609-1175-2026-2-61-65
Abstract
Objective: Modern To evaluate clinical and metabolic risk factors for significant liver fibrosis in patients with metabolic syndrome.
Materials and methods. A single-center, observational, cross-sectional study was conducted. Clinical and laboratory examinations, including glucose, lipid profile, transaminases, insulin, and HOMA-IR, as well as transient elastography, were performed. Clinically significant fibrosis was defined as ≥ F2, and advanced fibrosis as ≥ F3. Nonparametric methods and ROC analysis were used to assess the diagnostic significance of metabolic parameters in detecting ≥ F3.
Results. The frequency and severity of liver fibrosis increased as metabolic status worsened, particularly when type 2 diabetes mellitus (T2DM) was present: in the MetS + T2DM group, ≥ F2 fibrosis was detected in 76.2% of patients, and F3–F4 fibrosis in 49.3%. Among metabolic markers, HOMA-IR showed the highest discriminative ability for ≥ F3 (AUC = 0.88), followed by glucose (AUC = 0.83) and triglycerides (AUC = 0.79).
Conclusion. In patients with metabolic syndrome, insulin resistance and associated metabolic abnormalities can be linked to advanced stages of liver fibrosis. Transient elastography, when used in conjunction with routine metabolic markers, can identify high-risk patients.
About the Author
A. A. Ivanov
Tyumen State Medical University
Russian Federation
Russian Federation
Alexander A. Ivanov - Assistant, Department of Hospital Therapy with a Course in Endocrinology.
54 Odesskaya str., Tyumen, 625023
References
1. Volkova NI, Porksheyan MI. Nonalcoholic fatty liver disease: What do we know and what will we have to learn? Ter Arkh. 2017;89(2):91–98. (In Russ.). doi: 10.17116/terarkh201789291-98
2. Drapkina OM, Korneeva ON. Continuum of non-alcoholic fatty liver disease: from hepatic steatosis to cardiovascular risk. Rational Pharmacotherapy in Cardiology. 2016;12(4):424–429. (In Russ.). doi: 10.20996/1819-6446-2016-12-4-424-429
3. Demidova TY, Ushanova FO. Non-alcoholic fatty liver disease: aspects of management of a comorbid patient. A review. Ter Arkh. 2023;95(10):888–895. (In Russ.). doi: 10.26442/00403660.2023.10.202435
4. Kiseleva EV, Demidova TY. Non-alcoholic fatty liver disease and type 2 diabetes mellitus: the problem of conjunction and phasing. Obes Metab. 2021;18(3):313–9. (In Russ.). doi: 10.14341/omet12758
5. Petunina NA, Telnova ME, Goncharova EV, Martirosian NS, Kuzina IA. Non-alcoholic fatty liver disease and type 2 diabetes mellitus: general approaches to the choice of therapy. Ter Arkh. 2022;94(10):1155–1162. (In Russ.). doi: 10.26442/00403660.2022.10.201921
6. Yan Z, Liu Y, Li W, Zhao X, Lin W, Zhang J, et al. Liver fibrosis scores and prognosis in patients with cardiovascular diseases: a systematic review and meta-analysis. Eur J Clin Invest. 2022;52(11):e13855. doi: 10.1111/eci.13855
7. Livzan MA, Gaus OV, Nikolaev NA, Krolevetz TS. NAFLD: comorbidity and associated diseases. Experimental and Clinical Gastroenterology. 2019;(10):57–65. (In Russ.). doi: 10.31146/1682-8658-ecg-170-10-57-65
8. Ampuero J, Pais R, Aller R, Gallego-Durán R, Crespo J, GarcíaMonzón C, et al. Development and validation of Hepamet fibrosis scoring system – a simple, non-invasive test to identify patients with non-alcoholic fatty liver disease with advanced fibrosis. Clin Gastroenterol Hepatol. 2020;18(1):216–225. doi: 10.1016/j.cgh.2019.05.051
9. Bokova TA. Non-alcoholic fatty liver disease in children: relationship with the main components of metabolic syndrome. Experimental and Clinical Gastroenterology. 2020;(1):15–20. (In Russ.). doi: 10.31146/1682-8658-ecg-173-1-15-20
10. Duan Y, Pan X, Luo J, Xiao X, Li J, Bestman PL. Association of inflammatory cytokines with non-alcoholic fatty liver disease. Front Immunol. 2022;13:880298. doi: 10.3389/fimmu.2022.880298
11. Kovyazina VP, Raikhelson KL, Prashnova MK, Pazenko EV, Palgova LK, Kondrashina EA. Detectability of liver steatosis and fibrosis with transient elastography and controlled attenuation parameter in residents of St. Petersburg. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(1):31–38. (In Russ.). doi: 10.22416/13824376-2021-31-1-31-38
12. Lee DH, Cho EJ, Bae JS, Lee JY, Yu SJ, Kim H, et al. Accuracy of two-dimensional shear wave elastography and attenuation imaging for evaluation of patients with non-alcoholic steatohepatitis. Clin Gastroenterol Hepatol. 2021;19(4):797–805.e7. doi: 10.1016/j.cgh.2020.05.034
13. Morozova TG, Borsukov AV, Bueverov AO. Multiparametric elastography – principles of individual selection in diffuse liver diseases. Medical Council. 2017;(15):148–152. (In Russ.). doi: 10.21518/2079-701X-2017-15-148-152
14. Loomba R, Seguritan V, Li W, Long T, Klitgord N, Bhatt A, et al. Gut microbiome-based metagenomic signature for non-invasive detection of advanced fibrosis in human non-alcoholic fatty liver disease. Cell Metab. 2017;25(5):1054–1062. doi: 10.1016/j.cmet.2017.04.001
15. Long MT, Pedley A, Massaro JM, Hoffmann U, Fox CS. The association between non-invasive hepatic fibrosis markers and cardiometabolic risk factors in the Framingham Heart Study. PLoS One. 2016;11(6):e0157517. doi: 10.1371/journal.pone.0157517
Review
For citations:
Ivanov A.A. Clinical and metabolic determinants of liver fibrosis in patients with metabolic syndrome. Pacific Medical Journal. 2026;(2):61-65. (In Russ.) https://doi.org/10.34215/1609-1175-2026-2-61-65
Views:
51
JATS XML
Email this article 