Peculiarities of the clinical course of metabolic dysfunction-associated steatotic liver disease in comorbidity with community-acquired pneumonia of medium severity

Abstract

The comorbidity of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Community-Acquired Pneumonia (CAP) is an important issue in modern medicine due to the wide spread of diseases among the population. MASLD is a dynamic condition that can regress to isolated steatosis with a relatively constant level of activity or cause progressive fibrosis leading to liver cirrhosis (F4 fibrosis stage). 25% of patients with MASLD develop steatohepatitis, among which 25% develop liver cirrhosis. The aim of the study was to establish the features of the clinical course of steatotic liver disease in the presence of concomitant community-acquired pneumonia. 67 patients with MASLD on the background of obesity of the 1st degree were examined: 32 patients with steatohepatitis, obesity of the 1st degree and CAP of moderate severity (group 1); 35 patients with steatohepatitis and obesity of the 1st degree (group 2). We established that the clinical course of metabolic dysfunction-associated steatotic liver disease in comorbidity with obesity and non-hospital pneumonia of moderate severity is characterized by a higher frequency and intensity of clinical syndromes compared to patients with isolated MASLD: astheno-vegetative by 2.1 times, dyspeptic – 4.4 times, abdominal pain – 8.8 times, cholestatic – 3.7 times (p<0.05). We observed that in case of the comorbid course of MASLD and CAP a frequency of biochemical syndromes was higher: cytolysis – 2.2 times, mesenchymal inflammation – 2.3 times, cholestasis – 3.9 times, hepatocellular insufficiency – in 2.9 times (p<0.05). During the comorbid course of these two diseases a higher degree of hepatic steatosis (1.4 times) was observed in comparison with the group of patients with isolated MASLD (p<0.05). The frequency of cases of S3 degree of hepatic steatosis prevailed in MASLD in comorbidity with CAP by 2.0 times (p<0.05) in comparison with the isolated course of MASLD. Keywords: metabolic syndrome, obesity, hepatic steatosis, biochemical syndromes.