BIOCHEMICAL IMBALANCE IN ISCHEMIC HEART DAMAGE COMBINED WITH STEATOHEPATOSIS

Abstract

The development of steatohepatosis in most cases is the primary process and consequence of the metabolic syndrome. This disease has a long asymptomatic course. The connection of steatohepatosis with the development and progression of coronary heart disease occurs when steatohepatosis is associated with metabolic syndrome and obesity. Patients with steatohepatosis usually have signs of metabolic syndrome: arterial hypertension, abdominal obesity, impaired glucose tolerance, atherogenic dyslipidemia, which are considered risk factors for cardiovascular diseases. Biochemical parameters were determined in coronary artery disease complicated by steatohepatosis. 101 people were examined. When examining the serum level of brain natriuretic peptide in patients with ischemic heart disease in combination with steatohepatosis, a higher level was found than in uncomplicated coronary heart disease, which indicates a deeper violation of the functional state of the myocardium in ischemic heart disease in combination with steatohepatosis. When examining the cytolytic syndrome markers LDH, AST and ALT, a probable increase in their activity is observed. The detected activation of LDH is associated with damage, tissue necrosis, which is observed in the case of damage to the myocardium and hepatocytes in the examined groups, which indicates an inflammatory type of pathogenesis. Apparently, activation of transaminases is associated with cytolytic syndrome in myocardial damage and increased energy expenditure of hepatocytes in fatty hepatosis. Signs of impaired glucose tolerance were found in the examined subjects: the fasting glucose level and the postprandial glucose level probably exceeded normal values, the HbA1c level was 1.5 times higher than the control in myocardial ischemia, and 1.7 times higher in coronary heart disease and steatohepatosis (p< 0.05). Disruption of hormonal regulation of carbohydrate metabolism was detected in both examined groups. An elevated level of total cholesterol and dyslipoproteinemia were also found in both groups of examined patients, however, the most pronounced changes are observed in the case of complications of steatohepatosis. The obtained results indicate complex disorders of lipid metabolism in myocardial ischemia and ischemic heart damage in combination with steatohepatosis, which confirms the development of metabolic syndrome.