Metabolic fatty liver disease as a risk factor for early renal dysfunction in women of reproductive age

Abstract

Objective. To study the correlation of adipocytokines with early renal dysfunction indicators in women of reproductive age with obesity and metabolic fatty liver disease. Materials and methods. The study included 100 obese females divided into 2 groups. The 1st group consisted of patients (n=50) diagnosed with metabolic fatty liver disease aged 40,5±2,8, and the 2nd group contained patients (n=50) without metabolic fatty liver disease (MFLD). The level of insulin, cystatin C, resistin, leptin, monocyte chemoattractant protein (MCP-1), vascular endothelial growth factor (VEGF), interleukin 6 (IL 6), tumor necrosis factor α (TNF) were determined in blood serum by enzyme-linked immunosorbent assay (ELISA) method. Albumin-to-creatinine ratio, TNF- α, MCP-1, IL 6, cystatin C, b2-microglobulin, VEGF were determined in morning urine. Results. Increased levels of pro-inflammatory cytokines and endothelial dysfunction were revealed in group 1 in relation to both the comparison and control groups. In patients with MFLD associations of resistin level were the following: with HOMA(r=0,60), alanine aminotransferase (ALT) (r=0,54), aspartate aminotransferase (r=0,71), gamma-glutamyl transpeptidase (r=0,71), high-density lipoprotein (HDL) (r=‒0,54), VEGF (r=0,54), TNF- α (r=0,44), MCP-1 (r=0,57) р0,05. In the 1st and 2nd groups cytokine urinary excretion and renal dysfunction markers were higher than in the control group. Associations of urinary excretion of b2-mic­ro­globulin with BMI (r=0,33), НОМА (r=0,34), resistin (r=0,30), uric acid level (r=0,50), creatinine (r=0,34), thyroglobulin (r=0,31), urinary MCP-1(r=0,60), IL 6 (r=0,70) р0,05 were revealed in the 1st group. In group 1 associations of urinary IL 6 with BMI (r=0,35), waist/hip circumference (WC/HC) (r=0,33), uric acid level (r=0,44), urinary MCP-1(r=0,74) were positive, and associations with HDL (r=‒0,44) р0,05. Conclusions. Resistin can be considered as an unfavourable marker of cardiometabolic disturbances in patients with MFLD. The association of subclinical inflammation markers and endothelial dysfunction with the markers of early renal impairment in patients with MFLD which was determined allows to expand the understanding of cardio-renal-metabolic continuum.