nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-191-7-12-22nogr-1694Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYУровни жирных кислот сыворотки крови и мембран эритроцитов могут быть использованы как биомаркеры для оценки тяжести НАЖБПSerum and erythrocyte membrane fatty acid levels may be used as biomarkers to assess the severity of NAFLDhttps://orcid.org/0000-0003-0077-3823КручининаМ. В.KruchininaM. V.kruchmargo@yandex.ruПаруликоваМ. В.ParulikovaM. V.noemail@neicon.ruКуриловичС. А.KurilovichS. A.noemail@neicon.ruГромовА. А.GromovA. A.noemail@neicon.ruШашковМ. В.ShashkovM. V.noemail@neicon.ruСоколоваА. С.SokolovaA. S.noemail@neicon.ruhttps://orcid.org/0000-0002-9905-9031КручининВ. Н.KruchininV. N.noemail@neicon.ruНаучно- исследовательский институт терапии и профилактической медицины - филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»; ФГБОУ Новосибирский государственный медицинский университет Минздрава РоссииРоссияResearch Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, SB RAS; Novosibirsk State Medical UniversityRussian FederationНаучно- исследовательский институт терапии и профилактической медицины - филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»; ЧУЗ «Клиническая больница «РЖД-Медицина г. Новосибирск»РоссияResearch Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, SB RAS; ”RR” OJSK, Railway clinical hospital on the station Novosibirsk-GlavniyRussian FederationНаучно- исследовательский институт терапии и профилактической медицины - филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»РоссияResearch Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, SB RASRussian FederationФГБУН Институт катализа им. Г. К. БоресковаРоссияBoreskov Institute of Catalysis SB RASRussian FederationФГБУН Новосибирский институт органической химии им. Н. Н. Ворожцова СО РАНРоссияNovosibirsk Institute of Organic Chemistry SB RASRussian FederationФедеральное государственное бюджетное учреждение науки Институт физики полупроводников им. А. В. Ржанова Сибирского отделения Российской академии наукРоссияRzhanov Institute of Semiconductor Physics SB RASRussian Federation202127092021071222Copyright © Кручинина М.В., Паруликова М.В., Курилович С.А., Громов А.А., Шашков М.В., Соколова А.С., Кручинин В.Н., 20212021Кручинина М.В., Паруликова М.В., Курилович С.А., Громов А.А., Шашков М.В., Соколова А.С., Кручинин В.Н.Kruchinina M.V., Parulikova M.V., Kurilovich S.A., Gromov A.A., Shashkov M.V., Sokolova A.S., Kruchinin V.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1694

Цель работы - изучить возможности использования жирных кислот сыворотки крови (СК) и эритроцитов (Эр) в качестве диагностических маркеров тяжести НАЖБП. Материалы и методы. Обследованы 52 пациента с НАЖБП (51,8±3,9 года), подтвержденной индексом NLFS, и 20 условно здоровых мужчин (49,2±4,5 года). Степень фиброза печени установлена методом непрямой эластометрии (FibroScan® 502 Echosens, Франция). У 27 пациентов выявлена начальная степень фиброза (F0-1), 25 имели выраженный фиброз (F2-4). Состав жирных кислот (ЖК) Эр и СК исследован с помощью ГХ/МС системы на основе трех квадруполей Agilent 7000B (США). Результаты. Выявлены достоверные различия в уровнях жирных кислот сыворотки крови и мембран эритроцитов у пациентов с НАЖБП, ассоциированные со степенью фиброза и некровоспалительной активности. Для различения легкого и выраженного фиброза при НАЖБП оказались значимыми уровни насыщенных ЖК (миристиновая, пентадекановая, маргариновая) и омега-3 ПНЖК (эйкозапентаеновая, докозапентаеновая, докозагексаеновая) (p=0,002-0,0003). Для дифференцирования степени некровоспалительной активности (минимальная против выраженной) ключевую роль играли насыщенные и мононенасыщенные ЖК (пальмитэлаидиновая, пальмитолеиновая, вакценовая) (p=0,03-0,005). Созданные диагностические панели (ЖК сыворотки крови и мембран эритроцитов) позволили дифференцировать пациентов с НАЖБП с различной степенью фиброза. Выявлены корреляции уровней ЖК в мембранах эритроцитов и сыворотке крови с проявлениями метаболического синдрома, показателями повреждения печени у пациентов с НАЖБП. Выводы. Установленные различия в жирнокислотных профилях сыворотки крови и мембран эритроцитов у пациентов с НАЖБП, ассоциированные со степенью фиброза, некровоспалительной активности, проявлениями метаболического синдрома и показателями повреждения печени, следует рассматривать в качестве перспективных биомаркеров для оценки степени тяжести НАЖБП.

The aim of this work is to study the possibility of using blood serum (BS) fatty acids (FA) and erythrocytes (ER) as diagnostic markers of the severity of NAFLD. Materials and methods. We examined 52 patients with NAFLD (51.8 ± 3.9 years), confirmed by the NLFS index, and 20 apparently healthy men (49.2 ± 4.5 years). The degree of liver fibrosis was established by indirect elastometry (FibroScan® 502 Echosens, France). 27 patients had an initial degree of fibrosis (F0-1), 25 had severe fibrosis (F2-4). The study of the composition of fatty acids of Er and BS was carried out using a GC / MS system based on three Agilent 7000B quadrupoles (USA). Results. Significant differences in the levels of fatty acids in blood serum and erythrocyte membranes in patients with NAFLD were revealed, associated with the degree of fibrosis and necroinflammatory activity. To distinguish between mild and severe fibrosis in NAFLD, the levels of saturated fatty acids (myristic, pentadecane, margarine) and omega-3 PUFAs (eicosapentaenoic, docosapentaenoic, docosahexaenoic) were found to be significant (p = 0.002-0.0003). Saturated and monounsaturated FAs (palmitelaidic, palmitoleic, vaccenic) played a key role in differentiating the degree of necroinflammatory activity (minimal versus pronounced) (p = 0.03-0.005). The created diagnostic panels (FA of blood serum and erythrocyte membranes) made it possible to differentiate patients with NAFLD with varying degrees of fibrosis. Correlations of FA levels in erythrocyte membranes and blood serum with manifestations of metabolic syndrome, indicators of liver damage in patients with NAFLD were revealed. Conclusions. The established differences in fatty acid profiles of blood serum and erythrocyte membranes in patients with NAFLD, associated with the degree of fibrosis, necroinflammatory activity, manifestations of metabolic syndrome and indicators of liver damage, should be considered as promising biomarkers for assessing the severity of NAFLD.

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