nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-234-2-62-68nogr-3069Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYСравнительная характеристика диагностической значимости неинсулиновых индексов инсулинорезистентности в оценке воспаления при метаболически ассоциированной стеатозной болезни печениComparative characteristics of the diagnostic significance of non-insulin indices of insulin resistance in assessing inflammation in metabolically associated steatotic liver diseasehttps://orcid.org/0000-0003-2613-5694ДудановаО. П.DudanovaO. P.odudanova@gmail.comhttps://orcid.org/0000-0003-3830-6446ШиповскаяА. А.ShipovskayaA. A.noemail@neicon.ruhttps://orcid.org/0000-0001-7620-7065КурбатоваИ. В.KurbatovaI. V.noemail@neicon.ruhttps://orcid.org/0000-0002-0255-4054ЛаринаН. А.LarinaN. A.noemail@neicon.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Петрозаводский государственный университет» Министерства науки и образования Российской ФедерацииРоссияPetrozavodsk State UniversityRussian FederationИнститут биологии - обособленное подразделение Федерального государственного бюджетного учреждения науки Федерального исследовательского центра «Карельский научный центр Российской академии наук»РоссияInstitute of Biology of the Karelian Research Centre of the Russian Academy of SciencesRussian Federation202531082025026268Copyright © Дуданова О.П., Шиповская А.А., Курбатова И.В., Ларина Н.А., 20252025Дуданова О.П., Шиповская А.А., Курбатова И.В., Ларина Н.А.Dudanova O.P., Shipovskaya A.A., Kurbatova I.V., Larina N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/3069

Целью явилось определение диагностической значимости различных расчетных неинсулиновых индексов инсулинорезистентности (ИР) в качестве суррогатных маркеров воспаления при метаболически ассоциированной стеатозной болезни печени (МАСБП) у пациентов без сахарного диабета 2 типа. Материалы и методы. Обследован 51 больной МАСБП - 29 (56,9%) мужчин и 22 (43,1%) женщины и 40 здоровых доноров. Оценивались индексы ИР: триглицеридглюкозный индекс (ТГИ)= ТГИ = ln[(триглицериды мг/дл х глюкоза натощак мг/дл)/2]; ТГИхиндекс массы тела (ТГИхИМТ); lipide accumulation product (LAP) для мужчин = [(окружность талии (ОТ) см - 65) x ТГ (ммоль/л)] и LAP для женщин = [(ОТ - 58) x ТГ (ммоль/л)]; visceral adiposy index (VAI) для мужчин = [ОТ (см)/39,68 + (1,88 × ИМТ)] × (ТГ (ммоль/л)/1,03) × (1,31/ЛПВП (ммоль/л) и VAI для женщин = [ОТ (см)/36,58 + 1,89 × (ИМТ)] × (ТГ (ммоль/л)/0,81) × (1,52/ЛПВП (ммоль/л) и отношение триглицеридов к липопротеинам высокой плотности (ТГ/ЛПВП). Методом ИФА определялись провоспалительные цитокины ТНФ-α («Cloud-clone corp», США), ИЛ-1β, ИЛ-6 («Вектор-Бест», Россия) и ИЛ-8 («Cloud-clone corp», США). Результаты. Все индексы ИР у пациентов МАСБП достоверно превышали таковые у здоровых доноров: максимально увеличивался LAP - в 4,5 раза (p=0,003), VAI - в 2,6 раза (р=0,04), ТГИ х ИМТ - в 2,3 раза (р=0,03), ТГ/ЛПВП - в 2,1 раза (p< 0,001) и ТГИ - в 1,1 раза (p<0,001). При анализе корреляционных связей ИР с показателями воспаления выявлялась прямая корреляционная связь ТГ/ЛПВП с уровнями ИЛ-8 - r=0,63 (p=0,02), ИЛ-6 - r=0,52 (р=0,04) и АСТ - r=0,56 (p=0,001). ТГИ коррелировал с уровнем ИЛ-8 - r=0,65 (p=0,02). Заключение. Диагностическую значимость в качестве суррогатного маркера воспаления при МАСБП продемонстрировал ТГ/ЛПВП - легкодоступный и недорогой индекс инсулинорезистентности.

The aim of the study was to determine the diagnostic value of various calculated non-insulin indices of insulin resistance (IR) as surrogate markers of inflammation in metabolically associated steatotic liver disease (MASLD) in patients without type 2 diabetes mellitus. Materials and methods. Fifty-one patients with MASLD were examined: 29 (56.9%) men and 22 (43.1%) women and 40 healthy donors. The IR indices were estimated: triglyceride-glucose index (TGI) = ln[(triglycerides mg/dl x fasting glucose mg/dl)/2]; TGI x body mass index (TGI х BMI); lipid accumulation product (LAP) for men = [(waist circumference (WC) cm - 65) x TG (mmol/L)] and LAP for women = [(WC - 58) x TG (mmol/L)]; visceral adiposity index (VAI) for men = [WC (cm)/39.68 + (1.88 × BMI)] × (TG (mmol/l)/1.03) × (1.31/HDL (mmol/l) and VAI for women = [WC (cm)/36.58 + 1.89 × (BMI)] × (TG (mmol/l)/0.81) × (1.52/HDL (mmol/l) and the ratio of triglycerides to high-density lipoproteins (TG/HDL). The ELISA method was used to determine the proinflammatory cytokines TNF-α (“Cloud-clone corp”, USA), IL-1β, IL-6 (“Vector-Best”, Russia) and IL-8 (“Cloud-clone corp”, USA). Results. All IR indices in patients with MASLD significantly exceeded those in healthy donors: LAP increased to the maximum - 4.5 times (p = 0.003), VAI - 2.6 times (p = 0.04), TGI x BMI - 2.3 times (p = 0.03), TG/HDL - 2.1 times (p < 0.001) and TGI - 1.1 times (p < 0.001). When analyzing the correlation links of IR with inflammation indicators, a direct correlation was found between TG/HDL and the levels of IL-8 - r = 0.63 (p = 0.02), IL-6 - r = 0.52 (p = 0.04) and AST - r = 0.56 (p = 0.001). TGI correlated with the level of IL-8 - r = 0.65 (p = 0.02). Conclusion. TG/HDL, an easily accessible and inexpensive index of insulin resistance, has demonstrated diagnostic value as a surrogate marker of inflammation in MASLD.

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