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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nogr</journal-id><journal-title-group><journal-title xml:lang="ru">Экспериментальная и клиническая гастроэнтерология</journal-title><trans-title-group xml:lang="en"><trans-title>Experimental and Clinical Gastroenterology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-8658</issn><publisher><publisher-name>«Global Media Technologies»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31146/1682-8658-ecg-235-3-66-78</article-id><article-id custom-type="elpub" pub-id-type="custom">nogr-3135</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МЕТАБОЛИЧЕСКИЙ СИНДРОМ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>METABOLIC SYNDROME</subject></subj-group></article-categories><title-group><article-title>Жирные кислоты мембран эритроцитов и сыворотки крови как биомаркеры для дифференцирования начального и выраженного фиброза у пациентов с жировой болезнью печени алкогольного и смешанного генеза</article-title><trans-title-group xml:lang="en"><trans-title>Erythrocyte and serum membrane fatty acids as biomarkers for differentiation of initial and advanced fibrosis in patients with fatty liver disease of alcoholic and mixed genesis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0077-3823</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кручинина</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kruchinina</surname><given-names>M. V.</given-names></name></name-alternatives><email xlink:type="simple">kruchmargo@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5156-2842</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Осипенко</surname><given-names>М. Ф.</given-names></name><name name-style="western" xml:lang="en"><surname>Osipenko</surname><given-names>M. F.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Букарев</surname><given-names>Р. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bukarev</surname><given-names>R. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-9291-9414</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макарова</surname><given-names>Ю. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Makarova</surname><given-names>Yu. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9254-4192</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Громов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gromov</surname><given-names>A. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Научно-исследовательский институт терапии и профилактической медицины - филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики СО РАН»; Федеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский государственный медицинский университет» Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences; Novosibirsk State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Федеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский государственный медицинский университет» Министерства здравоохранения Российской Федерации<country>Россия</country></aff><aff xml:lang="en">Novosibirsk State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">Научно-исследовательский институт терапии и профилактической медицины - филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики СО РАН»<country>Россия</country></aff><aff xml:lang="en">Research Institute of Internal and Preventive Medicine - Branch of the Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>29</day><month>10</month><year>2025</year></pub-date><volume>0</volume><issue>3</issue><fpage>66</fpage><lpage>78</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кручинина М.В., Осипенко М.Ф., Букарев Р.А., Макарова Ю.В., Громов А.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Кручинина М.В., Осипенко М.Ф., Букарев Р.А., Макарова Ю.В., Громов А.А.</copyright-holder><copyright-holder xml:lang="en">Kruchinina M.V., Osipenko M.F., Bukarev R.A., Makarova Y.V., Gromov A.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nogr.org/jour/article/view/3135">https://www.nogr.org/jour/article/view/3135</self-uri><abstract><p>Цель работы: изучить возможности использования уровней жирных кислот мембран эритроцитов и сыворотки крови для различения начального и выраженного фиброза у пациентов с жировой болезнью печени алкогольного и смешанного генеза (алкогольный + метаболический). Материалы и методы. Обследовано 110 пациентов с жировой болезнью печени алкогольного и смешанного (алкогольный + метаболический) генеза, средний возраст - 47,9 ± 9,8 лет. В зависимости от степени фиброза пациенты были разделены на две группы - 1 группа с невыраженным фиброзом (F0-1) (n=76), 2 группа - с выраженным фиброзом (F2-4) (n=34) (FibroScan® 502 (Echosens, Франция). Содержание жирных кислот (ЖК) в мембранах эритроцитов и сыворотки крови определено с помощью методов газовой хроматографии/масс-спектрометрии (Agilent 7000B (США). Результаты. Выявлены жирные кислоты мембран эритроцитов и сыворотки крови, уровни которых позволили различить пациентов с начальным и выраженным фиброзом с жировой болезнью печени алкогольного и смешанного (алкогольный + метаболический) генеза. Выраженная степень фиброза (F2-4) оказалась ассоциированной с повышенными уровнями суммарного содержания насыщенных (p=0,00018), стеариновой C18:0 (p=0,001), пальмитиновой C16:0 (p=0,004), лауриновой С12:0 (p=0,07), отношения НЖК/ННЖК (p=0,0018) в мембранах эритроцитов и сывороточными уровнями НЖК/ННЖК (p=0,008), дигомо-γ-линоленовой C20:3n-6 (p=0,04). Напротив, при выраженном фиброзе печени по сравнению с начальными стадиями установлены более низкие уровни сывороточной пентадекановой кислоты С15:0 (p=0,04), эритроцитарной α-линоленовой C18:3n-3 (p=5,45e-10), суммарного содержания МНЖК (p=6,83e-08 для мембран эритроцитов и p=5,55e-06 для сыворотки крови), отдельных МНЖК (для эритроцитарной элаидиновой t-C18:1 - p=2,42e-06, для ее сывороточного уровня - p=0,0002; для сывороточной 7-пальмитолеиновой 7-C16:1 - p=0,0003; для сывороточной пальмитолеиновой 9-C16:1 - p=0,013; для ее уровня в мембранах эритроцитов - p=0,042); более низкие концентрации двух омега-6 ПНЖК как в мембранах эритроцитов (для гексадекадиеновой C16:2n-6 - p=2,69e-07, для эйкозадиеновой C20:2n-6 - p=8,52e-07), так и в сыворотке крови (для C16:2n-6 - p=1,33e-05, для C20:2n-6 - p=0,002). Оптимальной для дифференцирования групп пациентов со степенью фиброза F2-4 от F0-1 оказалась панель, включающая эритроцитарные уровни двух жирных кислот и суммарное содержание мононенасыщенных жирных кислот - С20:2n-6, МНЖК, С16:2n-6, которая обеспечила AUC 0,862 (95% ДИ 0,781-0,94), чувствительность 88,8%, специфичность 86,4%. Выводы. Жирные кислоты мембран эритроцитов, сыворотки крови следует рассматривать как перспективные диагностические маркеры и потенциальные таргеты для терапевтических воздействий для предотвращения прогрессирования фиброза печени у пациентов с жировой болезнью печени алкогольного и смешанного генеза.</p></abstract><trans-abstract xml:lang="en"><p>The aim of the work: to study the possibilities of using the levels of fatty acids in the membranes of erythrocytes and blood serum to distinguish between initial and severe fibrosis in patients with fatty liver disease of alcoholic and mixed genesis (alcoholic + metabolic). Materials and methods. 110 patients with fatty liver disease of alcoholic and mixed genesis were examined, the average age was 47.9 ± 9.8 years. Depending on the degree of fibrosis, patients were divided into two groups - group 1 with mild fibrosis (F0-1) (n=76), group 2 - with severe fibrosis (F2-4) (n=34) (FibroScan® 502 (Echosens, France). The content of fatty acids (FA) in the membranes of erythrocytes and blood serum was determined using gas chromatography/mass spectrometry (Agilent 7000B (USA). Results. Fatty acids of the membranes of erythrocytes and blood serum were identified, the levels of which made it possible to distinguish between patients with initial and severe fibrosis with fatty liver disease of alcoholic and mixed (alcoholic + metabolic) genesis. Severe fibrosis (F2-4) was associated with increased levels of total saturated (p=0.00018), stearic C18:0 (p=0.001), palmitic C16:0 (p=0.004), lauric C12:0 (p=0.07), the SFA/MUFA ratio (p=0.0018) in erythrocyte membranes and serum SFA/MUFA levels (p=0.008), dihomo-γ-linolenic C20:3n-6 (p=0.04). On the contrary, in severe liver fibrosis, compared with the initial stages, lower levels of serum pentadecanoic acid C15:0 (p=0.04), erythrocyte α-linolenic C18:3n-3 (p=5.45e-10), total MUFA content (p=6.83e-08 for erythrocyte membranes and p=5.55e-06 for blood serum), individual MUFA (for erythrocyte elaidic t-C18:1 - p=2.42e-06, for its serum level - p=0.0002; for serum 7-palmitoleic 7-C16:1 - p=0.0003; for serum palmitoleic 9-C16:1 - p=0.013; for its level in erythrocyte membranes - p=0.042); lower concentrations of two omega-6 PUFAs both in erythrocyte membranes (for hexadecadienoic C16:2n-6 - p=2.69e-07, for eicosadienoic C20:2n-6 - p=8.52e-07) and in blood serum (for C16:2n-6 - p=1.33e-05, for C20:2n-6 - p=0.002). A panel including erythrocyte levels of two fatty acids and total monounsaturated fatty acids - C20:2n-6, MUFA, C16:2n-6 - was optimal for differentiating groups of patients with fibrosis grade F2-4 from F0-1, which provided an AUC of 0.862 (95% CI 0.781-0.94), sensitivity of 88.8%, specificity of 86.4%. Conclusions. Fatty acids of erythrocyte membranes and blood serum should be considered as promising diagnostic markers and potential targets for therapeutic interventions to prevent the progression of liver fibrosis in patients with fatty liver disease of alcoholic and mixed genesis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>жировая болезнь печени</kwd><kwd>алкогольный</kwd><kwd>смешанный генез</kwd><kwd>степень фиброза печени</kwd><kwd>жирные кислоты</kwd><kwd>эритроциты</kwd><kwd>сыворотка</kwd><kwd>диагностика</kwd></kwd-group><kwd-group xml:lang="en"><kwd>fatty liver disease</kwd><kwd>alcoholic</kwd><kwd>mixed genesis</kwd><kwd>degree of liver fibrosis</kwd><kwd>fatty acids</kwd><kwd>erythrocytes</kwd><kwd>serum</kwd><kwd>diagnostics</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Mitra S., De A., Chowdhury A. 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