Clinical-laboratory constellations of non-alcoholic fatty liver disease and the gastroesophageal reflux disease: the possibilities of screening steatohepatosis and steatohepatitis based on the detection of hyperammoniemia in outpatient practice

Purpose of the study. The study of clinical and pathophysiological constellations in patients with non-alcoholic fatty liver disease (NAFLD), comorbid with gastroesophageal reflux disease (GERD) to determine the target of therapeutic effects, taking into account the level of ammonium. Material and methods. The study included 47 patients with comorbid NAFLD and GERD in age from 37 to 67 years who were surveyed, bioimpedansmetry, esophagogastroduodenoscopy, ultrasonic examination of the gastrointestinal tract, biochemical studies for noninvasive calculation steatogepatosis and liver fibrosis, determination of ammonia in the blood microdiffusion method on PocketChemTMBA analyzer. Results. Comorbidity of NAFLD and GERD is associated with obesity, high polymorbidity, severe heartburn, acid regurgitation and positive correlation with gallstone disease and type 2 diabetes. To the predictors of steatohepatosis and early liver fibrosis, in addition to the generally accepted, you can add increased levels of visceral fat, alkaline phosphatase and creatinine. Conclusion. In order to reduce the risk of steatohepatosis and fibrosis, patients with NAFLD must control the daily sufficient amount of fruits and vegetables and minimize the consumption of sausages. The determination of ammonia concentration is promising for the detection of minimal hepatic encephalopathy. The methodology requires regulation of standard values and indications for monitoring for such risk factors as tobacco smoking and non-systematic use of alcoholic beverages.

гастроэзофагеальная рефлюксная болезнь, коморбидность, неалкогольная жировая болезнь печени, гипераммониемия, висцеральный жир, gastroesophageal reflux disease, comorbidity, non-alcoholic fatty liver disease, hyperammoniemia, visceral fat