Kardiovaskulárne choroby na aterosklerotickom podklade predstavujú závažný zdravotnícky problém. Medzi dobre známe, závažné rizikové faktory pri vzniku kardiovaskulárnych ochorení patrí zmena v spektre lipoproteínov. Ako ukazujú práce viacerých autorov, môže vyšetrenie pomeru niektorých lipoproteínov poskytnúť presnejšiu informáciu o kardiovaskulárnom riziku u daného jedinca ako samotné jednotlivé lipidové parametre. Nealkoholová tuková choroba pečene (NAFLD) predstavuje v súčasnosti najčastejšiu formu chronickej hepatopatie. Cieľom našej práce bolo vyšetriť lipoproteínové indexy – aterogénny index plazmy (AIP) a pomer butyrylcholínesteráza/ HDL-cholesterol – u pacientov s NAFLD a zhodnotiť aj ich zmeny vo vzťahu ku závažnosti steatózy pečene. Vyšetrovaný súbor tvorilo 64 pacientov so steatózou pečene, 32 mužov a 32 žien. Z biochemických parametrov sme u pacientov vyšetrovali sérové koncentrácie celkového cholesterolu, HDL- a LDL-cholesterolu, triacylglycerolov a aktivitu butyrylcholínesterázy. Ako ukázali výsledky našej štúdie, oba základné lipidové parametre – celkový cholesterol a triacylglyceroly boli u pacientov so steatózou pečene zvýšené v porovnaní s hodnotami v kontrolnom súbore (Chol: 3,59 ± 0,16 vs. 5,14 ± 0,14 mmol/l; TAG: 0,85 ± 0,06 vs. 1,86 ± 0,14 mmol/l). Oba vyšetrované lipoproteínové indexy – AIP aj pomer BChE/HDL-cholesterol boli u pacientov so steatózou pečene taktiež signifikantne zvýšené (AIP: -0,191 ± 0,04 vs. 0,157 ± 0,04; BChE/HDL-C: 3171 ± 123 vs. 4602 ± 291). Hodnota pomeru BChE/HDL-cholesterol dobre korelovala s indexom celkový cholesterol/HDL cholesterol (korel.koef. 0,802) aj s aterogénnym indexom plazmy (korel.koef. 0,702). Nálezy zvýšených hodnôt AIP a pomeru BChE/ HDL-C potvrdili predpoklady o zvýšenom riziku vzniku kardiovaskulárnych ochorení u pacientov postihnutých stukovatením pečene. Nález signifikantnej pozitívnej korelácie medzi hodnotami AIP a BChE/HDL-C na jednej strane a fatty liver index (FLI) na druhej strane svedčí o tom, že toto riziko sa zvyšuje so závažnosťou steatotického poškodenia pečene.
Cardiovascular diseases on an atherosclerotic basis are a serious health problem. Atherosclerosis is a multifactorial pathological process with complex pathogenesis. Its origin and development is conditioned by a set of several risk factors. Changes in the spectrum of lipoproteins are one of the well-known, serious risk factors for cardiovascular disease. The results of several authors showed, that the examination of the ratio of some lipoproteins can provide more accurate information about the cardiovascular risk in a given individual than the individual lipid parameters alone. Non-alcoholic fatty liver disease (NAFLD) is currently the most common form of chronic hepatopathy. The aim of our study was to examine lipoprotein ratios – atherogenic index of plasma (AIP) and butyrylcholinesterase/ HDL-cholesterol ratio – in patients with NAFLD and to evaluate their changes in relation to the severity of hepatic steatosis. The study group consisted of 64 patients with hepatic steatosis, 32 men and 32 women. Patients were examined for fatty liver index (FLI), with FLI values above 60.0 signaling the presence of steatosis. From the biochemical parameters, we examined the serum concentrations of total cholesterol, HDL- and LDL-cholesterol, triacylglycerols and butyrylcholinesterase activity in patients with fatty liver disease. As the results of our study showed, both basic lipid parameters – total cholesterol and triacylglycerols – were increased in patients with hepatic steatosis compared to the values in the control group (Chol: 3,59 ± 0,16 vs. 5,14 ± 0,14 mmol/l; TAG: 0,85 ± 0,06 vs. 1,86 ± 0,14 mmol/l). Both investigated lipoprotein ratios – AIP and the BChE / HDL-cholesterol ratio were also significantly increased in patients with liver steatosis (AIP: -0,191 ± 0,04 vs. 0,157 ± 0,04; BChE/HDL-C: 3171 ± 123 vs. 4602 ± 291). The value of the BChE/HDL-cholesterol ratio correlated well with the total cholesterol/HDL cholesterol ratio (correl.coeff. 0,802) as well as with the atherogenic index of plasma (correl.coeff. 0,702). The findings of elevated AIP and BChE/HDL-C ratios confirmed the hypothesis of an increased risk of cardiovascular disease in patients with fatty liver disease. The finding of a significant positive correlation between AIP and BChE/HDL-C on the one hand and fatty liver index (FLI) on the other hand suggests that cardiovascular risk increases with the severity of steatotic liver injury.
