Problems of Radiation Medicine and Radiobiology

O. V. Nosach, E. O. Sarkissova, S. M. Alyokhina, O. Ya. Pleskach, O. M. Litvinets,
L. M. Ovsyannikova, A. A. Chumak

State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka Str., Kyiv, 04050, Ukraine

SUBCLINICAL INFLAMMATION IN NON-ALCOHOLIC FATTY LIVER DISEASE AT THE REMOTE PERIOD AFTER THE CHORNOBYL ACCIDENT

Objective: to evaluate the parameters of inflammatory reaction and oxidative stress in patients with non-alcoholic fatty liver disease (NAFLD) in the remote period after the influence of the Chornobyl accident factors.
Materials and methods. Eighty two patients with NAFLD who had been exposed to ionizing radiation as a result of the Chornobyl accident and have concomitant cardiovascular pathology were examined. Hematological parameters and the level of highly sensitive C-reactive protein (hsCRP) were determined, and the content of products of oxidative modification of lipids and proteins was evaluated.
Results. Activation of the processes of oxidative modification of lipids and proteins was observed in most patients with NAFLD. According to the level of hsCRP, the presence of subclinical inflammation and the risk of developing complicated cardiovascular pathology was found in 58 % of patients with NAFLD. The neutrophil / lymphocyte ratio correlates positively with hsCRP and can be used as an available routine clinical marker for selection among patients with NAFLD persons with increased risk of cardiovascular complications.
Conclusions. HsCRP, oxidative modification products of lipids and proteins, ESR, and leukograms should be used to assess the degree of systemic inflammation in people affected by the Chornobyl accident, suffering NAFLD with concomitant cardiovascular disease.
Key words: non-alcoholic fatty liver disease, chronic subclinical inflammation, Chornobyl accident.

Problems of Radiation Medicine and Radiobiology.
2021;26:437-448. doi: 10.33145/2304-8336-2021-26-437-448

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1. Xu X, Mishra GD, Jones M. Evidence on multimorbidity from defi nition to intervention: An overview of systematic reviews. Ageing Res Rev. 2017;37:53-68. doi: 10.1016/j.arr.2017.05.003.
2. Halli-Tierney AD, Scarbrough C, Carroll D. Polypharmacy: evaluating risks and deprescribing. Am Fam Physician. 2019;100(1):32-38.
3. Hanlon P, Hannigan L, Rodriguez-Perez J, Fischbacher C, Welton NJ, Dias S, et al. Representation of people with comorbidity and multimorbidity in clinical trials of novel drug therapies: an individual-level participant data analysis. BMC Med. 2019;17(1):201. doi: 10.1186/s12916-019-1427-1.
4. Jhee JH, Bang S, Lee D-G, Shin H. Comorbidity scoring with causal disease networks. IEEE/ACM Trans Comput Biol Bioinf. 2019;16(5):1627-1634. doi: 10.1109/TCBB.2018.2812886.
5. Gutierrez-Sacristan A, Bravo A, Giannoula A, Mayer MA, Sanz F, Furlong LI. comoRbidity: an R package for the systematic analysis of disease comorbidities. Bioinformatics. 2018;34(18):3228-3230. doi: 10.1093/bioinformatics/bty315.
6. Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology. 2020;158(7):1851-1864. doi: 10.1053/j.gastro.2020.01.052.
7. Rosato V, Masarone M, Dallio M, Federico A, Aglitti A, Persico M. NAFLD and extra-hepatic comorbidities: current evidence on a multi-organ metabolic syndrome. Int J Environ Res Public Health. 2019;16(18):3415. doi: 10.3390/ijerph16183415.
8. Anstee QM, Mantovani A, Tilg H, Targher G. Risk of cardiomyopathy and cardiac arrhythmias in patients with nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol. 2018;15(7):425-439. doi: 10.1038/s41575-018-0010-0.
9. Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020;73(1):202-209. doi: 10.1016/j.jhep.2020.03.039.
10. Denegri A, Boriani G. High sensitivity C-reactive protein (hsCRP) and its implications in cardiovascular outcomes. Curr Pharm Des. 2021;27(2):263-275. doi: 10.2174/1381612826666200717090334.
11. Belyi D, Nastina O, Sydorenko G, Gabulavichene Z, Kursina N, Bazyka O, et al. The assessment of comorbid pathology in clean-up workers of the accident consequences at the Chornobyl NPP having cardiovascular diseases. Probl Radiac Med Radiobiol. 2020;25:402-420. doi: 10.33145/2304-8336-2020-25-402-420.
12. Batskov SS, Inzhevatkin DI. [The clinical significance of hyperammonemia in the Chornobyl accident liquidators with nonalcoholic steatohepatitis at the precirrotic stage]. [Medico-Biological and Socio-Psychological Problems of Safety in Emergency Situations]. 2017;(3):18-25. Russian.
13. Hasanova OV, Nosach OV, Ovsyannikova LM, Sarkisova EO, Chumak AA. [Digestive system pathology]. In: [Thirty years of the Chornobyl disaster: radiological and medical consequences : National Report of Ukraine]. Kyiv, 2016. p. 130-134. Ukrainian.
14. Sarkisova EA, Sushko VO, Chumak AA, Ovsyannikova LM, Nosach OV, Alyokhina SM., et al. Retrospective assessment of clinical-morphological changes of the hepatobiliary system in liver cirrhosis of the Chornobyl NPP accident clean-up workers. Probl Radiac Med Radiobiol. 2019;24:465-479. doi: 10.33145/2304-8336-2019-24-465-479.
15. [Non-alcoholic steatohepatitis: unified clinical protocol of primary, secondary (specialized) medical care] [Internet]. 2014. 37 p. Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/2014_826_ykpmd_nstpt.pdf. Ukrainian.
16. [Non-alcoholic fatty liver disease. Adapted evidence-based clinical guideline] [Internet]. 2014. 55 p. Available from: https://www.dec.gov.ua/wp-content/uploads/2019/11/2014_826_akn_anghp.pdf. Ukrainian.
17. Byuyul A., Cefel P. [SPSS: the art of information processing. Analysis of the statistic data and recovery of the latent consistencies]. Sankt Peterburgb: DiaSoftYuP; 2002. 608 p. Russian.
18. Qi H, Yang S, ZhangL. Neutrophil extracellular traps and endothelial dysfunction in atherosclerosis and thrombosis. Front Immunol. 2017;8:928. doi: 10.3389/fimmu.2017.00928.
19. Doring Y, Libby P, Soehnlein O. Neutrophil extracellular traps participate in cardiovascular diseases: recent experimental and clinical insights. Circ Res. 2020;126(9):1228-1241. doi: 10.1161/CIRCRESAHA.120.315931.