aterosklerozАтеросклерозAteroscleroz2078-256X2949-3633НИИТПМ-филиал ИЦиГ СО РАН10.52727/2078-256X-2025-21-1-6-22ateroskleroz-1098Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПрофиль жирных кислот мембран эритроцитов, сыворотки крови пациентов со стеатозом и стеатогепатитом при жировой болезни печени различного генезаProfile of fatty acids of erythrocyte membranes, blood serum of patients with steatosis and steatohepatitis in fatty liver disease of various genesishttps://orcid.org/0000-0003-0077-3823КручининаМ. В.KruchininaM. V.

Маргарита Витальевна Кручинина, д-р мед. наук, доцент, зав. лабораторией гастроэнтерологии, ведущий научный сотрудник лаборатории гастроэнтерологии, проф. кафедры пропедевтики внутренних болезней

630089, г. Новосибирск, ул. Бориса Богаткова, 175/1

630091, г. Новосибирск, Красный пр., 52

Margarita V. Kruchinina, doctor of medical sciences, associate professor, head of the gastroenterology laboratory, leading researcher of the gastroenterology laboratory, professor of the department of propaedeutics of internal diseases

175/1, Boris Bogatkov st., Novosibirsk, 630089

52, Krasny ave., Novosibirsk, 630091

kruchmargo@yandex.ruБукаревР. А.BukarevR. A.

Рудольф Александрович Букарев, ординатор лаборатории гастроэнтерологии

630089, г. Новосибирск, ул. Бориса Богаткова, 175/1

Rudolf A. Bukarev, clinical resident of the laboratory of gastroenterology

175/1, Boris Bogatkov st., Novosibirsk, 630089

r.bukarev@mail.ruПаруликоваМ. В.ParulikovaM. V.

Марина Владимировна Паруликова, старший преподаватель отдела образования, врач-гастроэнтеролог

630089, г. Новосибирск, ул. Бориса Богаткова, 175/1

Marina V. Parulikova, senior lecturer of the department of education

175/1, Boris Bogatkov st., Novosibirsk, 630089

m_parulikova@mail.ruhttps://orcid.org/0000-0001-9254-4192ГромовА. А.GromovA. A.

Андрей Александрович Громов, канд. мед. наук, старший научный сотрудник лаборатории клинических биохимических и гормональных исследований терапевтических заболеваний, руководитель Центра профилактики тромбозов

630089, г. Новосибирск, ул. Бориса Богаткова, 175/1

Andrey A. Gromov, candidate of medical sciences, senior researcher at the laboratory of clinical biochemical and hormonal studies of therapeutic diseases, head of the thrombosis prevention center

175/1, Boris Bogatkov st., Novosibirsk, 630089

gromov.center@rambler.ruНаучно-исследовательский институт терапии и профилактической медицины – филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»; Федеральное государственное бюджетное образовательное учреждение высшего образования «Новосибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияResearch Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and Genetics, Siberian branch of Russian Academy of Sciences; Federal State Budgetary Educational Institution of Higher Education “Novosibirsk State Medical University” of the Ministry of Health of the Russian FederationRussian FederationНаучно-исследовательский институт терапии и профилактической медицины – филиал Федерального государственного бюджетного научного учреждения «Федеральный исследовательский центр Институт цитологии и генетики Сибирского отделения Российской академии наук»РоссияResearch Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and Genetics, Siberian branch of Russian Academy of SciencesRussian Federation202529032025211622Copyright © Кручинина М.В., Букарев Р.А., Паруликова М.В., Громов А.А., 20252025Кручинина М.В., Букарев Р.А., Паруликова М.В., Громов А.А.Kruchinina M.V., Bukarev R.A., Parulikova M.V., Gromov A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://ateroskleroz.elpub.ru/jour/article/view/1098

Цель исследования – изучить возможности использования жирных кислот (ЖК) мембран эритроцитов и сыворотки крови для дифференцирования стеатоза и стеатогепатита у пациентов с жировой болезнью печени (ЖБП) различного генеза. Материал и методы. Обследованы 84 мужчины с ЖБП различного генеза (алкогольный, неалкогольный, смешанный, т.е. алкогольный + метаболический), средний возраст 48,4 ± 13,9 года, степень фиброза 0-1 (FibroScan® 502 Echosens, Франция). С помощью сывороточных тестов NashTest, AshTest в составе FibroMax, ActiTest в составе FibroTest (BioPredictive, Франция) у 44 пациентов установлена минимальная некровоспалительная активность в ткани печени (стеатоз), у 40 – выраженная (рассматривали как стеатогепатит). Исследование ЖК состава мембран эритроцитов, сыворотки крови проведено с помощью газовой хроматографии/масс-спектрометрии – системы на основе трех квадруполей Agilent 7000B (США). Результаты. Установлены ЖК мембран эритроцитов, значимые для дифференцирования стеатогепатита и стеатоза у пациентов с ЖБП различного генеза: уровень докозатетраеновой С22:4n-6 (p = 0,0001), арахиновой С20:0 (p = 0,034) оказались значимо выше, а содержание пентадекановой С15:0 (p = 0,0006), 7-пальмитоолеиновой С16:1;7 (p = 0,0093), миристиновой С14:0 (p = 0,025), эйкозапентаеновой С20:5n-3 (p = 0,032), гексадекадиеновой С16:2 n-6 (p = 0,042) – ниже при стеатогепатите, чем у пациентов со стеатозом печени. Наибольшим потенциалом в различении степени не- кровоспалительной активности в печени обладала пентадекановая кислота С15:0 – AUC 0,736 (95 % ДИ 0,63–0,843), чувствительность 68,3%, специфичность 75,9 %. Созданная диагностическая панель из комбинации ЖК мембран эритроцитов (С15:0, С14:0, С16:1;7) показала наибольшую чувствительность – 76,5 % при невысокой специфичности 67,1 %. Заключение. Выявленные особенности профиля жирных кислот мембран эритроцитов, сыворотки крови следует рассматривать как перспективные биомаркеры для выявления стеатогепатита с точки зрения дальнейших исследований в данном направлении.

The aim of the study is to investigate the possibilities of using fatty acids of erythrocyte membranes and blood serum to differentiate steatosis and steatohepatitis in patients with fatty liver disease (FLD) of various origins. Material and methods. The study included 84 men with FLD of various origins (alcoholic, non-alcoholic, mixed, i.e. alcoholic + metabolic), average age 48.4 ± 13.9 years, fibrosis degree 0-1 (FibroScan® 502 Echosens, France). Using serum tests NashTest, AshTest as part of FibroMax, ActiTest as part of FibroTest (BioPredictive, France), 44 patients showed minimal necroinflammatory activity in the liver tissue (steatosis), and 40 patients showed pronounced necro- inflammatory activity (considered as steatohepatitis). The study of the composition of fatty acids of erythrocyte membrane, blood serum was carried out using gas chromatography/mass spectrometry – a system based on three Agilent 7000B quadrupoles (USA). Results. Fatty acids of erythrocyte membranes, significant for differentiation of steatohepatitis and steatosis in patients with FLD of various genesis, were established: levels of docosatetraenoic C22:4n-6 (p = 0.0001), arachidic C20:0 (p = 0.034) were significantly higher, and the content of pentadecanoic C15:0 (p=0.0006), 7-palmitoleic C16:1;7 (p = 0.0093), myristic C14:0 (p = 0.025), eicosapentaenoic C20:5n-3 (p = 0.032), hexadecadienoic acid C16:2 n-6 (p = 0.042) – lower in steatohepatitis than those in patients with liver steatosis. The greatest potential in distinguishing the degree of necroinflammatory activity in the liver was demonstrated by pentadecanoic acid C15:0 – AUC 0.736 (95 % CI 0.63–0.843), sensitivity 68.3 %, specificity 75.9 %. The created diagnostic panel of a combination of erythrocyte membrane fatty acids (C15:0, C14:0, C16:1;7) showed the highest sensitivity – 76.5 % with low specificity of 67.1 %. Conclusions. The identified features of the fatty acid profile of erythrocyte membranes and blood serum should be considered as promising biomarkers for the detection of steatohepatitis from the point of view of further research in this area.

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