EVALUATION OF LABORATORY AND ELASTOGRAPHY PARAMETERS IN PATIENTS WITH NONALCHOLIC FATTY LIVER DISEASE DURING THE THREE YEAR PERIOD IN CLINICAL HOSPITAL CENTER RIJEKA (2013.- 2016.)

Uvod: Nealkoholna masna bolest jetre (engl. non-alcoholic fatty liver disease; NAFLD) je kronična parenhimatozna bolest jetre usko vezana uz pretilost i metabolički sindrom. NAFLD zapravo predstavlja široki spektar bolesti jetre progresivnog tijeka . Danas se smatra vodećom kroničnom bolešću jetre te vodećim uzrokom alteriranih jetrenih enzima. (1,2) Cilj: Analizirati progresiju bolesti jetre u pacijenata s NAFLD-om u KBC-a Rijeka u periodu od 2013. do 2016.godine na osnovu praćenja elstografskih parametara, parametra steatoze (CAP) te parametra fibroze jetre (LSM). Ispitanici i metode: Ovom retrospektivnom analizom obuhvatili smo i analizirali 112 bolesnika s nealkoholnom masnom bolesti jetre. Za detekciju nealkoholne masne bolesti jetre služili smo se tranzijentnom elastografijom s CAP-om (Fibroscan®, Echosense, Pariz, Francuska). Rezultati: Analizom početnih elastografskih parametara te istih parametara nakon 12 i 24 mjeseca utvrdili smo postojanje statistički značajanog tranda porasta CAP-a tijekom perioda praćenja od 24 mjeseca, dok statistički značajne progresije LSM-a nije bilo tijekom istog perioda praćenja. Također, analizirali smo promjene dva najznačajnija jetrena enzima (ALT i GGT) u kontekstu NAFLD-a. Nije bilo značajne promjene u vrijednostima ALT-a i GGT-a tijekom perioda praćenja. Zaključak: Kroz trogodišnje praćenje bolesnika s NAFLD-om ustanovili smo tendencija progresije steatoze kroz isti period. Kako se radilo o kratkom vremenu praćenja i manjem broju ispitanika, nismo dobili statistički značajne promjene parametra tvrdoće jetre kao ni progresiju jetrenih enzima. No, obzirom da se kroz već kraći vremenski period pomoću CAP-a može vidjeti tendencija progresije steatoze, CAP bi mogao biti prvi korak u praćenju NAFLD-a.Introduction: Non-alcoholic fatty liver disease (NAFLD) is a chronic parenchymal liver disease closely related to obesity and metabolic syndrome. Today NAFLD is considered to be the leading chronic liver disease and the leading cause of alterated liver enzymes. (1,2) Aim: To analyze the progression of the disease in patients with NAFLD in Clinical Hospital Centar Rijeka from 2013 to 2016 by evaluation of elastography parameters, CAP and LSM. Subjects and Methods: This retrospective analysis included and analyzed 112 patients with NAFLD. For the detection of non-alcoholic fatty liver disease, we used transient elastography with CAP (Fibroscan®, Echosense, Paris, France). Results: By the analysis of initial elastographic parameters and the same parameters after 12 and 24 months we determined the existence of a statistically significant CAP growth rate over the 24 months follow-up period, while statistically significant LSM progression was not observed during the same period. We also analyzed the two most significant liver enzymes (ALT and GGT) in the context of NAFLD. There was no significant change in ALT and GGT values. Conclusion: Through the three-year follow-up of patients with NAFLD, we have found a tendency for steatosis progression over the same period. Due to a short time of monitoring and a small number of patients, we did not get statistically significant changes in LSM as well as progression of liver enzymes. However, since CAP can be seen through a short period of time with a tendency to steatosis progression, the CAP could be the first step in monitoring NAFLD