Peculiarities of neurohumoral regulation of the intestine in patients with metabolic dysfunction-associated steatotic liver disease after cholecystectomy

Abstract

Introduction. The study of hormonal changes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) after cholecystectomy (CE) and their impact on metabolic disorders and intestinal function in these patients is an unresolved issue in modern medicine. The purpose of the study: to determine the features of neurohumoral regulation and their impact on intestinal dysfunction in patients with MASLD after CE. Object and research methods. 140 patients with MASLD after CЕ were examined. The levels of neurohormones (serotonin (ST), melatonin MT)), hormones regulating metabolic processes (ghrelin, leptin, resistin) and gastrointestinal hormones (somatostatin (SST), gastrin (GH), cholecystokinin (CCK)) in blood serum were determined. Research results and their discussion. Intestinal damage in patients with MASLD after СE was mainly manifested by constipation – in 65 examined (46.4 %), who subsequently formed the I group of examined patients. In 45 patients (32.2 %) with MASLD after СE, intestinal damage was clinically manifested by constipation, alternating with diarrhea – these patients were assigned to the II group of examined patients. The III group of examined patients consisted of patients with MASLD after СE, in whom intestinal damage was clinically manifested by diarrhea – 30 patients (21.4 %). Hormonal regulation of the gastrointestinal tract (GI) is a complex physiological process that is disturbed in patients with a metabolically burdensome background. On the one hand, the profile of hormones regulating metabolic processes in the body changes, on the other hand, XE leads to changes in the levels of gastrointestinal hormones. Conclusions. 1. In patients with MASLD after СE, intestinal damage is clinically significantly more often manifested by constipation or a change in constipation and diarrhea (in 46.4% and 32.2% of patients). 2. In patients with MASLD after CE, changes in the levels of neurohormones, hormones regulating metabolic processes and gastrointestinal hormones were found depending on the nature of intestinal damage, namely – with constipation, these patients had an increase in the level of leptin and somatostatin and a decrease in the levels of serotonin, melatonin, ghrelin, gastrin, cholecystokinin in the blood serum. On the contrary, in patients with MASLD after CE, with a predominance of diarrhea, normal leptin levels and a decrease in the level of somatostatin were determined, while the levels of serotonin, melatonin, ghrelin, gastrin, cholecystokinin in the blood serum significantly exceeded these data in the control group.