Changes of amino acid levels in serum in patients with non-alcoholic fatty liver disease and type 2 diabetes

Abstract

Introduction. The modern patient is a patient with a comorbid, polymorphic background. Today, the community of pathogenetic mechanisms for non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome has been proven and their association with type 2 diabetes mellitus and cardiovascular disease is becoming apparent. The purpose of the study – to investigate changes in serum amino acid (AK) levels in patients with NAFLD and type 2 diabetes. Materials and methods of research. 76 patients with NAFLD and type 2 diabetes were examined. The patients were divided into groups, namely: in the I subgroup were 36 patients with non-alcoholic fat liver disease (NAFLD); The second subgroup was 40 patients with non-alcoholic steatohepatitis (NASH). All patients examined were subject-ed to general clinical, anthropometric, instrumental and laboratory testing. Quantitative determination of the level of free AK in serum was performed by the method of reversed-phase high-performance liquid chromatography in isocrat-ic mode of elution with electrochemical detection. Results and Discussion. The analysis of protein metabolism indicates a decrease in the amount of total protein in the serum mainly in patients of group II, accompanied by dysproteinemia. There was a predominant decrease in serum free AK levels in both groups of patients. However, a more significant deviation from the norm was established in the second group of patients, namely a decrease in levels of tryptophan, tyrosine, methionine, leucine, arginine (p<0.01), as well as a slight decrease in the content of alanine, threonine, serine, lysine (p>0.05). These changes were accompa-nied by statistically significant increases in cysteine levels, as well as glutamine, asparagine, phenylalanine, valine (p>0.05). Identical but less pronounced changes were found in the group of patients with NAFLD and type 2 diabetes. Conclusions. 1. Patients with NAFLD and type 2 diabetes have serum dysproteinemia with a predominant increase in α2- and γ-globulin levels. 2. Changes in serum free levels of AK in patients with NAFLD and type 2 diabetes are manifested by a decrease in tryptophan, tyrosine, methionine, leucine, arginine, as well as an increase in cysteine, proline, valine, and glutamine concentrations. These changes are more expressed in patients with type 2 diabetes mellitus with NASH than with NAFG.