[ASSESSMENT OF MATRIX METALLOPROTEINASES AND THEIR TISSUE INHIBITORS FOR NON-INVASIVE DIAGNOSIS OF LIVER FIBROSIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE].

ABSTRACT

Objective: To evaluate the diagnostic value of MMP-9, TIMP-1 and 2 as non-invasive markers of liver fibrosis in the NAFLD to improve the management of patients with this pathology. Materials and methods: We examined 99 patients with NAFLD and different stages of fibrosis, 83 men, 16 women, median age 45 (range 40-55) years. We assessed of risk factors for liver fibrosis in the NAFLD, anthropometric indicators, biochemical analysis of blood, abdominal ultrasonic studies, the levels of MMP-9, TIMP-1 and 2. Depending on the stage of fibrosis (0-4), established as a result of liver elastometry (Fibroscan), patients were divided into 5 groups n = 27, n = 22, n = 23, n = 14, n = 13, respectively. Results: Between the groups in medical history, physical examination, calculation of BMI and the ratio of waist to hip volume (W/H) no significant differences were found. 64,6% of patients had abdominal obesity (BMI - 31,5 (29,1-33,9), W/H - 1,02 (1,01-1,05). Obesity and abdominal obesity (BMI, W/H) had a significant positive relationship of moderate streight (rs = (0,257), p < 0,04, rs = (0,301), p < 0,02, respectively), with the stage of liver fibrosis. The groups were significant differences in the level of glucose, total bilirubin (p < 0,04, p < 0,03, respectively). At the time of the examination, 57,5% of patients had steatosis, other patients had steatohepatitis. No significant differences in the level of liver function tests (ALT, AST) in the study groups were found. Significant differences were found in level of TIMP-2 (p < 0,04). TIMP-2 had a significant positive correlation with the severity of fibrosis in the hepatic tissue (rs = (0,349), p < 0,004). Conclusion: TIMP-2 may be considered as a potential non-invasive marker for the diagnosis of liver fibrosis in patients with NAFLD.