Effectiveness of rifaximin and probiotics for the correction of intestinal permeability in patients with metabolic-associated fatty liver disease in combination with type 2 diabetes mellitus.

OBJECTIVE: Aim: To investigate the effectiveness of rifaximin and probiotics for the correction of intestinal permeability in patients with metabolic-associated fatty liver disease (MAFLD) in combination with type 2 diabetes mellitus. PATIENTS AND METHODS: Materials and Methods: The prospective interventional randomized investigation included 68 patients with MAFLD in combination with type 2 diabetes, who were examined and divided into the 2 groups of treatment. RESULTS: Results: The serum levels of interleukin (IL) - 6, IL-10 and zonulin, indicators of liver functional activity, liver attenuation coefficient between treatment group vs. control group after 2 weeks, 1 month, 3 and 6 months of therapy were significant differed. The serum levels of IL-6 and zonulin significantly decreasing and increasing of IL-10 in the treatment group after 2 weeks, 1, 3 and 6 months of combined therapy. When comparing of stool short-chain fatty acids concentration between treatment group vs. control group after 2 weeks, 1 month, 3 and 6 months of therapy the levels of acetic, butyric and propionic acids significantly differences and increase in their levels were established. CONCLUSION: Conclusions: The results of the study in dynamics during 6 months show that the additional appointment of rifaximin, multispecies probiotic and prebiotic to metformin in patients with MAFLD and type 2 diabetes led to the elimination of subclinical inflammation, modulation of the permeability of the intestinal barrier and lowering increased intestinal permeability, as well as to the lower serum activity of liver aminotransferases and decrease the stage of steatosis.

HEMOSTATIC POTENTIAL ASSESSMENT OF PATIENTS WITH LIVER CIRRHOSIS AND ATRIAL FIBRILLATION BY LOW-FREQUENCY PIEZOELECTRIC THROMBOELASTOGRAPHY.

OBJECTIVE: The aim: Our aim was to assess the hemostatic potential of patients with liver cirrhosis and atrial fibrillation by LPTEG global coagulation assay, to investigate changes in LPTEG parameters according to the stage of liver cirrhosis and compare results with liver cirrhosis group. PATIENTS AND METHODS: Materials and methods: We performed a prospective cross-sectional study including 70 patients with liver cirrhosis and atrial fibrillation, 36 patients with liver cirrhosis and 20 healthy individuals. LPTEG parameters were measured using ARP-01M "Mednord" in order to assess coagulation abnormalities. RESULTS: Results: t1 and Intensity of contact coagulation didn't differ (p>0,05), Constant of thrombin activity was increased (47.53±0.8vs.34.51±1.88, p<0.001), t3 was reduced (5,0±0.1vs.6.7±0.36 p<0.001), Intensity of coagulation drive was increased (52.8±1.8vs.38.55±1.54, p = 0.001), Intensity of clot polymerization was increased (19.66±0.28vs.16.29±0.28,p<0.001), time t5 was reduced (32.94±0.36 vs. 36.8±1.30, p<0.01), Maximum amplitude was increased (655.7±9.19 vs. 547±19.38, p<0.001), Intensity of total coagulation was increased (19.41±0.34vs.15,09±0.56, p<0.001), Intensity of clot retraction and lysis was increased (4.1±0.07vs.3±0.15, p<0.001) and Coefficient of total anticoagulant activity was increased (2.81±0.05 vs. 2.48 ± 0.06, p<0.001) compared to liver cirrhosis. CONCLUSION: Conclusions: In patients with liver cirrhosis and atrial fibrillation the hemostatic potential is significantly shifted towards hypercoagulation with a gradual worsening of coagulation disorders, starting from the compensated stage of liver cirrhosis.