[The diagnostics and clinical pattern of nonalcoholic fatty liver disease in patients with pre-diabetes and type 2 diabetes and obesity].

INTRODUCTION: The data of epidemiological researches confirm the tendency in increasing of non alcoholic fatty liver disease (NAFLD) in patients with insulin resistance which occurs because of obesity, diabetes type 2 and metabolic syndrome.

AIM: Optimization of diagnostic and treatment efficacy in patients with non alcoholic steatosis and steatohepatitis on the background of obesity.

MATERIALS AND METHODS: General clinical examination of patients, laboratory and instrumental methods ( fatty liver index, non invasive assessment of liver, morphology, electrocardiography, treadmillergometry, ultrasound examination of abdominal organs, liver elastography,CT,MRI, methods of statistical analysis.

RESULTS: NAFLD was diagnosed in 98.4% of patients with diabetes type 2, from which steatosis was found in 54.84% and steatohepatitis in 45.16%. In individuals with prediabetes NAFLD was in 70.5%, of which 85.45% with steatosis and 14.55% steatohepatitis (p<0.05). The clinical picture of patients with NAFLD prevailed such symptoms and complaints: flatulence in 43.59% of patients, weakness and pain in the right upper quadrant in 29.9% of patients. Fewer patients complained on discomfort in abdomen 28.21%, constipation 21.37% and feeling of bitterness in the mouth 21.37%.

CONCLUSION: Clinical features of NAFLD are polysymptomatic. There are prevalence of dyspeptic syndromes (bloating met in 43.59% of patients, pain in right upper quadrant and discomfort in abdomen -29.91%, constipation- 28.21%, bitterness in mouth-21.37%. Determination of fatty liver index is very informative method of screening patients with hepatisteatosis.