The purpose of the study was to find out the probable mutual influence of the state of the lipid spectrum of blood and content of adipokines in blood: leptin, adiponectin on the clinical course of non-alcoholic fatty liver disease against the background of obesity depending on its form and the presence of comorbid chronic kidney disease. Materials and methods. 444 patients were examined: of which 84 patients with non-alcoholic fatty liver disease with grade I obesity (group 1), which contained 2 subgroups: 32 patients with non-alcoholic hepatic steatosis and 52 patients with non-alcoholic steatohepatitis; 270 patients with non-alcoholic fatty liver disease with comorbid obesity of the I degree and chronic kidney disease of the I-III stage (group 2), including 110 patients with non-alcoholic steatosis of the liver and 160 patients with non-alcoholic steatohepatitis. The control group consisted of 90 patients with chronic kidney disease stage I-III with normal body weight (group 3). The mean age of patients was (45.8±3.81) years. Results and discussion. The study showed that patients with non-alcoholic steatohepatitis and obesity without concomitant chronic kidney disease are characterized by the following changes in the blood lipid spectrum: maximum increase in blood triacylglycerols (by 2.1 times, p <0.05), a probable increase in total cholesterol (by 1.4 times, p <0.05) and proatherogenic low-density lipoproteins (by 1.6 times, p <0.05), a probable decrease in anti-atherogenic high-density lipoproteins (by 1.6 times, p <0.05), which with the addition of comorbid chronic kidney disease are likely to deepen (within 1.5-1.8 times, p <0.05), in addition to hyper triacylglycerol. According to the results of the study, the content of leptin in the blood was significantly increased by 1.4 times (p <0.05) compared with almost healthy individuals, which differed significantly from patients with non-alcoholic steatosis of the liver with chronic kidney disease and non-alcoholic steatohepatitis with chronic kidney disease (p <0.05). The content of adiponectin in the blood was significantly reduced by 1.4 times compared with almost healthy individuals (p <0.05) and also differed significantly from patients with non-alcoholic hepatic steatosis with chronic kidney disease and non-alcoholic steatohepatitis with chronic kidney disease (p <0.05). Conclusion. Based on the results, it was found that significant metabolic prerequisites for the development of non-alcoholic steatohepatitis against the background of obesity and chronic kidney disease are probable postprandial hyperglycemia, hyperinsulinemia, increased glycosylation of hemoglobin. Hyperleptinemia and hypoadiponectinemia are also factors in the burden of non-alcoholic steatohepatitis and obesity due to the progression of mesenchymal inflammation and cytolysis of hepatocytes

Keywords: non-alcoholic fatty liver disease, chronic kidney disease, lipid spectrum, adipokines

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1. Tomic D, Kemp WW, Roberts SK. Nonalcoholic fatty liver disease: current concepts, epidemiology and management strategies. Eur J Gastroenterol Hepatol. 2018; 30(10): 1103-1115. https://doi.org/10.1097/MEG.0000000000001235
2. Babak OYa, Kolesnikova EV, Syitnik KA. Profilakticheskie meropriyatiya pri nealkogolnoy zhirovoy bolezni pecheni: suschestvuet li sposob snizit risk razvitiya zabolevaniya? [Preventive measures for non-alcoholic fatty liver disease: is there a way to reduce the risk of the disease?]. Suchasna gastroenterol. 2013; 3(71): 103-9. [Russian]
3. Kolesnyk MO, Gholubchykov MV, Sajdakova NO, ta in. Klasyfikacija khvorob sechovoji systemy ta vedennja reghionaljnykh ta nacionaljnogho rejestriv khvorykh z khronichnoju khvoroboju nyrok [Classification of the diseases of the urinary system and maintaining regional and national registers of patients with chronic kidney disease]. Metod rekomendaciji MOZ Ukrajiny, AMN Ukrajiny, Ukr Centr naukovoji med informaciji i patentno-licenzijnoji roboty. K; 2006. 24 s. [Ukrainian]
4. Zhao H, Song X, Li Z, Wang X. Risk factors associated with nonalcohol fatty liver disease and fibrosis among patients with type 2 diabetes mellitus. Medicine (Baltimore). 2018; 97(37): e12356. PMID: 30212992. PMCID: PMC6156034. https://doi.org/10.1097/MD.0000000000012356
5. Sweiss N, Sharma K. Adiponectin effects on the kidney. Best Pract Res Clin Endocrinol Metab. 2014; 28(1): 71-79. https://doi.org/10.1016/j.beem.2013.08.002
6. Baltieri L, Chaim EA, Chaim FDM, Utrini MP, Gestic MA, Cazzo E. Correlation between nonalcoholic fatty liver disease features and levels of adipokines and inflammatory cytokines among morbidly obese individuals. Arq Gastroenterol. 2018; 55(3): 247-51. PMID: 30540086. https://doi.org/10.1590/S0004-2803.201800000-62
7. Khukhlina OS. Antoniv AA, Dudka IV, Dudka TV, Mandryk OE. The state of blood lipid spectrum and the indicators of insulin resistance in patients with non-alchogolic steatohepatitis with obesity and hypertensive disease. Svit medytsyny ta biolohiyi. 2018; 2(64): 85–88. [Ukrainian]. https://doi.org/10.26724/2079-8334-2018-2-64-85-88
8. Grander C, Grabherr F, Moschen AR, Tilg H. Non-alcoholic fatty liver disease: Cause or effect of metabolic syndrome. Visc Med. 2016; 32(5): 329-34. PMID: 27921044. PMCID: PMC5122994. https://doi.org/10.1159/000448940
9. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7): 412-419. PMID: 3899825. https://doi.org/10.1007/BF00280883
10. Khukhlina OS, Antoniv AA, Kanovska LV, Matushchak M, Vivsyannuk V. The intensity of the antioxidant protection system and oxidative stress factors in patiencts with non-alcoholic steatohepatitis depending on the form of chronic kidney disease. Georgian Medical News. 2018; 3(276): 71-6. PMID: 29697385
11. Zhao H, Song X, Li Z, Wang X. Risk factors associated with nonalcohol fatty liver disease and fibrosis among patients with type 2 diabetes mellitus. Medicine (Baltimore). 2018; 97(37): e12356. PMID: 30212992. PMCID: PMC6156034.. https://doi.org/10.1097/MD.0000000000012356