[Diagnostic significance of clinical and laboratory indices in predicting non-alcoholic fatty liver disease during screening studies].

AIM: To study the significance of clinical and laboratory non-invasive indexes along with the insulin resistance index when carrying out diagnostic assessment of non-alcoholic fatty liver disease (NAFLD) during screening examinations. MATERIALS AND METHODS: The study involved 348 employees working at oil-production enterprises. An ultrasound scanning of the liver was carried out to assess the criteria of NAFLD. The following indexes were calculated: fatty liver index (FLI), hepatic steatosis index (HSI), lipid accumulation products (LAP), and homeostasis model assessment of insulin resistance (HOMA1-IR). The prognostic significance of these indexes in relation to the probability of NAFLD diagnosis based on ultrasound data was studied using single-factor and multi-factor logistic regression models followed by ROC-analysis. RESULTS: The FLI, HSI, and HOMA1-IR indexes in single-factor logistic regression models showed a high statistical significance when carrying out diagnostic assessment the NAFLD with good model calibration capability. The percentage of correct binary classification regards the presence/absence of NAFLD amounted to 82.4% for FLI, 79.7% for HSI, and 72.7% for HOMA1-IR (p0.001). According to the ROC-analysis, the area under the curve (AUC) by the NAFLD diagnostic assessment was 0.917 (95% CI 0.8890.945); 0.880 (95% CI 0.8460.915) and 0.849 (95% CI 0.7640.934), respectively. The multi-factor logistic regression model with the inclusion of FLI and HOMA1-IR 72.7% enabled us to achieve the correct binary classification in terms of NAFLD in 84.2% of cases. When it comes to the ROC-analysis, considering the probabilities predicted in the multi-factor logistic model as the test variable and NAFLD in ultrasound examination as the state variable, it was possible to set the value of AUC 0.933 (95% CI 0.8820.985). CONCLUSION: The studied clinical and laboratory indexes (FLI, HSI, HOMA1-IR) have a high diagnostic significance regarding NAFLD diagnosed using ultrasonographic criteria. The application of the proposed two-factor logistics model makes it possible to predict the presence of NAFLD when examining a large number of patients, without involving additional ultrasound diagnostics specialists in order to use medical resources rationally.

[Features of early stages of cardiovascular continuum in workers engaged in oil-extracting enterprise].

The authors present data on metabolic disorders and vascular state in workers of oil extracting enterprise, exposed to complex of occupational hazards (noise, work hardiness, chemical factors). Major role among chemical hazards is played by aromatic hydrocarbons. In clinical and epidemiologic studies, arterial hypertension was reliably more frequent in a group of oil extraction workers. Findings are that oil extraction workers, when compared to the reference group, demonstrate more marked metabolic disorders (dyslipidemia with increased total cholesterol and low density lipoproteins, hyperuricemia, hyperglicemia, increased lipids peroxidation) with endothelial dysfunction. These changes are associated with remodelling of arterial wall, that at early stages involves thickening intima-media complex. That leads to hardness and arteriosclerosis of arteries.

[Features of diurnal profile of blood pressure in workers having serum aromatic hydrocarbons level].

Features of diurnal profile of blood pressure in workers having serum level of benzol and ethylbenzene are high systolic and diastolic arterial blood pressure during the day, index of systolic arterial pressure time and index diastolic arterial pressure time was also high. These features should be considered in anti-hypertensives prescription.