RATIO OF MAIN PHYLOTYPES OF GUT MICROBIOTA IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE DEPENDING ON THE BODY MASS INDEX.

OBJECTIVE: The aim: To analyze the status of Gut microbiota (GM) at the level of the main phylotypes in patients with NAFLD, depending on the body mass index (BMI) and gender in comparison with a group of practically healthy individuals. PATIENTS AND METHODS: Materials and methods: The study involved 120 patients with NAFLD, who were divided into two groups depending on BMI and the control group containing 20 practically healthy individuals. RESULTS: Results: In patients with NAFLD with comorbid obesity, a statistically significant increase in the relative amount of Firmicutes (52.12 [42.38; 67.39]%) and Firmicutes/Bacteroidetes ratio (3.75 [1.7; 9.5]) against the background of a significant decrease in the amount of Bacteroidetes (13.41 [7.45; 26.07]%); in NAFLD patients with overweight, the relative amount of Firmicutes was 49.39 [37.47; 62.73]%, Firmicutes / Bacteroidetes ratio was 1.98 [1.15; 5.92], and the relative amount of Bacteroidetes was 23.69 [12.11; 36.16]%. In the control group, the distribution of the basic GM phylotypes was significantly different; the relative amount of Bacteroidetes was almost the same as of Firmicutes - 34.65 [24.58; 43.53]% and 29.97 [22.52; 41.75]% respectively, and the Firmicutes/Bacteroidetes ratio was 0.64 [0.52; 1.47]. CONCLUSION: Conclusions: The most statistically significant changes in the composition of IM occur due to the increase in the relative amount of Firmicutes and the ratio of Firmicutes/ Bacteroidetes against the background of a decrease in the relative amount of Bacteroidetes. These changes were directly proportional to the increase in BMI, but had no gender features.

The Role of Genetic Polymorphism in the Formation of Arterial Hypertension, Type 2 Diabetes and their Comorbidity.

BACKGROUND: Hereditary component plays a significant role in the formation of insulin resistance (IR) - one of the pathogenetic links of arterial hypertension (AH) and type 2 diabetes mellitus (DM2). However, the genetic predisposition to IR can not be realized and does not manifest itself clinically in the absence of appropriate factors of the environment (excessive nutrition, low physical activity, etc.). OBJECTIVE: The review summarizes the results of studies which describe the contribution of genetic polymorphism to the formation and progression of AH, DM2 and their comorbidity in various populations. RESULTS: In many studies, it has been established that genetic polymorphism of candidate genes is influenced by the formation, course and complication of AH and DM2. According to research data, the modulating effect of polymorphism of some genetic markers of AH and DM2 on metabolism and hemodynamics has been established. The results of numerous studies have shown a higher frequency of occurrence of AH and DM2, as well as their more severe course with adverse genetic polymorphisms. At the same time, the role of genetic polymorphism in the formation of AH and DM2 differs in different populations. CONCLUSION: Contradictory data on the influence of gene polymorphisms on the formation of AH and DM2 in different populations, as well as a small number of studies on the combined effects of several polymorphisms on the formation of comorbidity, determine the continuation of research in this direction.

Randomized, double-blind, controlled study of glycerol phenylbutyrate in hepatic encephalopathy.

UNLABELLED: Glycerol phenylbutyrate (GPB) lowers ammonia by providing an alternate pathway to urea for waste nitrogen excretion in the form of phenylacetyl glutamine, which is excreted in urine. This randomized, double-blind, placebo-controlled phase II trial enrolled 178 patients with cirrhosis, including 59 already taking rifaximin, who had experienced two or more hepatic encephalopathy (HE) events in the previous 6 months. The primary endpoint was the proportion of patients with HE events. Other endpoints included the time to first event, total number of events, HE hospitalizations, symptomatic days, and safety. GPB, at 6 mL orally twice-daily, significantly reduced the proportion of patients who experienced an HE event (21% versus 36%; P=0.02), time to first event (hazard ratio [HR]=0.56; P<0.05), as well as total events (35 versus 57; P=0.04), and was associated with fewer HE hospitalizations (13 versus 25; P=0.06). Among patients not on rifaximin at enrollment, GPB reduced the proportion of patients with an HE event (10% versus 32%; P<0.01), time to first event (HR=0.29; P<0.01), and total events (7 versus 31; P<0.01). Plasma ammonia was significantly lower in patients on GPB and correlated with HE events when measured either at baseline or during the study. A similar proportion of patients in the GPB (79%) and placebo groups (76%) experienced adverse events. CONCLUSION: GPB reduced HE events as well as ammonia in patients with cirrhosis and HE and its safety profile was similar to placebo. The findings implicate ammonia in the pathogenesis of HE and suggest that GPB has therapeutic potential in this population. (Clinicaltrials.gov, NCT00999167).