CLINICAL AND LABORATORY CHARACTERISTICS OF NONALCOHOLIC FATTY LIVER DISEASE IN WOMEN WITH PRIMARY (POSTOPERATIVE) HYPOTHYROIDISM
The article presents the results of a survey of 170 women: 58 - with primary (postoperative) hypothyroidism, 60 - with signs of fatty hepatosis but without structural and functional thyroid disorders, 52 - both without fatty hepatosis, structural and functional disorders of the thyroid gland. All of them carried out anthropometric study, the study of carbohydrate parameters of lipid, protein metabolism, liver function tests. It is established that in 86.2% of women with primary (postoperative) hypothyroidism non-alcoholic fatty liver disease is formed, which proceeds primarily in the form of steatohepatosis as a low-symptom liver lesion without distinct functional disorders. Among the calculated anthropometric indices greatest diagnostic significance in the aspect of the probability of non-alcoholic fatty liver disease and metabolic disorders have body mass index by Quetelet and the waist-hip ratio. Disorders of carbohydrate (insulin resistance) and lipid metabolism (atherogenic dyslipidemia) are found in the vast majority of women with post-operative hypothyroidism, the degree of their severity is determined by the presence of overweight (BMI≥25 kg/m2), especially the android and intermediate types of fat distribution (waist-hip ratio>0,8). The greatest diagnostic significance for detection of metabolic disorders are: index of insulin resistance, HOMO-IR, HDL, VLDL, Apob, and Apob index/АпоА1.