Some aspects of pathogenesis of nonalcoholic fatty liver disease in postmenopausal women.

In view of the reversibility of steatosis and steatohepatitis, their early diagnosis is one of the most significant problems of modern medicine. The aim of the study was the establishment futures of the pathogenesis of NAFLD in postmenopausal women. The study was conducted on postmenopausal women (n=5), with metabolic syndrome and rate of ALT in the blood at least 4 times greater than its normal maximal value. Patients had to fulfill the following inclusion criteria: at least 12 month of amenorrhea. Verification of the diagnosis of NAFLD was based on abdominal ultrosonografic examination. In addition to collecting history, study of blood lipid profile and ALT, AST, estrogen content in patients enrolled in the study free nitric oxide content in the blood and liver bioptants was determined by Electron Paramagnetic Resonance (EPR) method. The study protocol approved by the Ethics Committee of the Tbilisi State Medical University. Patients by written form confirmed their agreement to participate in the study. In patients with NAFLD levels of total cholesterol, LDL-cholesterol and triglycerides were generally increased in the blood serum, direct correlation revealed between level of NO EPR signal intensity in liver bioptat and triglycerides content in blood (r=0,96; p=0,009). It was concluded that estrogen-dependent factors, such as impaired lipid metabolism and increase expression of iNOS induce accumulation of triglycerides and free fatty acids in the liver, generation excess amounts of NO, which in oxidative stress reveal their cytotoxity and promote progression of NAFLD in postmenopausal women.