Today, non-alcoholic fatty liver disease (NAFLD) is a common pathology and pressing problem in pregnant women, especially among overweight, as the incidence of obese women of childbearing age is rapidly increasing. Disorders of lipid metabolism, which is an integral part of this disease, lead to pathological changes in the functional state of the liver, which in turn have a negative impact on pregnancy and lead to the formation of obstetric and perinatal complications. THE AIM OF OUR STUDY was to evaluate the clinical and laboratory markers of liver disorders in pregnant women with NAFLD depending on body mass index. MATERIALS AND METHODS. We’ve examined 98 pregnant women with NAFLD at the stage of non-alcoholic steatohepatitis (NASH) in combination with obesity. The age of the examined women ranged from 21 to 35 years (mean age 30.5 ± 1.5 years). The control group consisted of 30 almost healthy pregnant women. Depending on the body mass index (BMI), all surveyed women are divided into three groups: Group I - overweight pregnant women, Group II - pregnant women with grade I obesity, Group III - pregnant women with grade II obesity. We evaluated the incidence of major clinical complaints and changes in blood biochemical parameters in pregnant women depending on the increasing of BMI. RESULTS. When comparing the clinical manifestations of NAFLD on the stage of NASH in pregnant, the highest frequency is observed in the group of examined women with severe obesity compared with the group of patients with moderate obesity and overweight: symptoms of asthenic syndrome (increased fatigue, sleep disturbances, emotional lability, decreased and increased appetite) in 91.6.0%, 79.1% and 61.5% of patients (p<0.05), manifestations of dyspepsia (constipation, nausea, flatulence) - in 87.5%, 54% and 34.6% patients (p <0.05), feeling of heaviness or moderate pain in the right hypochondrium - in 62.5% 50% and 30.7% of patients, respectively (p <0.05). CONCLUSIONS. It has been established that pregnant women with non-alcoholic fatty liver disease on the stage of nonalcoholic steatohepatitits have pronounced clinical picture of the disease, which depends on the increase in BMI. It was found that in pregnant women with NAFLD liver dysfunction occurs on the background of grade I obesity, which can be considered as an early marker of steatohepatitis and risk of obstetric complications.
Correlation of gut Firmicutes/Bacteroidetes ratio with fibrosis and steatosis stratified by body mass index in patients with non-alcoholic fatty liver disease
