РАСПРОСТРАНЕННОСТЬ НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ СРЕДИ ПАЦИЕНТОВ АМБУЛАТОРНО-ПОЛИКЛИНИЧЕСКОГО ЗВЕНА В ДАЛЬНЕВОСТОЧНОМ ФЕДЕРАЛЬНОМ ОКРУГЕ

The rapidly growing incidence of obesity and diabetes mellitus, especially in developed countries, stimulates medical experts to closely study the epidemiology of non-alcoholic fatty liver disease (NAFLD). According to the published results of the epidemiological study DIREG 2, the prevalence of NAFLD in outpatients inRussiaincreased over the period from 2007 to 2015 and amounted to 37.3%. In the present report, the population of patients with NAFLD in the Far East Federal District (FEFD) was studied as part of the multicentre epidemiological study DIREG 2.The aim. To analyze the data on FEFD obtained in the DIREG 2 study and compare those with the DIREG 2 data on the entireRussia.Materials and Methods. The prospective disease registry study: epidemiological, observational, cross-sectional, multicentre study on the prevalence of NAFLD in outpatients. The total number of participating patients in FEFD was 2500, including 900 males and 1600 females. Epidemiological data were collected within two routine patient visits to the participating research centers.Results. The major result of this study is that the prevalence of NAFLD in FEFD was significantly lower than that in the entireRussia (21.4% vs 37.3%). Although the rank distribution of the concomitant diseases in FEFD patients was comparable to that in the across-Russia population, the prevalence of metabolic syndrome, menopausal syndrome and hypertriglyceridemia was significantly higher in the FEFD population.Conclusion. Despite the lower prevalence of NAFLD there is a significantly higher prevalence of disorders associated with NAFLD in the FEFD patients as compared with the acrossRussian patients from DIREG2. A set of measures preventing these risk factors from converting into full-scale disease is needed. Стремительный рост заболеваемости такими патологиями, как ожирение и сахарный диабет, принимающий в развитых странах характер эпидемии, неминуемо ведет к увеличению уровня заинтересованности специалистов в изучении различных аспектов неалкогольной жировой болезни печени (НАЖБП). Согласно опубликованным результатам эпидемиологического исследования DIREG 2, распространенность НАЖБП у амбулаторных пациентов в России увеличилась за период с 2007 по2015 г. и достигла 37,3%. В данной работе в рамках многоцентрового эпидемиологического исследования DIREG 2 изучалась популяция пациентов с НАЖБП в Дальневосточном федеральном округе (ДФО).Цель. Анализ и обобщение полученных в рамках исследования DIREG 2 данных по ДФО в сравнении с данными DIREG 2 по России.Материалы и методы. Проспективный регистр заболевания: эпидемиологическое, наблюдательное, кросс-секциональное, мультицентровое исследование распространенности НАЖБП у амбулаторных пациентов. Общее число пациентов, принявших участие в исследовании в ДФО – 2500 пациентов, из них 900 мужчин и 1600 женщин. Эпидемиологические данные были получены в ходе двух рутинных визитов пациентов в исследовательские центры.Результаты. Ключевым результатом, выявленным в ходе данного исследования, является факт определения достоверно более низкой распространенности НАЖБП в ДФО по сравнению с общей популяцией исследованных пациентов в рамках DIREG 2. При общероссийском уровне распространенности данной патологии в 37,3% в популяции ДФО распространенность составила 21,4%. При сопоставимом ранговом распределении долей сопутствующих патологий пациентов в ДФО и общей популяции пациентов, принимавших участие в исследовании DIREG 2, достоверно чаще в популяции ДФО встречался метаболический синдром, климактерический синдром у женщин и гипертриглицеридемия.Заключение. Несмотря на меньший уровень распространенности НАЖБП на территории ДФО в сравнении с общей популяцией пациентов, принимавших участие в исследовании DIREG 2, выявлена достоверно более высокая распространенность ассоциированных с развитием НАЖБП патологий. Это требует разработки комплекса мер, который не позволит реализовать патогенный потенциал данных факторов риска

THE PREVALENCE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN OUTPATIENTS IN THE FAR EAST FEDERAL DISTRICT

The rapidly growing incidence of obesity and diabetes mellitus, especially in developed countries, stimulates medical experts to closely study the epidemiology of non-alcoholic fatty liver disease (NAFLD). According to the published results of the epidemiological study DIREG 2, the prevalence of NAFLD in outpatients inRussiaincreased over the period from 2007 to 2015 and amounted to 37.3%. In the present report, the population of patients with NAFLD in the Far East Federal District (FEFD) was studied as part of the multicentre epidemiological study DIREG 2.The aim. To analyze the data on FEFD obtained in the DIREG 2 study and compare those with the DIREG 2 data on the entireRussia.Materials and Methods. The prospective disease registry study: epidemiological, observational, cross-sectional, multicentre study on the prevalence of NAFLD in outpatients. The total number of participating patients in FEFD was 2500, including 900 males and 1600 females. Epidemiological data were collected within two routine patient visits to the participating research centers.Results. The major result of this study is that the prevalence of NAFLD in FEFD was significantly lower than that in the entireRussia (21.4% vs 37.3%). Although the rank distribution of the concomitant diseases in FEFD patients was comparable to that in the across-Russia population, the prevalence of metabolic syndrome, menopausal syndrome and hypertriglyceridemia was significantly higher in the FEFD population.Conclusion. Despite the lower prevalence of NAFLD there is a significantly higher prevalence of disorders associated with NAFLD in the FEFD patients as compared with the acrossRussian patients from DIREG2. A set of measures preventing these risk factors from converting into full-scale disease is needed

Machine learning for predicting the outcomes and risks of cardiovascular diseases in patients with hypertension: results of ESSE-RF in the Primorsky Krai

Aim. To assess the prospects of using artificial intelligence technologies in predicting the outcomes and risks of cardiovascular diseases (CVD) in patients with hypertension (HTN).Material and methods. A software application was created for data mining from respondent profiles in a semi-automatic mode; libraries with data preprocessing were analyzed. We analyzed the main and additional parameters (35) of CVD risk factors in 2131 people as a part of ESSE-RF study (2014-2019). To create a forecasting model, a high-level language Python 2.7 was used using object-oriented programming and exception handling with multithreading support. Using randomization, learning (n=488) and test (n=245) samples were formed, which included data from patients with an established diagnosis of HTN.Results. The prevalence of HTN among subjects was 34,39%. There were following significant factors for predicting CVD: anthropometric parameters, smoking, biochemical profile (total cholesterol, ApoA, ApoB, glucose, D-dimer, C-reactive protein). As a result of a 5-year follow-up, CVD was found in 235 people (32,06%) with HTN and 187 people (13,38%) without HTN; mortality rates were 1,27% in subjects with HTN and 1,12% — without HTN. The absolute mortality risk among participants with HTN (0,037) was significantly higher (p<0,05) than in patients without HTN (0,017). To create a neural network (NN), the basic Sequential model from the Keras library was used. During machine learning, 26 variables important for the CVD development were used as input and 9 neurons — as output, which corresponded to the number of established cardiovascular events. The created NN had a predictive value of up to 97,9%, which exceeded the SCORE value (34,9%).Conclusion. The data obtained indicate the importance of risk factor phenotyping using anthropometric markers and biochemical profile for determining their significance in the top 20 predictors of CVD. The Python-based machine learning provides CVD prediction according to standard risk assessments

The Role of Lactobacillus reuteri DSMZ17648 for Helicobacter pylori eradication therapy (Review of literature and advisory council resolution, February 28, 2018)

Aim of review. To analyze the options of application of Lactobacillus reuteri DSMZ17648 (Pylopass™) within Helicobacter pylori eradication. Summary. H. pylori eradication therapy is considered as one of the optional spheres for clinical application of probiotic medications. According to available data certain strains of probiotics are effective in decreasing of gastrointestinal adverse effects rates, associated with eradication therapy while the other can potentiate the efficacy of H. pylori eradication itself. L. reuteri strain DSM17648 which was chosen from over 700 wildtype strains of Lactobacillus spp. possess the ability for selective adhesion to H. pylori in vivo in the gastric media. DSM17648 strain of L. reuteri form coaggregates with various H. pylori strains and serotypes both in vivo and in vitro. It was revealed that lyophilizate of this strain (PylopassTM) blocks adhesion of H. pylori to epithelial cells as well. Clinical trials demonstrate the effect of PylopassTMon gastric mucosa colonization by H. pylori according to the 13C urea breath test data and as well the increase in H. pylori eradication rate when the productis added the to triple therapy modes. Conclusion. Potential of PylopassTM combination to various H. pylori eradication therapy modes is a subject offutnet multicenter randomized clinical trials for assessment of optimal combination to antibiotic drugs, treatment duration and adverse effect rates. The value of monotherapy by this metabiotic at chronic H. pyloriassociated gastritis is a subject of further studies

The Role of Lactobacillus reuteri DSMZ17648 for Helicobacter pylori eradication therapy

Aim of review. To analyze the options of application of Lactobacillus reuteri DSMZ17648 (Pylopass™) within Helicobacter pylori eradication. Summary. H. pylori eradication therapy is considered as one of the optional spheres for clinical application of probiotic medications. According to available data certain strains of probiotics are effective in decreasing of gastrointestinal adverse effects rates, associated with eradication therapy while the other can potentiate the efficacy of H. pylori eradication itself. L. reuteri strain DSM17648 which was chosen from over 700 wildtype strains of Lactobacillus spp. possess the ability for selective adhesion to H. pylori in vivo in the gastric media. DSM17648 strain of L. reuteri form coaggregates with various H. pylori strains and serotypes both in vivo and in vitro. It was revealed that lyophilizate of this strain (PylopassTM) blocks adhesion of H. pylori to epithelial cells as well. Clinical trials demonstrate the effect of PylopassTMon gastric mucosa colonization by H. pylori according to the 13C urea breath test data and as well the increase in H. pylori eradication rate when the productis added the to triple therapy modes. Conclusion. Potential of PylopassTM combination to various H. pylori eradication therapy modes is a subject offutnet multicenter randomized clinical trials for assessment of optimal combination to antibiotic drugs, treatment duration and adverse effect rates. The value of monotherapy by this metabiotic at chronic H. pyloriassociated gastritis is a subject of further studies

Life quality of the Russian population by the data from ESSE-RF study

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness.Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study.Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)).Result. EQ-5D index of Russian population was 0,87 with no gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p<0,05). Wealth level negatively associated with LQ. Most common (p<0,0005) were disorders by the components pain/discomfort and anxiety/depression. Part of those with lower LQ among males is lesser than in females, by all 5 factors of the LQ, and in all educational states. Regional specifics of LQ by EQ-5D index: from 0,82 in Vladikcaucas to 0,95 in Orenburg (p<0,0005). There was significant correlation of EQ-5D index with unemployment level (0,4) and consumer prices index (0,29) in regions.Conclusion. Monitoring of LQ is necessary condition for assessment of efficacy of population health improvement interventions, and the LQ values obtained will be useful as populational norms for health condition assessment in addition to morbidity and mortality factors