CLINICOMORPHOLOGICAL CHANGES OF THE LIVER IN ATHEROGENIC DYSLIPIDEMIAAND IN THE TREATMENT WITH STATINS


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Abstract

Aim. To evaluate clinicofunctional and morphological changes in the liver of patients with atherogenic
dyslipidemia and in the course of treatment with statins.
Material and methods. A general clinical examination, biochemical hepatic tests, determination of
blood lipid spectrum, markers of viral hepatites B, C, G, TT, ultrasound hepatic imaging of the liver
of bile ducts, punch biopsy of the liver were made in 60 patients (38 females and 22 males) at the age
of 39 to 70 years with atherogenic dyslipidemia (ADL).
Results. Biochemical tests showed high activity of transaminases (1.5-2 times higher than normal) in
16 patients, hyperbilirubinemia in 12 patients, dyslipidemia of type Hb-III in all the examinees. Ultrasound
investigation of the liver has found fat dystrophy in 58, cholesterosis of the gallbladder in 32,
cholelithiasis in 17 patients. Histological examination of the liver evidenced for marked fat dystrophy
of hepatocytes, perihepatocellular and periportal fibrosis, moderate portal and periportal hepatitis. 22
of 54 patients treated with statins appeared to have morphological signs of drug damage to the liver.
Conclusion. ADL patients' livers are characterized by signs of non-alcoholic steatohepatitis. In its
presence statins treatment leads to development of drug-related hepatic disorder - statin hepatitis.
Therefore, hypolipidemic drugs in non-alcoholic steatohepatitis must be used individually or alternative
treatments should be tried.

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