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The aim of the study. To establish the mechanisms of mutual burden and progression of non-alcoholic steatohepatitis (NASH) and chronic kidney disease (CKD) in patients with obesity. Material and methods. 114 patients with NASH were examined against the background of І-ІІ degree obesity, including: 52 patients with NASH (group 1) (without accompanying CKD), 62 patients with NASH with a comorbid CKD І-ІІ degree (group 2). The average age of patients was (45.8 ± 3.81) years. The control group consisted of 20 practically healthy persons (PHPs) of the corresponding age and sex. Results. The obtained data testify that under the conditions of the H2S deficit and hyperproduction of homocysteine for the comorbidity of NASH from CKD I-II degree the synthesis and resorption of collagen are activated, but the anabolism processes predominate as a result of the activation of the fibroblasts system, with a significant hyperproduction of acute phase proteins, fibronectin, a higher degree of hyperthyroidism and dyslipidemia with predominance of proatherogenic lipoprotein fractions, and a higher degree of endothelium dysfunction. Conclusions. A significant increase in the synthesis of collagen and glycoproteins (fibronectin) in patients with NASH, which was observed on the background of obesity, was established, which is accompanied by an ineffective resorption of newly formed collagen due to inhibition of collagenolysis against activation of proteinase inhibitors (α2-MG), accompanied by hyperproduction of the fibroblast growth factor, homocysteine, endothelin‑1, deficiency in the liberation of hydrogen sulfide and nitrogen monoxide.

Features of the non-alcoholic steatohepatitis and chronic kidney disease courses, pathogenetic correction efficiency