Liver damage in type 1 diabetes mellitus (type 1 DM) can be a consequence and cause of inadequate glycemic control, which, in turn, causes a restructuring of physiological functions at the organ, cellular, and subcellular levels and leads to disruption of intersystem interaction. However, the question of the influence of functional disorders of the liver on the preservation of the physiological reserves of the body (PRB) remains unexplored.
PURPOSE OF THE STUDY
To identify and substantiate the relationship between the functional state of the liver and the physiological reserves of the body in patients with type 1 diabetes.
MATERIAL AND METHODS
47 patients with type 1 DM (27 women and 20 men) were examined; the median and interquartile interval of age was 34.0 [25.2—42.0] years. Inclusion criteria: the patient’s consent to participate in the study, the absence of diseases of the digestive system. In addition to the general clinical study, an ultrasound examination of the liver, dynamic hepatobiliary scintigraphy with the calculation of the index of the functional activity of hepatocytes were performed (RF patent for invention No. 2578080/20.03.16). The level of the patient’s PRB was determined using the method for assessing the basic component of the rehabilitation potential (RF patent for invention No. 2344751/27.01.2009) with automated assessment (certificate of official registration dated September 12, 2007 No. 2007613898).
RESULTS
In 45% of patients with type 1 DM, a slow absorption function of hepatocytes was detected, in 30% it was accelerated in the absence of clinical, laboratory and instrumental changes in the liver. 52.5% of the examined patients had a high level of PRB, 30% had an average level, and 17.5% had a low level. According to the ROC-analysis, markers of a low level of PRB were revealed: a slowdown in the absorption function of the liver Tmax. >11 min (AUC 0.625, p<0.05) and acceleration of excretory function T1/2 ≤37.9 min (AUC 0.656, p<0.05).
CONCLUSION
Functional disorders of the liver are markers of a low level of physiological reserves of the body and, therefore, indicators of a violation of intersystem interactions.
