ROLE OF ADIPOCYTOKINES, GHRELIN AND INCRETINS IN PREDICATION OF NON-ALCOHOLIC FATTY LIVER DISEASE AND ITS TREATMENT IN PATIENTS WITH TYPE 2 DIABETES
Incidence of non-alcoholic fatty liver disease (NAFLD) is growing rapidly throughout the world and has recently become the most common liver pathology. NAFLD's pathogenetic basis, which is insulin resistance, makes it similar to the metabolic syndrome diseases (visceral obesity, dyslipidemia, arterial hypertension and disorders of carbohydrate metabolism). High prevalence of NAFLD determines the importance of non-invasive predictors of its development and, particularly, of its progression to cirrhosis. Level of adipose tissue hormones (adipocytokines) is directly related to severity of insulin resistance and to high degree determines inflammation and fibrosis in liver. These hormones are good candidates both for predictors of NAFLD development and progression, and for markers of metabolic effects of therapy. Hormones involved in food behavior regulation (leptin, ghrelin, glucagon-like peptide type 1) have significant effects on adipose-tissue metabolism as well as adipose and liver tissue insulin sensitivity. Dynamics of these hormones in course of NAFLD treatment can also be an important marker of its effectiveness. This review explores the role of adipocytokines and other hormones in the insulin sensitivity, inflammation and fibrosis regulation in predicting development, progression and response to the therapy of NAFLD.