ОСОБЛИВОСТІ ЛІПІДНОГО МЕТАБОЛІЗМУ ТА ІНДЕКСІВ СТЕАТОЗУ ПЕЧІНКИ У ХВОРИХ НА СТЕАТОТИЧНУ ХВОРОБУ ПЕЧІНКИ, АСОЦІЙОВАНУ З МЕТАБОЛІЧНОЮ ДИСФУНКЦІЄЮ, ЗА КОМОРБІДНОСТІ З НЕГОСПІТАЛЬНОЮ ПНЕВМОНІЄЮ

Aim of the study – to determine the features of lipid metabolism, biochemical markers of liver injury, and the degree of hepatic steatosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) with obesity in the presence of comorbid community-acquired pneumonia (CAP) associated with coronavirus disease.Material and methods. A total of 125 patients with MASLD and class I obesity were examined: 90 patients with metabolic dysfunction-associated steatohepatitis (MASH) and comorbid CAP, 35 patients with MASH without pneumonia, and 35 patients with moderate CAP. The assessment included lipid profile parameters, atherogenic index, activities of cytolytic and cholestatic enzymes, protein-synthesizing function of the liver, ultrasonographic characteristics, hepatic steatosis indices (HSI, LFS), and the NAFLD Fibrosis Score.Results. Patients with MASLD and CAP exhibited the most pronounced dyslipidemia, including increased levels of total lipids, cholesterol, triglycerides, LDL-C, and elevated atherogenic index, along with a reduction in HDL-C. Comorbidity with CAP was associated with a significant intensification of cytolysis, cholestasis, mesenchymal inflammation, decreased protein synthesis, and more pronounced hepatomegaly. The HSI, LFS, and NAFLD FS indices indicated a higher degree of hepatic steatosis and fibrosis in the MASLD+CAP group compared to isolated MASLD.Conclusions. Community-acquired pneumonia is associated with a substantial enhancement of lipid distress syndrome, progression of hepatic steatosis and fibrosis, and deterioration of liver functional state in patients with MASLD and obesity. The comorbid course forms an unfavorable metabolic profile and requires therapeutic strategies that consider liver injury.