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The aim of the study was to establish the role of pro-apoptotic P-53 factor in the pathogenesis of nonalcoholic hepatosteatosis in postmenopausal women. Study was performed on menopausal women (12 month amenorea) with sings of metabolic syndrome and high level of ALT in blood (2 fold higher as maximal normal level). Verification of steatosis diagnosis was made on the basis of ultrasonography and histological study of bioptats obtained by method of percutal biopsy. The study of anamnesis, lipid profile, the concentration of ALT level in blood, histological analysis of bioptats and immunohistological study of P-53 were conducted. The control group consisted of postmenopausal women with metabolic syndrome, with normal level of ALT in blood. Histological analysis of liver bioptats revealed a micro-and macro-droplet steatosis of hepatocytes. Inflammation and fibrosis were present in all patients liver. Small necrotic focuses of hepatocytes without necrosis and single lymphocyte clusters were noted in samples of patients with high level of ALT. As a result imunohystochemical studies enhanced expression of the proapoptotic protein P-53 was found in that patients with hepatosteatosis; any dependence was not revealed between the intensity of protein P-53 expression and the degree of steatohepatitis (ALT content). It is concluded that the enhanced protein expression of P-53 which indicates on the intensification of apoptosis in hepatocytes can be induced by activation of inflammatory stimuli and oxidative stress. Considering the fact that it was not found correlation between the intensity of the protein P-53 expression and severity of disease, we can assume that its participation is just one element of multiple factors involved in pathogenesis of steatohepatosis. The timely correction of lipid metabolism and redox balance in the body is usfull for the prevention of hepatosteatosis.

In view of the reversibility of steatosis and steatohepatitis, their early diagnosis is one of the most significant problems of modern medicine. The aim of the study was the establishment futures of the pathogenesis of NAFLD in postmenopausal women. The study was conducted on postmenopausal women (n=5), with metabolic syndrome and rate of ALT in the blood at least 4 times greater than its normal maximal value. Patients had to fulfill the following inclusion criteria: at least 12 month of amenorrhea. Verification of the diagnosis of NAFLD was based on abdominal ultrosonografic examination. In addition to collecting history, study of blood lipid profile and ALT, AST, estrogen content in patients enrolled in the study free nitric oxide content in the blood and liver bioptants was determined by Electron Paramagnetic Resonance (EPR) method. The study protocol approved by the Ethics Committee of the Tbilisi State Medical University. Patients by written form confirmed their agreement to participate in the study. In patients with NAFLD levels of total cholesterol, LDL-cholesterol and triglycerides were generally increased in the blood serum, direct correlation revealed between level of NO EPR signal intensity in liver bioptat and triglycerides content in blood (r=0,96; p=0,009). It was concluded that estrogen-dependent factors, such as impaired lipid metabolism and increase expression of iNOS induce accumulation of triglycerides and free fatty acids in the liver, generation excess amounts of NO, which in oxidative stress reveal their cytotoxity and promote progression of NAFLD in postmenopausal women.