Tetiana Aleksandrova

EDUCATION

MD, General Medicine; PhD, Internal Medicine

RESEARCH, TEACHING, or OTHER INTERESTS

Internal Medicine, General Medicine, Cardiology and Cardiovascular Medicine, Gastroenterology

Scopus Publications

The Influence of Epigenetic Mechanisms on the Development of Metabolic Dysfunction Associated Steatotic Liver Disease: A Review
Natalia Zhelezniakova, Tetiana Aleksandrova
Journal of Gastrointestinal and Liver Diseases, 2026
Metabolic dysfunction-associated steatotic liver disease (MASLD) occupies a leading place in the structure of modern hepatology. A growing body of literature identifies MASLD as a global epidemic. Accumulated data from studies in the field of hepatology support the idea that MASLD is a hepatic manifestation of a systemic metabolic disease. MASLD is a multifactorial metabolic disease associated with the presence of insulin resistance, abdominal obesity, oxidative stress, endothelial dysfunction and a systemic inflammatory response. Current scientific data demonstrate the existence of a relationship between MASLD and an increased risk of developing cardiovascular disease, regardless of traditional risk factors such as diabetes mellitus, dyslipidemia, obesity and hypertension. The pathogenesis of MASLD includes the development of hepatic steatosis with subsequent progression to metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Epigenetics, a new field of biology that studies the influence of external factors on gene activity without changing in deoxyribonucleic acid (DNA) sequences, offers a new perspective on the pathogenesis of MASLD. This review summarizes current knowledge on the epigenetic determinants of MASLD, such as DNA methylation, histone modifications, noncoding ribonucleic acids (RNAs) and N6-methyladenosine in patients with MASLD which may also contribute to the development of preventive or therapeutic strategies for MASLD-associated complications.
Clinical efficacy of S-adenosyl-L-methionine and antihypertensive combination treatment in patients with comorbid course of metabolic-associated steatotic liver disease and arterial hypertension
T. M. Aleksandrova, N. M. Zhelezniakova, K. O. Prosolenko, V. I. Molodan, G. Y. Panchenko, et al.
Ukrainian Therapeutical Journal, 2025
Objective — to determine the likely effect of S‑adenosyl‑L‑methionine (SAMe) and antihypertensive combination treatment on the clinical course, liver enzymatic activity (the levels of aspartate aminotransferase, alanine aminotransferase, gamma‑glutamyl transpeptidase, alkaline phosphatase), nonalcoholic steatohepatitis activity and the stage of liver fibrosis (LF) stage in patients with metabolic dysfunction‑associated steatotic liver disease (MASLD) and arterial hypertension (AH) comorbid course. Materials and methods. We examined 40 patients with MASLD and AH comorbid course before and after 5 months of the SAMe and antihypertensive combination treatment. The control group comprised 20 apparently healthy people. Patients with viral hepatitis, liver cirrhosis, alcoholic liver disease, AH stage III, and liver fibrosis stage F3—4 were excluded. Liver cytolysis indicators analyses were performed using biochemical techniques. The severity of liver fibrosis was assessed using transient elastography results. Results. Analysis of SAMe and antihypertensive combination treatment in patients with MASLD and AH demonstrated a significant improvement in the clinical course of the disease (reduction in complaints of increased fatigue, headache, general weakness, right upper quadrant pain, sleep disturbance and mood worsening (p<0.05)), significant decrease of systolic blood pressure (p<0.01), diastolic blood pressure (p<0.05), body mass index (p<0.05) and waist‑to‑hip ratio (p=0.05), liver cytolysis indicators such as aspartate aminotransferase (p<0.01), alanine aminotransferase (p<0.01), gamma‑glutamyl transpeptidase (p<0.01) and alkaline phosphatase (p<0.05). Also, a decrease in nonalcoholic steatohepatitis activity (p<0.05) and regression of the liver fibrosis stage (p<0.05) were observed. Conclusions. The results of SAMe and combined antihypertensive therapy show the improvement of the clinical course of the disease, liver function, and the regression of the liver fibrosis stage. Therefore, the inclusion of SAMe in standard antihypertensive therapy of patients with a comorbid course of MASLD and AH is an appropriate treatment method as a pathogenetic drug with a pronounced cytoprotective, anti‑inflammatory, and antifibrotic effect.
The association of systemic inflammatory biomarkers with metabolic dysfunction-associated steatotic liver disease and arterial hypertension
T. M. Aleksandrova, N. M. Zhelezniakova, K. O. Prosolenko, M. O. Vizir, O. A. Chervona
Ukrainian Therapeutical Journal, 2024
Objective — to explore the relationship between metabolic dysfunction‑associated steatotic liver disease (MASLD) on the background of arterial hypertension (AH) and blood inflammatory markers including C‑reactive protein (CRP), Interleukin‑6 (IL‑6), IL‑4, haptoglobin and pentraxin‑3 (PTX‑3).Materials and methods. We examined 102 patients with MASLD. They were divided into 3 groups: group A included 52 patients with isolated MASLD, group B — 23 patients with MASLD and AH stage I, and group C — 27 patients with MASLD and AH stage II. The control group (group D) comprised 20 apparently healthy people. Patients with viral hepatitis, liver cirrhosis, alcoholic liver disease, and AH stage III were excluded. Systemic inflammatory biomarkers analyses were performed using electrochemiluminescence, immunoenzymatic, and immunoturbidimetry techniques.Results. The systemic inflammatory biomarkers analyses revealed significantly higher levels of CRP (p=0.001), IL‑6 (p=0.01), haptoglobin (p<0.05) and PTX‑3 (p<0.01) and decreased levels of IL‑4 (p<0.05) in group B and group C in comparison with the group A and control group (p1 <0.01, p2=0.01). Also, there was a significant increase of CRP (p=0.01), IL‑6 (p=0.01), and PTX‑3 levels (p<0.05) in group B compared with group C. However, the relationship between the IL‑4 (p>0.05) and haptoglobin (p>0.05) levels and the progression of the AH stages have not been confirmed in our study.Conclusions. Our findings indicate the direct relationship between the systemic inflammatory biomarkers’ involvement in developing liver tissue inflammation and the further progression of MASLD. The obtained data indicate the relationship of AH and its stages with the development of chronic systemic inflammatory response in patients with MASLD and AH comorbid course.
Endothelial functional status in patients with a comorbid course of metabolic dysfunctionassociated steatotic liver disease and arterial hypertension
N. M. Zhelezniakova, T. M. Aleksandrova, V. I. Molodan, G. Y. Panchenko
Ukrainian Therapeutical Journal, 2024
Objective — to investigate endothelial functional state in patients with a comorbid course of metabolic dysfunctionassociated steatotic liver disease (MASLD) and arterial hypertension (AH).Materials and methods. Examinations involved 102 patients, who were allocated into three groups: the main group included 40 patients with MASLD and AH comorbid course; the comparison group consisted of 42 patients with isolated MASLD course, and control group included 20 relatively healthy subjects. The mean patients’ age was 46.23±9.3 years. All patients underwent a collection of complaints, anamnesis, physical and general clinical examination, measurement of blood pressure (BP), daily BP monitoring, determination of endothelial dysfunction indicators (endothelial nitric oxide synthase (eNOS), uric acid (UA), fibrinogen, endotheliumdependent vasodilation of the brachial artery (EDV BA).Results. Significantly decreased levels of eNOS (p=0.001), EDV BA (p=0.001), and increased levels of UA (p <0.05) and fibrinogen (p <0.05) were revealed in the groups of patients with MASLD and AH combined course in comparison with the group of patients with isolated MASLD, as well as in comparison of these groups with the control group (p1 <0.01, p2 <0.01). Thus, the average eNOS levels in patients with comorbid pathology was 295.6±35.67 pg/ml, 356.7±28.34 pg/ml in the group of patients with isolated MASLD and 431.5±25.65 pg/ml in the control group. The average of EDV BA levels among examined patients were the following: 2.11±0.67% in patients with MASLD and AH, 2.15±0.48% in the group of isolated MASLD, and 3.07±0.56% in the control group. The following average UA level were defined: 406.4±25.6 µmol/l in patients with comorbid pathology, 369.3±27.8 µmol/l in the group of patients with MASLD, and (308, 9±15.7) µmol/l in the control group. The average level of fibrinogen in patients with the comorbid course of MASLD and AH was 4.4±1.4 g/l, 3.8±1.3 g/l in patients with isolated MASLD, and 2, 4±1.1 g/l in the control group. In addition, significantly decreased levels of eNOS (p=0.01), EDV BA (p=0.01), and increased levels of UA (p <0.01) were found in patients with MASLD against the background of AH stage II in comparison with patients with MASLD and AH stage I.Conclusions. Analysis of the levels of indicators of endothelial functional state demonstrated correlation between endothelial dysfunction and MASLD development and progression of AH in patients with MASLD and AH comorbid course.
Current state and prospects of implementation of data standardization in the health care system of Ukraine (literature review)
D.Ye. Kaduk, T.M. Aleksandrova, P.S. Talapova, I.B. Agieieva, M.M. Ved, et al.
Medicni Perspektivi, 2023
The orientation of the world medical community, and Ukraine in particular, towards the improvement of the quality of medical services includes the introduction of modern tools and methods for quality regulation in the healthcare system. The focus of research on the modernization of medical services, methods and forms of treatment and diagnosis, as well as focus on global experience in regulating the quality of services provided by relevant institutions, undoubtedly contributes to the transition of the Ukrainian healthcare system to a new level. One of the most powerful and modern ways to improve the medical health care system is to introduce the standardization of the format and content of medical data. Quality implementation of the standardization program is a leading factor in the improvement of the quality of medical services, such as: early detection of diseases and emergencies, setting new therapeutic goals, improving the quality of clinical trials, improving of assessment of the quality of medical services and work of the doctors and nursing staff, improving the efficiency of health care programs, improving the safety of use of medical devices, forecasting medical consequences, reducing administrative costs, integrating artificial intelligence into the healthcare system, etc.

Publications

1. Kaduk D. E., Aleksandrova T. M., Talapova P. S., Ageeva I. B., Ved M. M., Trofymenko M. O.,
Kolesnyk M. R., Nesmiyan T. S. (2023). Current status and prospects for the implementation of
data standardization in the healthcare system of Ukraine (literature review) // Medical
Perspectives. ─ 2023. ─ Vol. 28, No. 3. ─ P. 190─198.

2. Zheleznyakova N. M., Aleksandrova T. M., Molodan V. I., Panchenko G. Yu. (2024). Functional
state of the endothelium in patients with combined course of steatotic liver disease associated
with metabolic dysfunction and hypertension. Ukrainian Therapeutic Journal. 2024;2:22-27.

3. Aleksandrova T. M., Zhelezniakova N. M., Prosolenko K. O., Vizir M. O., Chervona O. A.
(2024). The association of systemic inflammatory biomarkers with metabolic dysfunctionassociated
steatotic liver disease and arterial hypertension. Ukrainian Therapeutic Journal.
2024;3:41-45.

4. Aleksandrova T.M., Zhelezniakova N.M., Prosolenko K.O., Molodan V.I, Panchenko G.Y., Vizir
M.O., Molodan D.V. (2025). Clinical efficacy of S-adenosyl-L-methionine and antihypertensive
combination treatment in patients with comorbid course of metabolic associated steatotic liver
disease and arterial hypertension // Ukrainian therapeutic journal. – 2025. – No. 2. - C. 18─24.

RESEARCH OUTPUTS (PATENTS, SOFTWARE, PUBLICATIONS, PRODUCTS)

1. Literary written work of a scientific nature “Research algorithm for non-invasive diagnostics of fibrosis in patients with non-alcoholic fatty liver disease”: author’s certificate for scientific work No. 127511 Ukraine / Zheleznyakova N.M., Aleksandrova T.M., Prosolenko K.O., Molodan V.I., Frolova-Romanyuk. E.Yu., Vizir M.O. (UA); applicant and owner Kharkiv National Medical University. – Registered on 06/17/2024 in the State Register of Certificates of Registration of Copyright for a Work. – Electronic document with identifier: CR2184170624

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2. Questionnaire for the level of satisfaction with the results of the educational component “Fundamentals of Cardiology” for 4th year students of the second (master's) level of higher education in the specialty 222 Medicine: author's certificate for a scientific work No. 139005 Ukraine / Zheleznyakova N.M., Vizir. M.O., Prosolenko K.O., Molodan V.I., Hoptsii O.V., Aleksandrova T.M. (UA) ; applicant and owner Kharkiv National Medical University. – Registered on 08/25/2025 in the State Register of Certificates of Registration of Copyright for a Work. – Electronic document with identifier: CR3135250825