Received: July 16, 2026
Accepted for publication: August 27, 2026
Published online: September 30, 2026
UDC: 616.36-008.6
DOI: 10.26212/2227-1937.2026.77.26.009
METABOLIC SYNDROME IN ADULTS AND THE ELDERLY: THE IMPACT OF LIFESTYLE ON LIVER FUNCTION TAKING INTO ACCOUNT THE CHARACTERISTICS OF THE COURSE OF TUBERCULOSIS (LITERATURE REVIEW)
K.M. Gazizova ᶥ, V.S. Rakhmetova ᶥ, D.S. Smailova ²
ᶥ Astana Medical University, Astana, Kazakhstan
²Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Introduction. Metabolic syndrome remains a major medical and social challenge in the context of population ageing. Age-related changes in body composition, insulin resistance, abdominal obesity, and disorders of lipid and carbohydrate metabolism increase the risk of metabolic dysfunction and liver injury. In patients with tuberculosis, nutritional status, changes in body weight, and potential drug-related hepatic burden are additional clinically relevant factors.
Objective. To analyse current evidence on metabolic syndrome in adults and older people, liver functional status in metabolic disorders, the role of diet and lifestyle, and the specific features of metabolic status in patients with tuberculosis.
Materials and Methods. A narrative review of domestic and international publications indexed in PubMed, Scopus, Web of Science, and Google Scholar was conducted. The main search covered the last 10 years; earlier publications were included when they had fundamental or historical relevance. Search terms addressed metabolic syndrome, ageing, liver, nutrition, lifestyle, and tuberculosis. Full-text original studies, systematic reviews, meta-analyses, clinical guidelines, and epidemiological studies relevant to the review objective were considered.
Results. Age-related physiological changes, including loss of muscle mass, changes in body composition, and reduced hepatic functional reserve, modify the course of metabolic syndrome and limit risk assessment based on body mass index alone. A comprehensive assessment of waist circumference, visceral adiposity, body composition, and laboratory markers is more informative. Balanced nutrition, regular physical activity, smoking cessation, and minimisation of alcohol consumption are associated with a more favourable metabolic profile and less severe hepatic steatosis. In patients with tuberculosis, weight gain during treatment may reflect clinical recovery, whereas excessive post-treatment weight gain may be accompanied by increased cardiometabolic risk.
Discussion. The available evidence is heterogeneous with respect to study design, age distribution, and diagnostic criteria. Metabolic liver disease in older people from different ethnic groups, including Central Asian populations, and the coexistence of metabolic syndrome with tuberculosis and anti-tuberculosis treatment remain insufficiently studied. The predominance of observational evidence limits causal interpretation of the reported associations.
Conclusion. Metabolic risk in adults and older people is determined by the combined effects of age, body composition, diet, physical activity, and liver functional status. In patients with tuberculosis, longitudinal monitoring of body weight, waist circumference, carbohydrate and lipid metabolism, and liver function is advisable. Lifestyle and dietary modification should be considered an important component of prevention and management of metabolic disorders.
Keywords: metabolic syndrome, older adults, ageing, liver, lifestyle, nutrition, tuberculosis.
