DOI: https://doi.org/10.22141/2308-2097.52.3.2018.141848

The feasibility of using ursodeoxycholic acid in the treatment of patients with non-alcoholic fatty liver disease: a clinical case

Ye.S. Sirchak

Abstract


Non-alcoholic fatty liver disease (NAFLD) is on a leading position among chronic liver diseases. In addition, the pathogenesis of NAFLD has not been fully studied for today. Some authors suggest that NAFLD is one of the components of metabolic syndrome (MS), considering it as a liver manifestation of MS. The article presents current views on the treatment of patients with NAFLD. The theoretical aspects of using ursodeoxycholic acid (UDCA) and the possibility of its application in patients with a combination of NAFLD and MS are also presented. As an example, the feasibility and efficacy of UDCA administration to the patient L. with NAFLD and MS (glucose intolerance, arterial hypertension, obesity) has been demonstrated. The prescription of Ursofalk to the patient L. is pathogenetically grounded due to the hypocholesterolemic, cytoprotective, antioxidant, anticholestatic and other its beneficial effects. UDCA can be considered as an effective and safe drug for the treatment of patients not only with NAFLD, but also with MS, diseases of the cardiovascular system and obesity.

Keywords


non-alcoholic fatty liver disease; treatment; ursodeoxycholic acid

References


Ivashkin VT, Maevskaia MV, Pavlov ChS, et al, authors; Ivashkin VT, editor. Diagnostika i lechenie nealkogol'noi zhirovoi bolezni pecheni: klinicheskie rekomendatsii [Diagnosis and treatment of nonalcoholic fatty liver disease: clinical guidelines]. Moscow: MEDpress-inform; 2015. 32 р. (in Russian).

Stepanov YuM, Nedzvetskaya NV, Yagmur VB, Klenina IA, Oshmyanskaya NYu. Noninvasive diagnosis of liver fibrosis in patients with nonalcoholic fatty liver disease. Gastroenterologìa. 2017;51(3):188-195. doi: 10.22141/2308-2097.51.3.2017.112635. (in Ukrainian).

Stepanov YuM, Nedzvetskaya NV, Yagmur VB, Klenina IA. Non-alcoholic fatty liver disease: features of metabolic changes at different stages of the disease. Gastroenterologìa. 2018;52(1):1-6. doi: 10.22141/2308-2097.52.1.2018.130772. (in Ukrainian).

Fadeenko GD, Gridnev AE. Efficacy and safety of ademetionine in the correction of liver function in patients with steatohepatitis. Results of open comparative post-marketing research. Gastroenterologìa. 2018;52 (2):27-34. (in Russian).

European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402. doi: 10.1016/j.jhep.2015.11.004.

Dragomiretska NV, Zabolotna IB, Izha GM. New potential of non-drug treatment of non-alcoholic fatty liver disease. Gastroenterologìa. 2014;(52):42-45. doi: 10.22141/2308-2097.2.52.2014.81951. (in Russian).

Asrih M, Jornayvaz FR. Inflammation as a potential link between nonalcoholic fatty liver disease and insulin resistance. J Endocrinol. 2013 Aug 28;218(3):R25-36. doi: 10.1530/JOE-13-0201.

Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism. 2016 Aug;65(8):1038-48. doi: 10.1016/j.metabol.2015.12.012.

Satapati S, Sunny NE, Kucejova B, et al. Elevated TCA cycle function in the pathology of diet-induced hepatic insulin resistance and fatty liver. J Lipid Res. 2012 Jun;53(6):1080-92. doi: 10.1194/jlr.M023382.

Stepanov YuM, Kosynska SV. Features of ursodeoxycholic acid use in various pathologies of hepatobiliary tract and other organs and systems. Gastroenterologìa. 2014;(54):129-135. doi: 10.22141/2308-2097.4.54.2014.82088. (in Ukrainian).

Kaziulin AN, Goncharenko AIu, Kaliagin IE. The use of ursodeoxycholic acid in the prevention and treatment of cholelithiasis in the practice of "first contact" physicians. RMJ. Medical Review. 2017;(2):2-11. (in Russian).

Novytska АV, Pogrebnyak OA, Odynets MA Ursodeoxycholic acid in the practice of a cardiologist. Liky Ukrai'ny. 2018;(217):19-23. (in Ukrainian).

Murakami M, Une N, Nishizawa M, Suzuki S, Ito H, Horiuchi T. Incretin secretion stimulated by ursodeoxycholic acid in healthy subjects. Springerplus. 2013 Dec;2(1):20. doi: 10.1186/2193-1801-2-20.

Wang X, Liu H, Chen J, Li Y, Qu S. Multiple Factors Related to the Secretion of Glucagon-Like Peptide-1. Int J Endocrinol. 2015;2015:651757. doi: 10.1155/2015/651757.

Ratziu V, de Ledinghen V, Oberti F, et al. A randomized controlled trial of high-dose ursodesoxycholic acid for nonalcoholic steatohepatitis. J Hepatol. 2011 May;54(5):1011-9. doi: 10.1016/j.jhep.2010.08.030.

Shima KR, Ota T, Kato KI, et al. Ursodeoxycholic acid potentiates dipeptidyl peptidase-4 inhibitor sitagliptin by enhancing glucagon-like peptide-1 secretion in patients with type 2 diabetes and chronic liver disease: a pilot randomized controlled and add-on study. BMJ Open Diabetes Res Care. 2018 Mar 17;6(1):e000469. doi: 10.1136/bmjdrc-2017-000469.

Mueller M, Thorell A, Claudel T, et al. Ursodeoxycholic acid exerts farnesoid X receptor-antagonistic effects on bile acid and lipid metabolism in morbid obesity. J Hepatol. 2015 Jun;62(6):1398-404. doi: 10.1016/j.jhep.2014.12.034.

Ozel Coskun BD, Yucesoy M, Gursoy S, et al. Effects of ursodeoxycholic acid therapy on carotid intima media thickness, apolipoprotein A1, apolipoprotein B, and apolipoprotein B/A1 ratio in nonalcoholic steatohepatitis. Eur J Gastroenterol Hepatol. 2015 Feb;27(2):142-9. doi: 10.1097/MEG.0000000000000264.

Nakagawa T, Tuttle KR, Short RA, Johnson RJ. Hypothesis: fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndrome. Nat Clin Pract Nephrol. 2005 Dec;1(2):80-6. doi: 10.1038/ncpneph0019.

Mahmoud AA, Elshazly SM. Ursodeoxycholic acid ameliorates fructose-induced metabolic syndrome in rats. PLoS One. 2014 Sep 9;9(9):e106993. doi: 10.1371/journal.pone.0106993.




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