Dynamics of changes in lipid peroxidation and antioxidant protection under the influence of complex treatment in patients with comorbid course of non-alcoholic steatohepatitis
DOI:
https://doi.org/10.14739/2310-1210.2019.3.169015Keywords:
non-alcoholic fatty liver disease, obesity, lipid peroxidation, antioxidants, ursodeoxycholic acid, arginine glutamateAbstract
O. Yu. Filippova
The aim to assess the effect of various complex treatment regimens on lipid peroxidation (LPO) and antioxidant protection (AOP) in patients with non-alcoholic steatohepatitis (NASH) in combination with obesity (OB) and biliary tract pathology (BT), based on 6-month follow-up data.
Materials and methods. We examined 100 patients with NASH in combination with OB and pathology of BT. The control group consisted of 30 practically healthy persons. Patients of all groups within 6 months have been prescribed a lifestyle correction, in particular: diet, exercise, work and rest. Patients of the 1 group (n = 34) received standard treatment for 30 days. Patients of the 2 group (n = 33) were prescribed standard treatment combined with the use of ursodeoxycholic acid (UDCA) for 30 days at a dose of 15 mg·kg-1·d-1. Patients of the 3 group (n = 33) received standard treatment and UDCA combined with the use of arginine glutamate for 30 days. All LPO-AOP were performed at the beginning and at the end of treatment in all patients and 6 months after treatment in 20 patients in each group of observation.
Results. A more significant decrease in the levels of intermediate and final products of lipid peroxidation in blood serum (from P < 0.05 to P < 0.001) was observed in patients of the 2 group and especially of the 3 group, as compared to the same values in the 1 group. The maximum effect of UDCA and glutamate arginine on the decrease in the formation of LPO toxic products in the blood was observed in the 3 group compared to the 2 group when studying the indices of diene conjugates and isolated double bonds 6 months after the treatment (P < 0.05).
Conclusions. Combination therapy (non-medicamentous and medicamentous) with the addition of UDCA and glutamate arginine to the standard treatment in the comorbid course of NASH can be considered as a promising direction in the treatment of this category of patients, which allows to restore the basic indices of lipoperoxidation and antioxidant protection.
References
Zvyaginceva, T. D., & Chernobaj, A. I. (2015). Khronicheskoe zabolevanie pecheni i oksidativnyj stress [Chronic liver disease and oxidative stress]. Zdorov’ye Ukrainy, 2, 58–59. [in Russian].
Komshilova, K. A., & Troshina, E. A. (2015). Ozhirenie i nealkogol'naya zhirovaya bolezn' pecheni: metabolicheskie riski i ikh korrekciya [Obesity and nonalcoholic fatty liver disease: metabolic risks and their correction]. Ozhirenie i metabolizm, 12(2), 35–39. [in Russian].
Kuryata, O. V., & Grechanyk, M. M. (2016). Ateroskleroz magistral'nykh arterij golovy, uroven' leptina i postprandial'naya gipertrigliceridemiya u paciyentov s ishemicheskoj bolezn'yu serdca v sochetanii s nealkogol'noj zhirovoj bolezn'yu pecheni v zavisimosti ot indeksa massy tela [Atherosclerosis of cerebral arteries, leptin levels and postprandial hypertriglyceridemia in patients with coronary heart disease combined with non-alcoholic fatty liver disease, depending on the body mass index]. Ukrainskyi terapevtychnyi zhurnal, 4(51), 55–62. [in Russian].
Promenasheva, T. E., Kolesnichenko, L. S., & Kozlova, N. M. (2014). Rol' oksidativnogo stressa i sistemy glutationa v patogeneze nealkogol'noj zhirovoj bolezni pecheni [Role of oxidative stress and glutathione system in the pathogenesis of nonalcoholic fatty liver disease]. Byulleten' Vostochno-Sibirskogo nauchnogo centra Sibirskogo otdeleniya Rossijskoj akademii medicinskih nauk, 5(99), 80–83. [in Russian].
Fadieienko, G. D., Nesen, A. O. (2015). Komorbidnist ta intehratyvna rol terapii vnutrishnikh khvorob [Comorbidity and integration role of therapy of internal diseases]. Ukrainskyi terapevtychnyi zhurnal, 2, 7–15. [in Ukrainian].
Filippova, A. Yu. (2016). Porushennia oksydatyvnoho metabolizmu ta aktyvnosti fermentatyvnykh antyoksydantiv u patsiientiv z nealkoholnym steatohepatytom v poiednanni z ozhyrinniam i patolohiieiu biliarnoho traktu [Disorders of oxidative metabolism and activity of enzymatic antioxidants in patients with non-alcoholic steatohepatitis combined with obesity and biliary tract pathology]. Ukrainskyi terapevtychnyi zhurnal, 3, 19–26. [in Ukrainian].
Filippova, A. Yu. (2016). Vzaiemozv’iazky mizh nealkoholnym steatozom pechinky, antropometrychnymy pokaznykamy ta porushenniamy u protsesakh perekysnoho okyslennia lipidiv i antyoksydantnoho zakhystu u khvorykh z oznakamy ozhyrinnia [The interaction between nonalcoholic steatosis, anthropometric indicators and disturbance of lipid peroxidation and antioxidant defense in patients with signs of obesity]. Medychni perspektyvy, 4, 54–62. [in Ukrainian].
Nan, Y. M., Fu, N., Li, W. C., Kong, L. L., Yuan, X. W., Zhang, S. Y., et al. (2017). An interpretation of the AASLD practice guideline on the diagnosis and management of nonalcoholic fatty liver disease in 2017. Zhonghua Gan. Zang. Bing. Za. Zhi, 25(9), 687–694. doi: 10.3760/cma.j.issn.1007-3418.2017.09.008
Abd El-Kader, S. M., Al-Shreef, F. M., & Al-Jiffri, O. H. (2016). Biochemical parameters response to weight loss in patients with non-alcoholic steatohepatitis. Afr Health Sci, 16(1), 242–249. doi: 10.4314/ahs.v16i1.32
Carr, R. M., Oranu, A., & Khungar, V. (2016). Nonalcoholic Fatty Liver Disease: Pathophysiology and Management. Gastroenterol Clin North Am, 45(4), 639–652. doi: 10.1016/j.gtc.2016.07.003
Della Corte, C., Mazzotta, A. R., & Nobili, V. (2016). Fatty liver disease and obesity in youth. Curr Opin Endocrinol Diabetes Obes, 23(1), 66–71. doi: 10.1097/MED.0000000000000221
Diehl, A. M., & Day, C. (2017) Cause, Pathogenesis, and Treatment of Nonalcoholic Steatohepatitis. N Engl J Med, 377(21), 2063–2072. doi: 10.1056/NEJMra1503519
Younossi, Z., Anstee, Q. M., Marietti, M., & Hardy, T. (2018). Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol, 15(1), 11–20. doi: 10.1038/nrgastro.2017.109
Lazaridis, N., & Tsochatzis, E. (2017). Current and future treatment options in non-alcoholic steatohepatitis (NASH). Expert Rev Gastroenterol Hepatol, 11(4), 357–369. doi: 10.1080/17474124.2017.1293523
Manne, V., Handa, P., & Kowdley, K. V. (2018). Pathophysiology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Clin. liver Dis, 22(1), 23–37. doi: 10.1016/j.cld.2017.08.007
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