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Ursodeoxycholic acid as a means of preventing atherosclerosis,steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2021年第10期27卷 959-975页

作者： Maria Nadinskaia Marina Maevskaya Vladimir Ivashkin Khava Kodzoeva Irina Pirogova Evgeny Chesnokov Alexander Nersesov Jamilya Kaibullayeva Akzhan Konysbekova Aigul Raissova feruza khamrabaeva Elena Zueva Department of Propaedeutics of Internal Diseases Gastroenterology and HepatologySechenov First Moscow State Medical University(Sechenov University)Moscow 119991Russia Vasilenko Clinic of Internal Diseases Propedeutics Gastroenterology and HepatologyUniversity Clinical Hospital№2Sechenov First Moscow State Medical University(Sechenov University)Moscow 119991Russia LLC MC“Lotus” Center for Gastroenterology and HepatologyChelyabinsk 454092Russia Department of Hospital Therapy with the Course of Endocrinology and Clinical Pharmacology Tyumen State Medical UniversityTyumen 625003Russia Department of Gastroenterology S.Asfendiyarov Kazakh National Medical UniversityAlmaty 050000Kazakhstan Functional and Ultrasound Diagnostics Scientific and Research Institute of Cardiology and Internal DiseasesAlmaty 050000Kazakhstan Department of Internal Diseases Scientific and Research Institute of Cardiology and Internal DiseasesAlmaty 050000Kazakhstan Faculty of Therapy Tashkent Institute of Advanced Medical StudiesTashkent 100007Uzbekistan Department of Therapy№1 with Training General Practitioners Tashkent Medical AcademyTashkent 100109Uzbekistan

BACKGROUND Atherosclerotic cardiovascular disease(ASCVD)is the leading cause of mortality in patients with nonalcoholic fatty liver disease(NAFLD).Weight loss is a key factor for successful NAFLD and CVD *** acid(UDCA),which is one of the first-line therapeutic agents for treatment of NAFLD,is reported to have a beneficial effect on dyslipidemia and ASCVD risk because of antioxidant *** To evaluate the effects of 6 mo of UDCA treatment on hepatic function tests,lipid profile,hepatic steatosis and fibrosis,atherogenesis,and ASCVD risk in men and women with NAFLD,as well as to assess the impact of>5%weight reduction on these *** An open-label,multicenter,international noncomparative trial was carried out at primary health care settings and included 174 patients with ultrasound-diagnosed NAFLD who received 15 mg/kg/d UDCA for 6 mo and were prescribed lifestyle modification with diet and *** efficacy criteria were liver enzymes,lipid profile,fatty liver index(FLI),noninvasive liver fibrosis tests(nonalcoholic fatty liver disease fibrosis score and liver fibrosis index),carotid intima-media thickness(CIMT),and ASCVD risk *** test statistical hypotheses,the Wilcoxon test,paired t-test,Fisher’s exact test,and Pearson's chi-squared test were *** The alanine aminotransferase(ALT)level changed by-14.1 U/L(-31.0;-5.3)from baseline to 3 mo and by-6.5 U/L(-14.0;0.1)from 3 to 6 *** magnitude of ALT,aspartate transaminase,and glutamyltransferase decrease was greater during the first 3 mo of treatment compared to the subsequent 3 mo(P<0.001,P<0.01,P<0.001,respectively).At 6 mo,in the total sample,we observed a statistically significant decrease in body weight and levels of FLI:84.9±10.4 vs 72.3±17.6,P<0.001,total cholesterol:6.03±1.36 vs 5.76±1.21,Р<0.001,lowdensity lipoprotein:3.86±1.01 vs 3.66±0.91,Р<0.001,and triglyceride:3.18(2.00;4.29)vs 2.04(1.40;3.16),Р<*** effect on nonalcoholic fatty liver disease

关键词： Ursodeoxycholic acid Nonalcoholic fatty liver disease Liver function tests Fatty liver index Carotid intima-media thickness Atherosclerotic cardiovascular disease

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