Diagnostic capabilities and treatment strategies depending on the form of nonalcoholic fatty liver disease in patients with hypertonic disease

Maksimova EV Crimean Federal

Abstract

Objective: to provide data corroborating the relationship between non-alcoholic fatty liver disease (NAFLD) (in particular, non-alcoholic steatohepatitis (NASH)) and diseases of the cardiovascular system (in particular, hypertonic disease) and to study the prevalence of NAFLD in patients with hypertonic disease in Republic of Crimea and to compare the effectiveness of different strategies of treatment of NAFLD. Materials and methods: The study included 100 patients with hypertonic disease stage II 2 degree. Dyslipidemia was registered in 65 % of patients. All patients underwent ultrasound of the abdomen, biochemical blood analysis, blood tests for markers of viral hepatitis, and 13C-metathetin breath test. Frequency of NAFLD in the studied population was 55 %, in the group with hypercholesterolemia – 45 persons (69.2 %). Among them, the patients were divided into 2 groups: 1 GR (n =22) with NASH received rosuvastatin 10 mg at bedtime, essential phospholipids 2 caps. x 3 t/d; Group 2 (n =23) without NASH received vitamin E 400 IU 2 t/d for 1 month and rosuvastatin 20 mg at night, for 6 months.] Results of the study: After 6 months of treatment comparable results were obtained in both groups: normal levels of transaminases and decreased total cholesterol and lipid profile parameters in 90.9 % of patients 1 GR vs. 91.3% of patients 2 GR, as well as improvement in the 13C-metathetin breath test that indicates the increase in mass of functioning hepatocytes. Conclusion: Considering the high incidence of NAFLD in patients with cardiovascular disorders, especially in combination with hypercholesterolemia, it is useful in complex survey of patients include abdominal ultrasound, 13C-metathetin breath test, as well as determining of the level of transaminases, bilirubin, alkaline phosphatase and GGT. In the presence of NASH it is advisable to include essential phospholipids in therapy; in case of steatosis it is advisable to include vitamin E for 1 month which will reduce overall and cardiovascular mortality

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