Possibilities for the use of ursodeoxycholic acid in the treatment of patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease
- 作者: Rasskazova M.1, Vorobyev S.2, Butova H.2
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隶属关系:
- City Hospital №6
- Rostov State Medical University
- 期: 卷 95, 编号 4 (2023)
- 页面: 316-321
- 栏目: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/132922
- DOI: https://doi.org/10.26442/00403660.2023.04.202125
- ID: 132922
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Aim. To investigate the effect of ursodeoxycholic acid (UDCA) on the degree of steatosis, indicators of carbohydrate, lipid metabolism, body weight in patients with type 2 diabetes mellitus (DM) in combination with non-alcoholic fatty liver disease (NAFLD).
Materials and methods. A prospective cohort comparative study included 36 patients with DM and NAFLD. Patients received UDCA at a dose of 15 mg/kg/day for 6 months, and also followed the recommendations for lifestyle changes through diet and exercise. To compare the results obtained during the study, a control group of patients was recruited that met the criteria for inclusion in the study. The statistical analysis included an assessment of the normality of the distribution of quantitative indicators, followed by the determination of the mean values and standard deviation or medians and quartiles, depending on the nature of the distribution, the reliability coefficient was determined by the Student, by Wilcoxon. Statistical processing was carried out in the Statistica 10 program.
Results. According to the results of the study, a positive trend was noted in the change in the severity of fatty hepatosis. During the study, a statistically significant decrease in the level of ALT, AST was achieved in the group receiving UDCA (Ursofalk). The results of our study showed that the inclusion of UDCA (Ursofalk) in complex hypoglycemic therapy provides an additional improvement in carbohydrate metabolism. The obtained indicators in the course of the study demonstrate the positive effect of UDCA on weight loss. The greatest result was achieved in reducing waist, which is a positive prognostic factor in reducing the development and progression of NAFLD, diabetes and cardiovascular diseases. Positive changes were observed in relation to the lipid profile.
Conclusion. The study demonstrated the positive effect of the drug UDCA (Ursofalk) on reducing the degree of liver steatosis, on carbohydrate, lipid metabolism, body weight in patients with DM in combination with NAFLD.
作者简介
Maria Rasskazova
City Hospital №6
Email: abutova@yandex.ru
ORCID iD: 0000-0002-2085-6055
врач-эндокринолог
俄罗斯联邦, Rostov-on-DonSergey Vorobyev
Rostov State Medical University
Email: abutova@yandex.ru
ORCID iD: 0000-0001-7884-2433
д-р мед. наук, проф., зав. каф. эндокринологии (с курсом детской эндокринологии)
俄罗斯联邦, Rostov-on-DonHelen Butova
Rostov State Medical University
编辑信件的主要联系方式.
Email: abutova@yandex.ru
ORCID iD: 0009-0000-2670-3642
канд. мед. наук, доц. каф. гастроэнтерологии и эндоскопии
俄罗斯联邦, Rostov-on-Don参考
- Lazo M, Solga S, Horska A, et al. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care. 2010;33:2156-63. doi: 10.2337/dc10-0856
- Musso G, Gambino R, Cassader M. Non-alcogolic fatty liver disease from pathogenesis to management: an update. Obes Rev. 2010;11:430-45. doi: 10.1111/j.1467-789X.2009.00657.x
- Маевская М.В., Котовская Ю.В., Ивашкин В.Т., и др. Национальный Консенсус для врачей по ведению взрослых пациентов с неалкогольной жировой болезнью печени и ее основными коморбидными состояниями. Терапевтический архив. 2022:94(2):216-53 [Maevskaya MV, Kotovskaya YuV, Ivashkin VT, et al. The National Consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(2):216-53 (in Russian)]. doi: 10.26442/00403660.2022.02.201363
- Бакулин И.Г., Сандлер Ю.Г., Кейян В.А., и др. Оценка стеатоза печени с помощью неинвазивного метода: миф или реальность? Доктор.Ру. Гастроэнтерология. 2015;12(113):57-64 [Bakulin IG, Sandler YuG, Keiyan VA, et al. Noninvasive assessment of hepatic steatosis: myth or reality? Doctor.ru. Gastroenterology. 2015;12(113):57-64 (in Russian)].
- Lupşor-Platon M, Stefănescu H, Mureșan D, et al. Noninvasive assessment of liver steatosis using ultrasound method. Med Ultrason. 2014;16(3):236-45. doi: 10.11152/mu.2013.2066.163.1mlp
- Кащенко В.А., Мицинская А.И., Соколов А.Ю., и др. Ожирение и неалкогольная жировая болезнь печени: возможности терапевтического лечения. Сибирское медицинское обозрение. 2020;3:20-9 [Kaschenko VA, Mitsinskaya AI, Sokolov AY, et al. Obesity and non-alcoholic fatty liver disease: therapeutic options. Siberian Medical Review. 2020;3:20-9 (in Russian)]. doi: 10.20333/2500136-2020-3-20-29
- Mahfood Haddad T, Hamdeh S, Kanmanthareddy A, Alla VM. Nonalcoholic fatty liver disease and the risk of clinical cardiovascular events: A systematic review and meta-analysis. Diabetes Metab Syndr. 2017;11(Suppl. 1):S209-16. doi: 10.1016/j.dsx.2016.12.033
- Ratziu V, de Ledinghen V, Oberti F, et al. FRESGUN. A randomized controlled trial of high-dose ursodesoxycholic acid for nonalcoholic steatohepatitis. J Hepatol. 2011;54(5):1011-9. doi: 10.1016/j.jhep.2010.08.030
- Simental-Mendía LE, Simental-Mendía M, Sánchez-García A, et al. Impact of ursodeoxycholic acid on circulating lipid concentrations: a systematic review and meta-analysis of randomized placebo-controlled trials. Lipids Health Dis. 2019;18(1):88. doi: 10.1186/s12944-019-1041-4
- Sánchez-García A, Sahebkar A, Simental-Mendía M, Simental-Mendía LE. Effect of ursodeoxycholic acid on glycemic markers: A systematic review and meta-analysis of clinical trials. Pharmacol Res. 2018;135:144-9. doi: 10.1016/j.phrs.2018.08.008
- Shima KR, Ota T, Kato K, 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;6(1):e000469. doi: 10.1136/bmjdrc-2017-000469
- Wu P, Zhao J, Guo Y, et al. Ursodeoxycholic acid alleviates nonalcoholic fatty liver disease by inhibiting apoptosis and improving autophagy via activating AMPK. Biochem Biophys Res Commun. 2020;529(3):834-8. doi: 10.1016/j.bbrc.2020.05.128
- Trauner M, Claudel T, Fickert P, et al. Bile acids as regulators of hepatic lipid and glucose metabolism. Dig Dis. 2010;28(1):220-4. doi: 10.1159/000282091
- Драпкина О.М., Фомичева Е.И. Мембранный рецептор желчных кислот TGR5 – новая мишень в изучении метаболических воспалительных и опухолевых заболеваний. Рациональная фармакотерапия в кардиологии. 2016;12(3):344-50 [Drapkina OM, Fomicheva EI. Membrane bile acid receptor TGR5-A new target in the study of metabolic, inflammatory and neoplastic diseases. Rational Pharmacotherapy in Cardiology. 2016;12(3):344-50 (in Russian)]. doi: 10.20996/1819-6446-2016-12-3-344-350
- Zhang Y, Lee FY, Barrera G. Activation of the nuclear receptor FXR improves hyperglycemia and hyperlipidemia in diabetic mice. Proc Natl Acad Sci U S A. 2006;103(4):1006-11. doi: 10.1073/pnas.0506982103
- Duran-Sandoval D, Cariou B, Percevault F, et al. The farnesoid receptor X modulates carbohydrate metabolism in the liver during the transition from fasting to resuming nutrition. J Biol Chem. 2005;280:29971-9. doi: 10.1074/jbc.M501931200
- Ma K, Saha PK, Chan L, Moore DD. Farnesoid X receptor is essential for normal glucose homeostasis. J Clin Invest. 2006;116:1102-9. doi: 10.1172/JCI25604