Non-alcoholic fatty liver disease and cognitive impairment

Aim. To evaluate the efficacy of oral administration of the original ademetionine (Geptral) at a dose of 1500 mg/s in patients with NAFLD at the steatosis stage and cognitive impairment within the framework of a prospective observational open non-comparative study in real clinical practice against the background of achieved lifestyle modification.

Materials and methods. Thirty patients with NAFLD and cognitive impairment were examined using routine methods examination. NAFLD was diagnosed in accordance with the clinical guidelines of the Ministry of Health of the Russian Federation. All patients met the criteria for MAFLD. Cognitive functions were assessed using the Montreal Cognitive Assessment Scale. After selection, patients were recommended dietary and physical activity modification in combination with oral administration of the original ademetionine at a dose of 1500 mg/day. The duration of the study was 6 months.

Results. Oral administration of the original ademetionine for 6 months against the background of lifestyle modification improved cognitive functions with an increase in the Montreal Cognitive Assessment Scale score from 19.1 (16.3–20.1) to 27.6 (25.1–29.0; p=0.001). In addition, the study found a decrease in the severity of steatosis according to the FLI index and quantitative ultrasound. Additionally, a decrease in the Fatigue Assessment Scale (FAS) scores from 34 [25–39] to 19 [16–27]; p=0.000002, and 10-year fatal and non-fatal cardiovascular risk according to the SCORE2 scale from 34 [15–44] to 9 [7–13]; p=0.000002, was revealed.

Conclusion. The original ademetionine as a multitarget drug for NAFLD may be useful in terms of improving cognitive functions, increasing adherence to lifestyle modification, and improving its quality and duration.