Применение комплекса аминокислот, холина и витаминов группы B для улучшения ранней стадии стеатозного заболевания печени, сопряженного с метаболической дисфункцией*

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Метаболически ассоциированная жировая болезнь печени (МАЖБП) стала наиболее распространенной причиной хронических заболеваний печени во всем мире, затронув, по оценкам, 25% населения планеты. До 80% случаев МАЖБП развиваются бессимптомно и могут не сопровождаться биохимическими отклонениями. Это значит, что МАЖБП часто протекает незаметно до появления осложнений, что затрудняет ее раннюю диагностику. Изменение образа жизни, включая изменение рациона питания, регулярную физическую активность и устойчивое снижение веса, – основа лечения МАЖБП. Однако в настоящее время во всем мире все еще не существует универсальной стандартизированной фармакологической терапии МАЖБП, и лечение по-прежнему основывается в первую очередь на изменении образа жизни. Ожидается, что аминокислоты и комплекс витаминов группы B будут эффективны при лечении ранних стадий стеатогепатоза и стеатогепатита, снижая уровень аминотрансфераз и уменьшая накопление жировых клеток в печени.

Данная статья публикуется в журнале Consilium Medicum на русском языке с разрешения правообладателей. Исходная статья: Murane N, Sprudza KL, Ivanova J, Zalizko P. Complex of Amino Acids, Choline, and B-Group Vitamins for the Improvement of Early-Stage Metabolic Dysfunction-Associated Steatotic Liver Disease. Health. 2025;17:1252-71. DOI: 10.4236/health.2025.1710083 распространяется на условиях лицензии CC BY 4.0.

Об авторах

Natalija Murane

Университет Латвии

Email: polina.zalizko@lu.lv

студентка VI курса

Латвия, Рига

Klinta Luize Sprudza

Рижский университет им. Паула Страдыня

Email: polina.zalizko@lu.lv
ORCID iD: 0009-0001-6686-021X

д-р мед. наук, фак-т медицины

Латвия, Рига

Jelena Ivanova

Рижский университет им. Паула Страдыня; Клиника «Оливия»

Email: polina.zalizko@lu.lv

гастроэнтеролог, Центр гастроэнтерологии, гепатологии и нутрициологии Клинической университетской больницы

Латвия, Рига; Рига

Polina Zalizko

Университет Латвии; Рижский университет им. Паула Страдыня; Клиника «Оливия»

Автор, ответственный за переписку.
Email: polina.zalizko@lu.lv
ORCID iD: 0000-0003-3657-6418

д-р мед. наук, доц. каф. внутренних болезней, Центр гастроэнтерологии, гепатологии и нутрициологии Клинической университетской больницы

Латвия, Рига; Рига; Рига

Список литературы

  1. Rinella ME, Lazarus JV, Ratziu V, et al. A Multisociety Delphi Consensus Statement on New Fatty Liver Disease Nomenclature. Hepatology. 2023;78:1966-86. doi: 10.1097/HEP.0000000000000520
  2. Rinella ME, Sookoian S. From NAFLD to MASLD: Updated Naming and Diagnosis Criteria for Fatty Liver Disease. J Lipid Res. 2024;65(1):100485. doi: 10.1016/j.jlr.2023.100485
  3. Li J, Zou B, Yeo YH, et al. Prevalence, Incidence, and Outcome of Non-Alcoholic Fatty Liver Disease in Asia, 1999–2019: A Systematic Review and Meta-Analysis. Lancet Gastroenterol Hepatol. 2019;4:389-98. doi: 10.1016/s2468-1253(19)30039-1
  4. Hydes T, Alam U, Cuthbertson DJ. The Impact of Macronutrient Intake on Non-Alcoholic Fatty Liver Disease (NAFLD): Too Much Fat, Too Much Carbohydrate, or Just Too Many Calories? Front Nutr. 2021;8:640557. doi: 10.3389/fnut.2021.640557
  5. Li Y, Yang P, Ye J, et al. Updated Mechanisms of MASLD Pathogenesis. Lipids Health Dis. 2024;23(1):117. doi: 10.1186/s12944-024-02108-x
  6. Wang D, Xu Y, Zhu Z, et al. Changes in the Global, Regional, and National Burdens of NAFLD from 1990 to 2019: A Systematic Analysis of the Global Burden of Disease Study 2019. Front Nutr. 2022;9:1047129. doi: 10.3389/fnut.2022.1047129
  7. Huang DQ, Singal AG, Kono Y, et al. Changing Global Epidemiology of Liver Cancer from 2010 to 2019: NASH Is the Fastest Growing Cause of Liver Cancer. Cell Metab. 2022;34(7):969-77.e2. doi: 10.1016/j.cmet.2022.05.003
  8. Ge X, Zheng L, Wang M, et al. Prevalence Trends in Non-Alcoholic Fatty Liver Disease at the Global, Regional and National Levels, 1990–2017: A Population-Based Observational Study. BMJ Open. 2020;10(8):e036663. doi: 10.1136/bmjopen-2019-036663
  9. Wang T, George J, Zheng M. Metabolic (Dysfunction) Associated Fatty Liver Disease: More Evidence and a Bright Future. Hepatobiliary Surg Nutr. 2021;10(6):849-52. doi: 10.21037/hbsn-21-352
  10. Quek J, Chan KE, Wong ZY, et al. Global Prevalence of Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis in the Overweight and Obese Population: A Systematic Review and Meta-analysis. Lancet Gastroenterol Hepatol. 2023;8(1):20-30. doi: 10.1016/s2468-1253(22)00317-x
  11. Kleiner DE, Brunt EM, Van Natta M, et al. Design and Validation of a Histological Scoring System for Non-alcoholic Fatty Liver Disease. Hepatology. 2005;41(6):1313-21. doi: 10.1002/hep.20701
  12. Siddiqui MS, Harrison SA, Abdelmalek MF, et al. Case Definitions for Inclusion and Analysis of Endpoints in Clinical Trials for Nonalcoholic Steatohepatitis through the Lens of Regulatory Science. Hepatology. 2018;67(5):2001-12. doi: 10.1002/hep.29607
  13. European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD) and European Association for the Study of Obesity (EA-SO) (2016) EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. J Hepatol. 2016;64(6):1388-402. doi: 10.1016/j.jhep.2015.11.004
  14. Wong VW, Chan W, Chitturi S, et al. Asia-Pacific Working Party on Non-Alcoholic Fatty Liver Disease Guidelines 2017 – Part 1: Definition, Risk Factors and Assessment. J Gastroenterol Hepatol. 2018;33(1):70-85. doi: 10.1111/jgh.13857
  15. Chalasani N, Younossi Z, Lavine JE, et al. The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-57. doi: 10.1002/hep.29367
  16. Zatloukal K, French SW, Stumptner C, et al. From Mallory to Mallory-Denk Bodies: What, How and Why? Exp Cell Res. 2007;313(10):2033-49. doi: 10.1016/j.yexcr.2007.04.024
  17. Brown GT, Kleiner DE. Histopathology of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis. Metabolism. 2016;65(8):1080-6. doi: 10.1016/j.metabol.2015.11.008
  18. Radu F, Potcovaru C, Salmen T, et al. The Link between NAFLD and Metabolic Syndrome. Diagnostics (Basel). 2023;13(4):614. doi: 10.3390/diagnostics13040614
  19. Ioannou GN. Epidemiology and Risk-Stratification of NAFLD-Associated HCC. J Hepatol. 2021;75(6):1476-84. doi: 10.1016/j.jhep.2021.08.012
  20. Sanyal AJ. Past, Present and Future Perspectives in Nonalcoholic Fatty Liver Disease. Nat Rev Gastroenterol Hepatol. 2019;16(6):377-86. doi: 10.1038/s41575-019-0144-8
  21. Cataldo I, Sarcognato S, Sacchi D, et al. Pathology of Non-Alcoholic Fatty Liver Disease. Pathologica. 2021;113(3):194-202. doi: 10.32074/1591-951x-242
  22. Eslam M, Newsome PN, Sarin SK, et al. A New Definition for Metabolic Dysfunction-Associated Fatty Liver Disease: An International Expert Consensus Statement. J Hepatol. 2020;73(1):202-9. doi: 10.1016/j.jhep.2020.03.039
  23. Eslam M, Sanyal AJ, George J; International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020;158(7):1999-2014.e1. doi: 10.1053/j.gastro.2019.11.312
  24. Monelli F, Venturelli F, Bonilauri L, et al. Systematic Review of Existing Guidelines for NAFLD Assessment. Hepatoma Research. 2021;7:25. doi: 10.20517/2394-5079.2021.03
  25. Wong VW, Adams LA, de Ledinghen V, et al. Noninvasive Biomarkers in NAFLD and NASH – Current Progress and Future Promise. Nat Rev Gastroenterol Hepatol. 2018;15(8):461-78. doi: 10.1038/s41575-018-0014-9
  26. Tacke F, Horn P, Wai-Sun Wong V, et al. EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). J Hepatol. 2024;81(3):492-542. doi: 10.1016/j.jhep.2024.04.031
  27. Taylor RS, Taylor RJ, Bayliss S, et al. Association between Fibrosis Stage and Outcomes of Patients with Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Gastroenterology. 2020;158(6):1611-25.e12. doi: 10.1053/j.gastro.2020.01.043
  28. Wong VW, Tak WY, Goh GB, et al. Performance of Noninvasive Tests of Fibrosis among Asians, Hispanic, and Non-Hispanic Whites in the STELLAR Trials. Clin Gastroenterol Hepatol. 2023;21(1):90-102.e6. doi: 10.1016/j.cgh.2022.01.015
  29. Wong VW, Zelber-Sagi S, Cusi K, et al. Management of NAFLD in Primary Care Settings. Liver Int. 2022;42(11):2377-89. doi: 10.1111/liv.15404
  30. Kaswala DH, Lai M, Afdhal NH. Fibrosis Assessment in Nonalcoholic Fatty Liver Disease (NAFLD) in 2016. Dig Dis Sci. 2016;61(5):1356-64. doi: 10.1007/s10620-016-4079-4
  31. Romero-Gomez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with Diet, Physical Activity and Exercise. J Hepatol. 2017;67(4):829-46. doi: 10.1016/j.jhep.2017.05.016
  32. American Diabetes Association. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes – 2019. Diabetes Care. 2018;42(Suppl. 1):S90-102. doi: 10.2337/dc19-s009
  33. Raschi E, Mazzotti A, Poluzzi E, et al. Pharmacotherapy of Type 2 Diabetes in Patients with Chronic Liver Disease: Focus on Non-alcoholic Fatty Liver Disease. Expert Opin Pharmacother. 2018;19(17):1903-14. doi: 10.1080/14656566.2018.1531126
  34. Mantovani A, Byrne CD, Scorletti E, et al. Efficacy and Safety of Anti-Hyperglycaemic Drugs in Patients with Non-Alcoholic Fatty Liver Disease with or without Diabetes: An Updated Systematic Review of Randomized Controlled Trials. Diabetes Metab. 2020;46(6):427-41. doi: 10.1016/j.diabet.2019.12.007
  35. Kalavalapalli S, Bril F, Guingab J, et al. Impact of Exenatide on Mitochondrial Lipid Metabolism in Mice with Non-alcoholic Steatohepatitis. J Endocrinol. 2019;241(3):293-305. doi: 10.1530/joe-19-0007
  36. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease. Hepatology. 2023;77(5):1797-835. doi: 10.1097/hep.0000000000000323
  37. He W, Xu Y, Ren X, et al. Vitamin E Ameliorates Lipid Metabolism in Mice with Nonalcoholic Fatty Liver Disease via Nrf2/CES1 Signaling Pathway. Dig Dis Sci. 2019;64(11):3182-91. doi: 10.1007/s10620-019-05657-9
  38. Uchida D, Takaki A, Adachi T, Okada H. Beneficial and Paradoxical Roles of Anti-Oxidative Nutritional Support for Non-Alcoholic Fatty Liver Disease. Nutrients. 2018;10(8):977. doi: 10.3390/nu10080977
  39. Butterworth RF, Canbay A. Hepatoprotection by L-Ornithine L-Aspartate in Non-Alcoholic Fatty Liver Disease. Dig Dis. 2019;37(1):63-8. doi: 10.1159/000491429
  40. Voloshin I, Hahn-Obercyger M, Anavi S, Tirosh O. L-Arginine Conjugates of Bile Acids-a Possible Treatment for Non-Alcoholic Fatty Liver Disease. Lipids Health Dis. 2014;13:69. doi: 10.1186/1476-511x-13-69
  41. Canbay A, Gotze O, Kucukoglu O, et al. L-Ornithine-L-Aspartate (LOLA) Normalizes Metabolic Parameters in Models of Steatosis, Insulin Resistance and Metabolic Syndrome. Pharmaceutics. 2024;16(4):506. doi: 10.3390/pharmaceutics16040506
  42. Kircheis G, Luth S. Pharmacokinetic and Pharmacodynamic Properties of L-Ornithine L-Aspartate (LOLA) in Hepatic Encephalopathy. Drugs. 2019;79(Suppl. 1):23-9. doi: 10.1007/ёs40265-018-1023-2
  43. Oleshchuk OM, Datsko VA, Loi HYa, et al. Hepatoprotective Effects of L-Ornithine-L-Aspartate in Toxic Liver Injury. Pharmacol Online. 2021;3:146-55.
  44. Hadi A, Arab A, Moradi S, et al. The Effect of L-Arginine Supplementation on Lipid Profile: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Br J Nutr. 2019;122(9):1021-32. doi: 10.1017/s0007114519001855
  45. Wu G, Meininger CJ, McNeal CJ, et al. Role of L-Arginine in Nitric Oxide Synthesis and Health in Humans. Adv Exp Med Biol. 2021;1332:167-87. doi: 10.1007/978-3-030-74180-8_10
  46. Stach K, Stach W, Augoff K. Vitamin B6 in Health and Disease. Nutrients. 2021;13(9). doi: 10.3390/nu13093229
  47. Wang J, Zhang C, Zhang Z, et al. BL153 Partially Prevents High-Fat Diet Induced Liver Damage Probably via Inhibition of Lipid Accumulation, Inflammation, and Oxidative Stress. Oxid Med Cell Longev. 2014;2014:674690. doi: 10.1155/2014/674690
  48. Liu Z, Zeng Y, Shen S, et al. Association between Folate and Non-Alcoholic Fatty Liver Disease among US Adults: A Nationwide Cross-Sectional Analysis. Chin Med J. 2023;136(2):233-5. doi: 10.1097/cm9.0000000000002516
  49. Chan C, Chan P, Lin B. Folate Deficiency Increased Lipid Accumulation and Leptin Production of Adipocytes. Front Nutr. 2022;9:852451. doi: 10.3389/fnut.2022.852451
  50. Tripathi M, Singh BK, Zhou J, et al. Vitamin B12 and Folate Decrease Inflammation and Fibrosis in NASH by Preventing Syntaxin 17 Homocysteinylation. J Hepatology. 2022;77(5):1246-55. doi: 10.1016/j.jhep.2022.06.033
  51. Molaqanbari MR, Zarringol S, Talari HR, et al. Effects of Folic Acid Supplementation on Liver Enzymes, Lipid Profile, and Insulin Resistance in Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Adv Biomed Res. 2023;12:103. doi: 10.4103/abr.abr_90_22
  52. Abe RA, Masroor A, Khorochkov A, et al. The Role of Vitamins in Non-Alcoholic Fatty Liver Disease: A Systematic Review. Cureus. 2021;13(8):e16855. doi: 10.7759/cureus.16855
  53. Koplay M, Gulcan E, Ozkan F. Association between Serum Vitamin B12 Levels and the Degree of Steatosis in Patients with Nonalcoholic Fatty Liver Disease. J Investig Med. 2011;59(7):1137-40. doi: 10.2310/jim.0b013e31822a29f5
  54. Talari HR, Molaqanbari MR, Mokfi M, et al. The Effects of Vitamin B12 Supplementation on Metabolic Profile of Patients with Non-Alcoholic Fatty Liver Disease: A Randomized Controlled Trial. Sci Rep. 2022;12(1):14047. doi: 10.1038/s41598-022-18195-8
  55. Lonardo A, Nascimbeni F, Ballestri S, et al. Sex Differences in Nonalcoholic Fatty Liver Disease: State of the Art and Identification of Research Gaps. Hepatology. 2019;70(4):1457-69. doi: 10.1002/hep.30626
  56. Polyzos SA, Kountouras J, Mantzoros CS. Obesity and Nonalcoholic Fatty Liver Disease: From Pathophysiology to Therapeutics. Metabolism. 2019;92:82-97. doi: 10.1016/j.metabol.2018.11.014
  57. Pang Q, Zhang JY, Song SD, et al. Central Obesity and Nonalcoholic Fatty Liver Disease Risk after Adjusting for Body Mass Index. World J Gastroenterol. 2015;21(5):1650-62. doi: 10.3748/wjg.v21.i5.1650
  58. Reis SS, Callejas GH, Marques RA, et al. Correlation between Anthropometric Measurements and Non-Alcoholic Fatty Liver Disease in Individuals with Obesity Undergoing Bariatric Surgery: Cross-Sectional Study. Obes Surg. 2021;31(8):3675-85. doi: 10.1007/s11695-021-05470-2
  59. Xing J, Guan X, Zhang Q, et al. Triglycerides Mediate Body Mass Index and Nonalcoholic Fatty Liver Disease: A Population-Based Study. Obesity Facts. 2021;14(2):190-6. doi: 10.1159/000514848
  60. Minciuna I, Taru M, Fodor A, et al. Multiparametric Ultrasound Evaluation of Liver Fibrosis, Steatosis, and Viscosity in Patients with Chronic Liver Disease. Med Ultrason. 2024;26(2):117-24. doi: 10.11152/mu-4327
  61. Baldini F, Khalil M, Bartolozzi A, et al. Relationship between Liver Stiffness and Steatosis in Obesity Conditions: In Vivo and in Vitro Studies. Biomolecules. 2022;12(5):733. doi: 10.3390/biom12050733
  62. Fujii I, Matsumoto N, Ogawa M, et al. Artificial Intelligence and Image Analysis-Assisted Diagnosis for Fibrosis Stage of Metabolic Dysfunction-Associated Steatotic Liver Disease Using Ultrasonography: A Pilot Study. Diagnostics (Basel). 2024;14(22):2585. doi: 10.3390/diagnostics14222585

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* Murane N, Sprudza KL, Ivanova J, Zalizko P. Complex of Amino Acids, Choline, and B-Group Vitamins for the Improvement of Early-Stage Metabolic Dysfunction-Associated Steatotic Liver Disease. Health. 2025;17:1252-71. https://doi.org/10.4236/health.2025.1710083
Авторские права © 2025 закреплены за авторами и издательством Scientific Research Publishing Inc.
Оригинал статьи опубликован в Health 2025;17:1252-71.
Настоящая статья лицензирована в соответствии с лицензией Creative Commons Attribution International License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0/).


© Murane N., Sprudza K., Ivanova J., Zalizko P. ООО "Консилиум Медикум", 2025

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