Patsient s NAZhBP: algoritm diagnostiki i lecheniya


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Abstract

The article analyzes the current data on the methods of diagnosis and principles of treatment of non-alcoholic fatty liver disease (NAFLD), a disease accompanied by the accumulation of fat in the liver more than 5 % of the hepatocyte number. NAFLD is a diagnosis of exclusion, the definition of which is possible only after a careful analysis of all possible specific reasons (alcohol, hepatitis viruses, genetic diseases, etc.) and confirmation of the nature of metabolic disease. Screening for NAFLD is necessarily required in patients with obesity. For diagnosis of NAFLD, the determination of appropriate symptoms of liver diseases, biochemical analysis, including conventional liver function tests, tests characterizing lipid and carbohydrate metabolism, liver ultrasound, elastography and, if necessary, morphological examination are required. Treatment of NAFLD includes low-calorie diet with sufficient level of polyunsaturated fats and dietary fibers, graduated exercise to reduce body weight, the use of insulin-sensitizing agents, the use of essential phospholipids and antioxidants. Principles of diagnosis and treatment of NAFLD are developing rapidly, which requires the attention of physicians and gastroenterologists.

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References

  1. Blachier M, Leleu H, Peck-Radosavljevic M, et al. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol 2013;58(3):593-608.
  2. Eckard C, Cole R, Lockwood J, et al. Prospective histopathologic evaluation of lifestyle modification in nonalcoholic fatty liver disease: a randomized trial. Therap Adv Gastroenterol 2013;6(4):249-59.
  3. Цуканов В.В. Клинико-биохимические особенности заболеваний желчевыводящих путей у населения азиатского Севера. Дисс. докт. мед. наук. Томск, 1996.
  4. Цуканов В.В., Ноздрачев К.Г., Тонких Ю.Л. Метаболические факторы защиты коренного населения Севера при ИБС и холелитиазе // Бюлл. СО РАМН 2006. № 2. С. 100-4.
  5. Цуканов В.В., Селиверстова Е.В., Догадин С.А. Показатели липидного состава сыворотки крови и желчи при заболеваниях желчевыводящих путей у больных сахарным диабетом // Тер. архив 2005. Т. 77. № 2. С. 15-8.
  6. Цуканов В.В., Тонких Ю.Л., Бронникова Е.П. Механизм нормолипидемии у северных народностей // Клин. медицина 1999. № 2. С. 38-42.
  7. Цуканов В.В., Ноздрачев К.Г., Тонких Ю.Л. и др. Механизм обратного транспорта холестерина и холелитиаз у северных народностей// Клиническая медицина 2007. № 2. С. 33-5.
  8. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology 2012;142(7):1592-609.
  9. Oh MK, Winn J, Poordad F. Review article: diagnosis and treatment of non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2008;28(5):503-22.
  10. Dowman JK, Tomlinson JW, Newsome PN. Systematic review: the diagnosis and staging of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2011;33(5):525-40.
  11. Wong VW, Chu WC, Wong GL, et al. Prevalence of non-alcoholic fatty liver disease and advanced fibrosis in Hong Kong Chinese: a population study using proton-magnetic resonance spectroscopy and transient elastography. Gut 2012;61(3):409-15.
  12. Tomeno W, Yoneda M, Imajo K, et al. Emerging drugs for non-alcoholic steatohepatitis. Expert Opin Emerg Drugs 2013;[Epub ahead of print].
  13. de Wit NJ, Afman LA, Mensink M, et al. Phenotyping the effect of diet on non-alcoholic fatty liver disease. J Hepatol 2012;57(6): 1370-73.
  14. Rakoski MO, Singal AG, Rogers MA, et al. Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2010;32(10):1211-21.
  15. Pathil A, Mueller J, Warth A, et al. Ursodeoxycholyl lysophosphatidylethanolamide improves steatosis and inflammation in murine models of nonalcoholic fatty liver disease. Hepatology 2012;55(5):1369-78.
  16. Anstee QM, Day CP. A lipid to treat non-alcoholic fatty liver disease - the dawn of liporehabilitation? J Hepatol 2012;56(4):987-89.
  17. Sas E, Grinevich V, Efimov O, et al. Beneficial influence of polyunsaturated phosphatidylcholine enhances functional liver condition and liver structure in patients with nonalcoholic steatohepatitis. Results of prolonged randomized blinded prospective clinical study. J Hepatology 2013;58( Suppl. 1):S549.
  18. Tsukanov VV, Tonkikh JL, Bronnikova EP. Treatment with polyunsaturated phosphatidilcholine and metformin associated with increas of phosphatidylcholine in blood serum and clinical dynamics in patients with NASH. Gut 2012:61(Suppl. 2):A224.
  19. Andreone P, Brisc MC, Chiaramonte M, et al. Silybin conjugated with phosphatidilcholine and vitamin E improves liver damage in patients with NAFLD: the results of a randomized multicentre double-blind vs. placebo trial. J Hepatol 2011;54(Suppl.):S330-S331.
  20. Hoofnagle JH, Van Natta ML, Kleiner DE, et al. Vitamin E and changes in serum alanine aminotransferase levels in patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2013;38(2):134-43.
  21. Haedrich M, Dufour JF. UDCA for NASH: End of the story? J Hepatol 2011:54(5):856-58.

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