Nonalcoholic fatty liver disease combined with dyslipidemia: the role of ursodeoxycholic acid in complex therapy

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Abstract

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases, affecting up to 30% of the adult population. It is closely associated with metabolic disorders such as obesity, type 2 diabetes mellitus and dyslipidemia, which increase the risk of cardiovascular diseases (CVD). Patients with NAFLD have a 2–3 times higher risk of developing CVD compared to the general population, which emphasizes the need for a comprehensive approach to treatment. One of the promising drugs for the treatment of NAFLD is ursodeoxycholic acid (UDCA), which, due to its cytoprotective, antioxidant, anti-inflammatory and immunomodulatory properties, not only reduces liver steatosis and fibrosis, but also reduces the risk of cardiovascular complications. The effectiveness of UDCA has been confirmed by numerous studies, including in combination therapy with statins. Studies demonstrate improvement in lipid profile and reduction in liver injury with UDCA treatment, making UDCA an important component of therapy for NAFLD and associated dyslipidemia.

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About the authors

Olga D. Ostroumova

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: ostroumova.olga@mail.ru
ORCID iD: 0000-0002-0795-8225
SPIN-code: 3910-6585

Dr. Sci. (Med.), Professor, Head of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi, Professor of the Department of Clinical Pharmacology and Propaedeutics of Internal Diseases

 

Russian Federation, Moscow; Moscow

Svetlana V. Litvinova

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: batyukina.svetlana@yandex.ru
ORCID iD: 0000-0003-1316-7654

Cand. Sci. (Med.), Assistant of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Aleksey I. Kochetkov

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: ak_info@list.ru
ORCID iD: 0000-0001-5801-3742
SPIN-code: 9212-6010

Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Natalia A. Plotnikova

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: na_tasah_90@mail.ru
ORCID iD: 0000-0001-5454-9339

Cand. Sci. (Med.), Associate Professor of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Maria V. Klepikova

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: pelageam@yandex.ru
ORCID iD: 0000-0003-4258-1889

Cand. Sci. (Med.), Associate Professor at the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Sofya S. Eremina

Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: sofya.eremina@mail.ru
ORCID iD: 0000-0001-7989-354X

2nd year resident of the Department of Therapy and Polymorbid Pathology named after Academician M.S. Vovsi

Russian Federation, Moscow

Sergey V. Cheremushkin

Russian University of Medicine

Email: svch555362@yandex.ru
ORCID iD: 0000-0002-0982-2006

Cand. Sci. (Med.), Associate Professor of the Department

Russian Federation, Moscow

References

  1. Younossi Z.M., Henry L. Understanding the Burden of Nonalcoholic Fatty Liver Disease: Time for Action. Diab Spectr. 2024;37(1):9–19. doi: 10.2337/dsi23-0010.
  2. Jichitu A., Bungau S., Stanescu A.M.A., et al. Non-Alcoholic Fatty Liver Disease and Cardiovascular Comorbidities: Pathophysiological Links, Diagnosis, and Therapeutic Management. Diagnostics (Basel). 2021;11(4):689. doi: 10.3390/diagnostics11040689.
  3. Клинические рекомендации. Неалкогольная жировая болезнь печени. Год утверждения: 2024. [Clinical guidelines. Nonalcoholic fatty liver disease. Year of approval: 2024. (In Russ.)].
  4. Estes C., Anstee Q.M., Arias-Loste M.T., et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol. 2018;69(4):896–904. doi: 10.1016/j.jhep.2018.05.036.
  5. Younossi Z.M., Koenig A.B., Abdelatif D., et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84. doi: 10.1002/hep.28431.
  6. Zhou Y.J., Li Y.Y., Nie Y.Q., et al. Natural course of nonalcoholic fatty liver disease in southern China: a prospective cohort study. J Dig Dis. 2012;13(3):153–60. doi: 10.1111/j.1751-2980.2011.00571.x.
  7. Targher G., Byrne C.D., Lonardo A., et al. Non-alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. J Hepatol. 2016;65(3):589–600. doi: 10.1016/j.jhep.2016.05.013.
  8. Byrne C.D., Targher G. Non-alcoholic fatty liver disease-related risk of cardiovascular disease and other cardiac complications. Diab Obes Metab. 2022;24(Suppl. 2):28–43. doi: 10.1111/dom.14484.
  9. Mei S., Ni H.M., Manley S., et al. Differential roles of unsaturated and saturated fatty acids on autophagy and apoptosis in hepatocytes. J Pharmacol Exp Ther. 2011;339(2):487–98. doi: 10.1124/jpet.111.184341.
  10. Маевская М.В. Урсодезоксихолевая кислота: уникальные свойства и клиническое применение. Медицинский совет. 2023;17(8):96–105. [Maevskaya M.V. Ursodeoxycholic acid: unique properties and clinical applications. Med Sovet. 2023;17(8):96–105. (In Russ.)]. doi: 10.21518/ms2023-136.
  11. Xiang Z., Chen Y.P., Ma K.F., et al. The role of ursodeoxycholic acid in non-alcoholic steatohepatitis: a systematic review. BMC. Gastroenterol. 2013;13:140. doi: 10.1186/1471-230X-13-140.
  12. Zhang W., Tang Y., Huang J., Hu H. Efficacy of ursodeoxycholic acid in nonalcoholic fatty liver disease: An updated meta-analysis of randomized controlled trials. Asia Pac J Clin Nutr. 2020;29(4):696–705. doi: 10.6133/apjcn.202012_29(4).0004.
  13. Lin X., Mai M., He T., et al. Efficiency of ursode- oxycholic acid for the treatment of nonalcoholic steatohepatitis: A sys- tematic review and meta-analysis. Exp Rev Gastroenterol Hepatol. 2022;16(6):537–45. doi: 10.1080/17474124.2022.2083605.
  14. Ozel Coskin B.D., Yucesov M., Gursoy S., et al. Effects of ursodeoxycholic acid therapy on carotid intima media thickness, apolipoprotein A1, apolipoprotein B, and apolipoprotein B/A1 ratio in nonalcoholic steatohepatitis. J Gastroenterol Hepatol. 2015;27(2):142–9. doi: 10.1097/MEG.0000000000000264.
  15. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017;67(1):145–72. doi: 10.1016/j.jhep.2017.03.022.
  16. Lindor K.D., Kowdley K.V., Luketic V.A., et al. High-dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis. Hepatology. 2009;50(3):808–14. doi: 10.1002/hep.23082.
  17. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017;67(1):145–72. doi: 10.1016/j.jhep.2017.03.022.
  18. Nadinskaia M., Maevskaya M., Ivashkin V., et al. Ursodeoxycholic acid as a means of preventing atherosclerosis, steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease. World J Gastroenterol. 2021;27(10):959–75. doi: 10.3748/wjg.v27.i10.959.
  19. Huang D.Q., El-Serag H.B., Loomba R. Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2021;18(4):223–38. doi: 10.1038/s41575-020-00381-6.
  20. Ежов М.В., Кухарчук В.В., Сергиенко И.В. и др. Нарушения липидного обмена. Клинические рекомендации 2023. Российский кардиологический журнал. 2023;28(5):5471. [Ezhov M.V., Kukharchuk V.V., Sergienko I.V., et al. Disorders of lipid metabolism. Clinical Guidelines 2023. Rus J Cardiol. 2023;28(5):5471 (In Russ.)]. doi: 10.15829/1560-4071-2023-5471.
  21. Taylor F., Huffman M.D., Macedo A.F., et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;2013(1):CD004816. doi: 10.1002/14651858.CD004816.pub5.
  22. Марцевич С.Ю., Кутишенко Н.П., Дроздова Л.Ю. и др. Исследование РАКУРС: повышение эффективности и безопасности терапии статинами у больных с заболеваниями печени, желчного пузыря и/или желчевыводящих путей с помощью урсодеоксихолевой кислоты. Тер. архив. 2014;86(12):48 52. [Martsevich S.Iu., Kutishenko N.P., Drozdova L.Iu., et al. Ursodeoxycholic acid-enhanced efficiency and safety of statin therapy in patients with liver, gallbladder, and/or biliary tract diseases: The RACURS study. Ther Arch. 2014;86(12):48 52. (In Russ.)]. Doi: 10.17116/ terarkh2014861248-52.
  23. Seo S.H., Lee D.H., Lee Y.S., et al. Co-administration of ursodeoxycholic acid with rosuvastatin/ezetimibe in a non-alcoholic fatty liver disease model. Gastroenterol Rep (Oxf). 2022;10:goac037. doi: 10.1093/gastro/goac037.

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