Урсодезоксихолевая кислота в комбинации с менопаузальной гормональной терапией корригирует метаболические нарушения у женщин в менопаузе с неалкогольной жировой болезнью печени

Abstract

The purpose of the study is to develop and introduce into clinical practice an algorithm for managing perimenopausal patients suffering from menopausal metabolic syndrome (MMS) and having hepatobiliary system disorders (non-alcoholic fatty liver disease (NAFLD), cholestasis, biliary sludge), to identify the effectiveness of menopausal hormone therapy (Femoston) in combination with ursodeoxycholic acid. 60 women with the specified syndromes aged 45 to 60 years were included in the study. Prospective clinical and laboratory examinations were performed, a modified menopause index (MMI) was measured before treatment and after 6 months. The levels of follicle-stimulating hormone (FSH) and estradiol have changed significantly. Beneficial changes in the lipid spectrum and a statistically significant decrease in transaminases and bilirubin levels were identified. The combined use of low-dose menopausal hormone therapy and udhc leads to a pronounced positive dynamics in the lipid spectrum by reducing total serum cholesterol (OHS) from 5.92±0.45 mmol/l to 4.90±0.46 mmol/l, triglycerides from 2.01±0.87 to 1.07±0.65 mmol/l, increasing HDL from 1.41±0.25 to 1.81±0.31 mmol/l, reducing LDL from 3.48±0.72 up to 2.70±0.53 mmol/l and VLDL from 1.26±0.58 mmol/l to 0.55±0.34 mmol/l); It was found that the combined use of low - dose MGT and udhc effectively reduces the activity of enzymes: ALT - from 27.76±9.1 to 17.35±7.6 units⁄l; AST - from 22.56±4.7 units⁄l to 17.45±6.64 units⁄l, schf-from 146.26±63.77 units⁄l to 90.37±29.1 units⁄l. the level of bilirubin and its fractions is Normalized: the total bilirubin in the main group decreased from 11.45±6.34 to 7.32±4.56 mmol/l. The coagulogram has not changed. Femoston and ursodeoxycholic acid improved the climacteric syndrome, normalized the lipid profile, and had a beneficial effect on the hepatobiliary system. Thе combination therapy improved liver function, improved the quality of life of patients, and reduced the risk of NAFLD progression.