Comorbidity of non-alcoholic fatty liver disease and cardiovascular disease: focus on ademetionine and ursodeoxycholic acid

Abstract

Changes in the nature of the interaction of risk factors and global aging of the population have led to a rapid increase in patients with combined pathology, elevated to the rank of a new non-infectious epidemic. The previously existing ‘one disease, one patient’ paradigm is losing its relevance and no longer meets medical needs, therefore patients with comorbidities need a broader approach and individualized treatment regimens, which are currently not fully defined. According to modern concepts, the coexistence of pathogenetically and pathophysiologically interrelated two or more diseases in one individual is defined by the term ‘comorbidity’. The most common comorbidity phenotype is cardiometabolic. Of particular interest is the relationship between cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD), since both diseases are highly prevalent in the population and have common metabolic risk factors (obesity, diabetes mellitus, hypertension, and dyslipidemia). In addition, there is evidence that NAFLD is an independent risk factor for CVD, which suggests not only the presence of common pathogenetic mechanisms other than metabolic pathways, but also the likelihood that treatment of liver disease can reduce the burden of CVD. In this regard, this review comprehensively analyzes the relationship between NAFLD and CVD and discusses a possible therapeutic strategy, including the use of a combination of ademetionine with ursodeoxycholic acid.