Correction of lipid metabolism disorders with atorvastatin in combination with UDCA in NAFLD

Abstract

Objective: to evaluate the therapeutic efficacy of the combined use of ursodeoxycholic acid and atorvastatin in non-alcoholic fatty liver disease (NAFLD) with concomitant atherogenic dyslipidemia.Materials and methods.123 patients with NAFLD at the stage of steatosis were examined, among them 66 women and 57 men aged 30 to 70 years. In verification of NAFLD, an ultrasound examination (ultrasound) of the hepatobiliary system was used using the SONIX OP apparatus (Canada). To exclude fibrosis in the liver parenchyma, sonoelastographywas performed on an AIXPLORER apparatus (France) and the FibroTest and FibroMax tests developed by BioPredictiv (Paris, France) were used. The lipid profile was determined on an analyzer FP-901 (M) from Labsystems (Finland) (Spain, Barcelona). The method of multifractional (5-phase) duodenal sounding (MFDZ) was used, which makes it possible to evaluate bile indices (cholesterol and bile acids).Results. Ultrasound of the liver and SteatoTest revealed steatosis in all patients with NAFLD. The examined identified signs of atherogenic dyslipidemia. There was a significant increase in cholesterol in portions “B” and “C” of bile (by 79.9% (p = 0.001) and 76.89% (p = 0.001), respectively), a decrease in the amount of bile acids in portions “B” and “ C ”bile (by 46.74% (p = 0.001) and 30.56% (p = 0.1), respectively). A sharp decrease in the cholecholesterol coefficient (by 90.55% (p = 0.001) and 86.03% (p = 0.01), respectively) confirms the high lithogenic properties of bile. The combined use of ursodeoxycholic acid (UDCA), simultaneously with atorvastatin, manifested a more pronounced both lipid-lowering effect and correction of the lithogenic properties of bile, in comparison with UDCA monotherapy.Conclusion. The effectiveness of the course application of UDCA in combination with atorvastatin in the correction of hyper- and dyslipidemia and biochemical parameters of bile in patients with NAFLD at an early stage of steatosis was determined.