Evaluation of the effectiveness of the dioscorea in the treatment of patients with non-alcoholic fatty liver disease and dyslipidemia

Abstract

Introduction. The effective and safe management of dyslipidemia is an important step in the treatment of non-alcoholic fatty liver disease (NAFLD).Aim. To evaluate the experience of the use of dioscorea drug in the treatment of patients with NAFLD and dyslipidemia.Materials and methods. The effectiveness of a six-month course of dioscorea monotherapy of dyslipidemia was evaluated in 30 patients diagnosed with NAFLD. The observation period was 24 weeks and included 3 visits: before treatment, at week 12 and 24 of the therapy. Changes in complaints, values of lipidograms and biochemical blood tests, liver elastometry were assessed over time, quality of life was measured by SF-36 questionnaire.Results. A decrease in the frequency of the initially recorded symptoms such as weakness, fatigue, pain or feeling of heaviness in the epigastric region and upper abdomen, flatulence, anorexia, nausea/heartburn was observed by week 12. No flatulence and nausea were recorded by week 24, the frequency of the remaining symptoms did not exceed 3-20%. During a six-month course of treatment, the reduction ratio for total cholesterol was 16%, LDL – 27%, triglycerides and atherogenic coefficient – 38% each, HDL level increased by 25%. The decrease in the levels of ALT, AST, gamma-glutamyl transpeptidase, alkaline phosphatase to the reference values was recorded by week 12, which was maintained until visit 3. According to elastometry findings, a decrease in liver stiffness (from 5.5 ± 4.2 to 4.3 ± 1.2 kPa; p < 0.01) and an increase in the percentage of patients corresponding to the METAVIR F0 score (from 43 to 77%, p = 0.01) was reported by visit 3. The therapy resulted in increase of SF-36 total score: physical well-being improved from 46.3 ± 9.1 to 50.3 ± 7.2 scores (p < 0.001); psychological well-being from 40.6 ± 9.2 to 48 ± 6.9 scores (p < 0.001).Conclusion. The inclusion of dioscorea drug in the NAFLD therapy allows to achieve a persistent decrease in atherogenic indices of lipidograms, normalization of biochemical markers of the functional state of liver, which clinically determines the regression and relief of the main symptoms of the disease, improving the patients’ quality of life. From the objective point of view, the decrease in liver stiffness was recorded, which is essential for improving prognosis and reducing the risk of NAFLD progression.