Ursodeoxycholic acid as a means of preventing atherosclerosis, steatosis and liver fibrosis in patients with nonalcoholic fatty liver disease

Nadinskaia M. Maevskaya M. Ivashkin V. Kodzoeva K. Pirogova I. Chesnokov E. Nersesov A. Kaibullayeva J. Konysbekova A. Raissova A. Khamrabaeva F. Zueva E.
14 March 2021 Baishideng Publishing Group Co

World Journal of Gastroenterology
2021 #27 Issue 10 959 - 975 pp.

BACKGROUND Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in patients with nonalcoholic fatty liver disease (NAFLD). Weight loss is a key factor for successful NAFLD and CVD therapy. Ursodeoxycholic acid (UDCA), which is one of the first-line therapeutic agents for treatment of NAFLD, is reported to have a beneficial effect on dyslipidemia and ASCVD risk because of antioxidant properties. AIM To evaluate the effects of 6 mo of UDCA treatment on hepatic function tests, lipid profile, hepatic steatosis and fibrosis, atherogenesis, and ASCVD risk in men and women with NAFLD, as well as to assess the impact of > 5% weight reduction on these parameters. METHODS An open-label, multicenter, international noncomparative trial was carried out at primary health care settings and included 174 patients with ultrasound-diagnosed NAFLD who received 15 mg/kg/d UDCA for 6 mo and were prescribed lifestyle modification with diet and exercise. The efficacy criteria were liver enzymes, lipid profile, fatty liver index (FLI), noninvasive liver fibrosis tests (nonalcoholic fatty liver disease fibrosis score and liver fibrosis index), carotid intima-media thickness (CIMT), and ASCVD risk score. To test statistical hypotheses, the Wilcoxon test, paired t-test, Fisher’s exact test, and Pearsons chi-squared test were used. RESULTS The alanine aminotransferase (ALT) level changed by -14.1 U/L (-31.0; -5.3) from baseline to 3 mo and by -6.5 U/L (-14.0; 0.1) from 3 to 6 mo. The magnitude of ALT, aspartate transaminase, and glutamyltransferase decrease was greater during the first 3 mo of treatment compared to the subsequent 3 mo (P < 0.001, P < 0.01, P < 0.001, respectively). At 6 mo, in the total sample, we observed a statistically significant decrease in body weight and levels of FLI: 84.9 ± 10.4 vs 72.3 ± 17.6, P < 0.001, total cholesterol: 6.03 ± 1.36 vs 5.76 ± 1.21, Р < 0.001, low-density lipoprotein: 3.86 ± 1.01 vs 3.66 ± 0.91, Р < 0.001, and triglyceride: 3.18 (2.00; 4.29) vs 2.04 (1.40; 3.16), Р < 0.001. No effect on nonalcoholic fatty liver disease fibrosis score or liver fibrosis index was found. The CIMT decreased significantly in the total sample (0.985 ± 0.243 vs 0.968 ± 0.237, P = 0.013), whereas the high-density lipoprotein (Р = 0.036) and 10-year ASCVD risk (Р = 0.003) improved significantly only in women. Fifty-four patients (31%) achieved > 5% weight loss. At the end of the study, the FLI decreased significantly in patients with (88.3 ± 10.2 vs 71.4 ± 19.6, P < 0.001) and without > 5% weight loss (83.5 ± 10.3 vs 72.8 ± 16.7, P < 0.001). The changes in ALT, aspartate transaminase, glutamyltransferase, total cholesterol, and low-density lipoprotein levels were similar between the subgroups. CONCLUSION UDCA normalizes liver enzymes greatly within the first 3 mo of treatment, improves lipid profile and hepatic steatosis independent of weight loss, and has a positive effect on CIMT in the total sample and 10-year ASCVD risk in women after 6 mo of treatment.

Atherosclerotic cardiovascular disease , Carotid intima-media thickness , Fatty liver index , Liver function tests , Nonalcoholic fatty liver disease , Ursodeoxycholic acid

Text of the article Перейти на текст статьи

Department of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation
Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology, University Clinical Hospital №2, Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation
LLC MC “Lotus”, Center for Gastroenterology and Hepatology, Chelyabinsk, 454092, Russian Federation
Department of Hospital Therapy, Course of Endocrinology and Clinical Pharmacology, Tyumen State Medical University, Tyumen, 625003, Russian Federation
Department of Gastroenterology, S. Asfendiyarov Kazakh National Medical University, Almaty, 050000, Kazakhstan
Functional and Ultrasound Diagnostics, Scientific and Research Institute of Cardiology and Internal Diseases, Almaty, 050000, Kazakhstan
Department of Internal Diseases, Scientific and Research Institute of Cardiology and Internal Diseases, Almaty, 050000, Kazakhstan
Faculty of Therapy, Tashkent Institute of Advanced Medical Studies, Tashkent, 100007, Uzbekistan
Department of Therapy № 1, Training General Practitioners, Tashkent Medical Academy, Tashkent, 100109, Uzbekistan

Department of Propaedeutics of Internal Diseases
Vasilenko Clinic of Internal Diseases Propedeutics
LLC MC “Lotus”
Department of Hospital Therapy
Department of Gastroenterology
Functional and Ultrasound Diagnostics
Department of Internal Diseases
Faculty of Therapy
Department of Therapy № 1

10 лет помогаем публиковать статьи Международный издатель

Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026