Dynamics of changes in lipid peroxidation and antioxidant protection under the influence of complex treatment in patients with comorbid course of non-alcoholic steatohepatitis

• Main Author: O. Yu. Filippova
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2019-06-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: non-alcoholic fatty liver disease; obesity; lipid peroxidation; antioxidants; ursodeoxycholic acid; arginine glutamate
• Online Access: http://zmj.zsmu.edu.ua/article/view/169015/169287

The aim to assess the effect of various complex treatment regimens on lipid peroxidation (LPO) and antioxidant protection (AOP) in patients with non-alcoholic steatohepatitis (NASH) in combination with obesity (OB) and biliary tract pathology (BT), based on 6-month follow-up data. Materials and methods. We examined 100 patients with NASH in combination with OB and pathology of BT. The control group consisted of 30 practically healthy persons. Patients of all groups within 6 months have been prescribed a lifestyle correction, in particular: diet, exercise, work and rest. Patients of the 1 group (n = 34) received standard treatment for 30 days. Patients of the 2 group (n = 33) were prescribed standard treatment combined with the use of ursodeoxycholic acid (UDCA) for 30 days at a dose of 15 mg·kg-1·d-1. Patients of the 3 group (n = 33) received standard treatment and UDCA combined with the use of arginine glutamate for 30 days. All LPO-AOP were performed at the beginning and at the end of treatment in all patients and 6 months after treatment in 20 patients in each group of observation. Results. A more significant decrease in the levels of intermediate and final products of lipid peroxidation in blood serum (from P < 0.05 to P < 0.001) was observed in patients of the 2 group and especially of the 3 group, as compared to the same values in the 1 group. The maximum effect of UDCA and glutamate arginine on the decrease in the formation of LPO toxic products in the blood was observed in the 3 group compared to the 2 group when studying the indices of diene conjugates and isolated double bonds 6 months after the treatment (P < 0.05). Conclusions. Combination therapy (non-medicamentous and medicamentous) with the addition of UDCA and glutamate arginine to the standard treatment in the comorbid course of NASH can be considered as a promising direction in the treatment of this category of patients, which allows to restore the basic indices of lipoperoxidation and antioxidant protection.