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PREDICTORS AFFECTING THE COURSE AND EFFECTIVENESS OF NAFLD THERAPY WITH UDCA DRUGS

Ufimtseva Irina Vladimirovna  (gastroenterologist, LLC Medical Center "Lotus", Chelyabinsk)

Yakovleva Sofia Vasilyevna  (cardiologist, head of the department of therapy of LLC Medical Center "Lotus" Chelyabinsk)

Introduction: NAFLD has many factors that influence its course and prognosis. Aim. To identify the predictors that have the greatest impact on the treatment of NAFLD with UDCA drugs and to build a mathematical model for predicting the outcome. Materials and methods: 55 people with NAFLD aged 18 to 65 years, 30 women (54.5%), 25 men (45.5%) were included. The average age of the patients was 47.7±9 years. All patients were prescribed UDCA 15 mg/kg for 1 year. The groups were divided according to the achievement of steatosis regression into 2 groups: 1 group with steatosis regression - 31 people (56.4%) and without steatosis regression - 24 people (43.6%). All patients underwent general clinical, biochemical blood tests, abdominal ultrasound, abdominal MSCT, liver elastometry on a fibroscan device with an XL sensor, fibrosis indices (FIB4, APRI) and liver steatosis (FLI) were calculated. The results of the study: in the group with steatosis regression, the indices of Sarelastometry, the FLI index, the CIRS-G comorbidity index were significantly lower, the waist circumference, the NOMA index, blood glucose indices were lower and the liver density index according to MSCT was higher (p<0.05). After UDCA therapy, statistically significant differences were achieved in both groups in terms of AST, ALT, total bilirubin, GGTP, OHS, TG, LDL, HDL (Wilcoxon criterion p<0.05), but regression of steatosis was achieved only in 56.4% of people. After evaluating the predictors of steatosis regression, we identified the main ones: blood glucose, BMI, waist circumference, FLI index.They were included in the prognostic model for evaluating the therapy of liver steatosis. Conclusions: The factors that have the greatest impact on the development and effectiveness of NAFLD therapy should be taken into account before treatment and adjusted in a timely manner to achieve steatosis regression.

Keywords:NAFLD, obesity, metabolic syndrome, comorbidity

 

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Citation link:
Ufimtseva I. V., Yakovleva S. V. PREDICTORS AFFECTING THE COURSE AND EFFECTIVENESS OF NAFLD THERAPY WITH UDCA DRUGS // Современная наука: актуальные проблемы теории и практики. Серия: Естественные и Технические Науки. -2023. -№08. -С. 215-221 DOI 10.37882/2223-2966.2023.08.35
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