CHANGES IN FIBROSIS UNDER THE INFLUENCE OF TREATMENT OF PATIENTS WITH ALCOHOLIC CIRRHOSIS OF THE LIVER IN COMBINATION WITH OBESITY USING ADEMETHYANINIUM AND ARGININE GLUTAMATE
ARTICLE PDF

Keywords

alcoholic liver disease, liver cirrhosis, obesity, fibrosis

How to Cite

Matkovska, N. (2020). CHANGES IN FIBROSIS UNDER THE INFLUENCE OF TREATMENT OF PATIENTS WITH ALCOHOLIC CIRRHOSIS OF THE LIVER IN COMBINATION WITH OBESITY USING ADEMETHYANINIUM AND ARGININE GLUTAMATE. Clinical and Preventive Medicine, (3), 27-34. https://doi.org/10.31612/2616-4868.3(13).2020.07

Abstract

Aim: to study the changes in liver parenchymal fibrosis under the influence of treatment of patients with alcoholic liver cirrhosis in combination with obesity using ademethionine and arginine glutamate.

Material and methods. 215 patients, diagnosed with alcoholic liver cirrhosis (ALC), took part in the study, including 66 women and 149 men aged (48.1±9.7) years and a median disease duration (5.8 ± 2.6) years. 109 people had ALC with obesity (group I) and 106 people had ALC without obesity (group II). Patients were divided into subgroups depending on the stage of decompensation according to Child-Pugh: class A – group IA (n=40), class B – group IB (n=39), class C – group IC (n=30) and IIA (n=39), IIB (n=36), IIC (n=31) groups, respectively. Depending on the treatment protocol (b protocol – basic therapy, h protocol – basic therapy in combination with ademethionine and arginine glutamate), all patients were divided into subgroups.

Results. In patients with ALC in combination with obesity, the elasticity of the liver parenchyma according to shear wave elastography and the FIB-4 index were higher than classes A, B and C compared to those in patients with ALC without obesity. According to the study results, obese patients with ALC had a more severe course of ALC according to the Child-Pugh and MELD scores. There is a direct relationship between the level of fibrosis in patients with ALC in combination with obesity according to elastography and the FIB-4 index with the severity of the disease according to the Child-Pugh ad MELD scores. The inclusion of ademethionine and arginine glutamate in the treatment regimen has improved the general condition of patients, compensated for clinical and laboratory parameters and reduced the rate of progression of liver fibrosis.

Conclusion. In patients with ALC in combination with obesity, the inclusion in the treatment of ademethionine and arginine glutamate has improved the course of the disease, as evidenced by changes in the parameters of the disease severity by Child-Pugh and MELD scores, and helped to reduce the rate of progression of liver fibrosis according to elastography and the FIB-4 index.

https://doi.org/10.31612/2616-4868.3(13).2020.07
ARTICLE PDF

References

O’Rourke, J. M., Sagar, V. M., Shah, T., & Shetty Sh. (2018). Carcinogenesis on the background of liver fibrosis: Implications for the management of hepatocellular cancer. World J Gastroenterol, 24(39), 4436-4447. doi: 10.3748/wjg.v24.i39.4436

Potze, W., Siddiqui, MS., & Sanyal, AJ. (2015). Vascular Disease in Patients with Nonalcoholic Fatty Liver Disease. Semin Thromb Hemost, 41(5), 488-93. doi: 10.1055/s-0035-1550433.

Anstee, Q. M., Targher, G., & Day, C. P. (2013). Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nature Reviews Gastroenterology & Hepatology, 10(6), 330-344. doi: 10.1038/nrgastro.2013.41

2.Wu, S., Wu, F., Ding, Y., Hou, J., Bi, J., & Zhang Zh. (2016). Association of non-alcoholic fatty liver disease with major adverse cardiovascular events: A systematic review and meta-analysis. Sci Rep, 6 (33386), 1-14. doi: 10.1038/srep333863

Bellentani, S. (2017). The epidemiology of non-alcoholic fatty liver disease. Liver International, 37, 81-84. doi:10.1111/liv.13299

Charlton, M. R., Burns, J. M., Pedersen, R. A., Watt, K. D., Heimbach, J. K., & Dierkhising, R. A. (2011). Frequency and Outcomes of Liver Transplantation for Nonalcoholic Steatohepatitis in the United States. Gastroenterology, 141(4), 1249-1253. doi:10.1053/j.gastro.2011.06.061

Tsai, E., & Lee, T.-P. (2018). Diagnosis and Evaluation of Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis, Including Noninvasive Biomarkers and Transient Elastography. Clinics in Liver Disease, 22(1), 73-92. doi: 10.1016/j.cld.2017.08.004

Hashemi, S.A., Alavian, S.M., & Gholami-Fesharaki, M. (2016). Assessment of transient elastography (FibroScan) for diagnosis of fibrosis in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Caspian J Intern Med, 7(4), 242-252. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153515/

Cantero, I., Elorz, M., Abete, I., Marin, B. A., Herrero, J. I., Monreal, J. I., Benito, A., Quiroga, J., Martínez, A., Huarte, M. P., & Isidro, J. (2019). Ultrasound/Elastography techniques, lipidomic and blood markers compared to Magnetic Resonance Imaging in non-alcoholic fatty liver disease adults. International Journal of Medical Sciences. 16(1), 75-83. doi: 10.7150/ijms.28044

Papadopoulos, N., Vasileiadi, S., Michalea, S., Antonakaki, P., Papavdi, M., Dellaporta, E., Koullias, E., Koutli, E., Manolakopoulos, S., Koskinas, I., & Deutsch, M. (2019). The use of APRI and FIB-4 scores versus transient elastography (TE) for the assessment of liver fibrosis stage in patients with chronic hepatitis C (CHC): is it possible to reduce the need for elastography? J of Hepatology, 70(1S), e191. https://www.postersessiononline.eu/173580348_eu/congresos/ILC2019/aula/-THU_73_ILC2019.pdf

Vilar-Gomez, E., & Chalasani, N. (2018). Non-invasive assessment of non-alcoholic fatty liver disease: Clinical prediction rules and blood-based biomarkers. Journal of Hepatology, 68(2), 305-315. doi:10.1016/j.jhep.2017.11.013

Castera, L. (2018). Diagnosis of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: Non-invasive tests are enough. Liver International, 38, 67-70. doi:10.1111/liv.13658

Ampuero, J., Pais, R., Aller, R., Gallego-Durán, R., Crespo, J., García-Monzón, C., Boursier, J., Vilar, E., Petta, S., Ming-Hua, Z., Escudero, D., Calleja, J. L., Aspichueta, P., Diago, M., Rosales, J. M., Caballería, J., Gómez-Camarero, J., Iacono, O. L., Benlloch, S., Albillos, A., Turnes, J., Banales, J. M., Ratziu, V., & Romero-Gómez, M. (2019). Development and Validation of Hepamet Fibrosis Scoring System – a Simple, Non-invasive Test to Identify Patients With Nonalcoholic Fatty liver Disease With Advanced Fibrosis. Clinical Gastroenterology and Hepatology, 10, 1-10. doi:10.1016/j.cgh.2019.05.051

Stahl, E. P., Dhindsa, D. S., Lee S. K., Sandesara, P. B., Chalasani, N. P., & Sperling, L. S. (2019). Nonalcoholic Fatty Liver Disease and the Heart JACC State-of-the-Art Review. Journal of the American college of cardiology, 73(8), 948-963. doi: 10.1016/j.jacc.2018.11.050

Sonneveld, M. J., Brouwer, W. P., Chan, H. L-Y., Piratvisuth, T., Jia, J.-D., Zeuzem, S., Liaw, Y.-F., Hansen, B. E., Choi, H., Wat, C., Pavlovic, V., Gaggar, A., Xie, Q., Buti, M., de Knegt, R. J., & Janssen, H. LA. (2019). Optimisation of the use of APRI and FIB-4 to rule out cirrhosis in patients with chronic hepatitis B: results from the SONIC-B study. Lancet Gastroenterol Hepatol, 4(7), 538-544. doi: 10.1016/S2468-1253(19)30087-1

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.