Nonalcoholic fatty liver disease: modern aspects etiopathogenesis and treatment

N.V. Efimenko¹, A.S. Kaysinova¹, T.E. Fedorova¹, T.I. Ledovskaya², E.N. Chalaya¹

¹Federal State Budget Institution «Pyatigorsk State Research Institute of Balneology of the Federal Medical and Biological Agency», Pyatigorsk
²FederalState Budget Institution «Volgograd Medical Clinical Centre» of the Federal Medical and Biological Agency, Volgograd

A review on the actual problem of modern medicine - nonalcoholic fatty liver disease (NAFLD).

Current views on the pathogenesis of NAFLD allocate two stages of its development («two-hits model»). As the main reasons for the formation of a cascade of metabolic disorders is considered a phenomenon of insulin resistance. Reduced sensitivity of peripheral tissues to insulin and impaired glucose entering the cells lead to the development of hyperinsulinemia, increased flow of free fatty acids in the liver and development of steatosis («one hit»). Lipotoxicity leads to increased formation of free-radical reactive oxygen species. Reactive oxygen species contribute to the progression of the pathological process and the transition of steatosis to steato-hepatitis («2 hit» – oxidative stress). An important role is also played by

a violation of adipocytokines secretion.

The most important tasks of the treatment of non-alcoholic fatty liver disease are: correction of metabolic disorders (weight loss, diet, exercise); increased sensitivity of cell receptors to insulin (metformin, thiazolidinediones); lipid-lowering therapy (statins); treatment of oxidative stress (vitamin E, ursodeoxycholic acid, essential phospholipids); recovery of bowel microbiocenosis. Sanatorium treatment (diet, drinking mineral water, balneotherapy, physiotherapy) activates the main regulatory systems of the body and influence on the basic pathogenetic links of non-alcoholic fatty liver disease.

Keywords: non-alcoholic fatty liver disease, insulin resistance, sanatorium therapy.

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