retracted

Literature Reviews

doi: 10.25005/2074-0581-2017-19-3-393-398
NON-ALCOHOLIC FATTY LIVER DISEASE: MODERN ASPECTS OF ETIOPATHOGENESIS AND TREATMENT

N.V. Efimenko1, T.I. Ledovskaya2, Т.Е. Fyodorova1, Z.A. Vakhaeva3, A.S. Kaysinova1

1Federal State Budgetary Institution «Pyatigorsk State Scientific Research Institute of Balneology» of the Federal Medical-Biological Agency, Pyatigorsk, Russia
2Federal State Budgetary Institution «Volgograd Medical Clinical Center» of the Federal Medical-Biological Agency, Volgograd, Russia
3LLC “Diagnosticum”, Grozny, Russia

In modern gastroenterology, non-alcoholic fatty liver disease (NAFLD) occupies a special place, in the pathogenesis of which the two stages of development are distinguished («two-hit model»): I hit – is the development of steatosis, based on insulin resistance, and II hit – the transition of steatosis to steatohepatitis caused by course of oxidative stress. Recent studies indicate a significant role in the development of NAFLD adipocytokines and inflammatory mediators (leptin, tumour necrosis factor-α, adiponectin, interleukins, etc.), which contribute to increased insulin resistance, and also support the inflammatory response and stimulate fibrogenesis. In the medical rehabilitation of NAFLD, along with drug therapy, non-drug methods are widely used, in particular, the use of drinking mineral waters inside and outside, which contribute to the activation of the basic bioregulatory systems of the body.

Keywords: Non-alcoholic fatty liver disease, insulin resistance, oxidative stress, health-resort therapy.

Download file:


References
  1. Vyalov SS. Kliniko-patofiziologicheskie aspekty gepatoprotektivnoy terapii u lits molodogo vozrasta [Clinico-pathophysiological aspects of hepatoprotective therapy in young people]. Doktor.ru. 2011;5(64):42-8.
  2. Gundermann KY. Nealkogol’naya zhirovaya bolezn’ pecheni: ot opredeleniya k lecheniyu [Non-alcoholic fatty liver disease: from definition to treatment]. Rossiyskie meditsinskie vesti. 2009;XIV(2):1-7.
  3. De Alwis NM, Day CP. Non-alcoholic fatty liver disease: the mist gradually clears. J Hepatol. 2008;48(1):104-12.
  4. Clark JM. The prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol. 2003;98:955-6.
  5. Drapkina OM, Gatsolaeva DS, Ivashkin VT. Nealkogol’naya zhirovaya bolezn’ pecheni kak komponent metabolicheskogo sindroma [Non-alcoholic fatty liver disease as a component of the metabolic syndrome]. Rossiyskie meditsinskie vesti. 2010;2:72-8.
  6. Balukova EV, Uspenskiy YuP. Essentsial’nye fosfolipidy v kompleksnoy terapii nealkogol’noy zhirovoy bolezni pecheni [Essential phospholipids in the complex therapy of non-alcoholic fatty liver disease]. RMZh. Bolezni organov pishchevareniya. 2011;28:1766-9.
  7. Kimura Y, Hyogo H, Ishitobi T, Nabeshima Y, Arihiro-Chayama K. Postprandial insulin secretion pattern is associated with histological severity in nonalcoholic fatty liver disease patients without prior known diabetes mellitus. Journal of Gastroenterology and Hepatology. 2011;26:517-22.
  8. Gaiani S, Avogaro A, Bombonato GC. Nonalcoholic fatty liver disease (NAFLD) in non obese patients with diabetes: Prevalence and relationships with hemodynamic alterations detected with Doppler sonography. Journal of Ultrasound. 2009;12:1-5
  9. Hojo M, Watanabe S. Pharmacological therapy of nonalcoholic steatohepatitis. Hepatol Res. 2011;41(3):209-16.
  10. Golofeevskiy VYu. Vazhneyshie voprosy patomorfogeneza i lecheniya nealkogol’noy zhirovoy bolezni pecheni u bol’nykh sakharnym diabetom [The most important issues of pathomorphogenesis and treatment of non-alcoholic fatty liver disease in patients with diabetes mellitus]. Vrach. 2012;8:8-11.
  11. Korochina IE. Gastroenterologicheskie aspekty metabolicheskogo sindroma [Gastroenterological aspects of metabolic syndrome]. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii. 2008;1:26-37.
  12. Rizza R. Pathogenesis of fasting and postprandial hyperglycemia in type 2 diabetes: implications for therapy. Diabetes. 2010;11:2697-707.
  13. Krasilnikova EN, Bystrova AA. Sindrom insulinorezistentnosti i pechen’ [Insulin resistance syndrome and liver]. Effektivnaya farmakoterapiya. 2011;2:24-8.
  14. Musso G, Gambino R, Cassader M. Non-alcoholic fatty liver disease from pathogenesis to management: an update. Obesity Reviews. 2010;11(6):430-45.
  15. Efimenko NV, Kaysinova AS, Fyodorova TE, Botvineva LA. Effektivnost’ kurortnoy terapii s primeneniem pit’evykh mineral’nykh vod Essentukskogo tipa pri lechenii nealkogol’noy zhirovoy bolezni pecheni u bol’nykh sakharnym diabetom 2 tipa [The effectiveness of spa therapy with the use of drinking mineral waters of Essentuki type in the treatment of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus]. Voprosy kurortologii, fizioterapii i lechebnoy fizkul’tury. 2015;3:14-7.
  16. Shilov AM, Osiya AO, Eryomina IV, Cherepanova EA. Insulinorezistentnost’, narusheniya tolerantnosti k glyukoze i ikh korrektsiya u patsientov s metabolicheskim sindromom [Insulin resistance, disorders of glucose tolerance and their correction in patients with metabolic syndrome]. Vrach. 2011;2:16-20.
  17. Bueverov AO, Bogomolov PO. Nealkogol’naya zhirovaya bolezn’ pecheni: obosnovanie patogeneticheskoy terapii [Non-alcoholic fatty liver disease: rationale for pathogenetic therapy]. Klinicheskie perspektivy gastroenterologii i gepatologii. 2009;1:3-9.
  18. Vovk EI. Lechenie nealkogol’noy zhirovoy bolezni pecheni v praktike terapevta: Chto? Gde? Kogda? [Treatment of nonalcoholic fatty liver disease in the practice of the therapist: What? Where? When?]. RMZh. Bolezni organov pishchevareniya. 2011;11:1038-46.
  19. Cusi K. Role of insulin resistance and lipotoxicity in nonalcoholic steatohepatitis. Clin Liver Dis. 2009;13 (4):545-63.
  20. Kimura Y, Hyogo H, Ishitobi T, Nabeshima Y, Arihiro-Chayama K. Postprandial insulin secretion pattern is associated with histological severity in nonalcoholic fatty liver disease patients without prior known diabetes mellitus. Journal of Gastroenterology and Hepatology. 2011;26:517-22.
  21. Zheng L, Guo-cai L, Sheng J, Yang Y. Effect of miRNA-10b in regulating cellular steatosis level by targeting PPAR-alpha expression, a novel mechanism for the pathogenesis of NAFLD. Journal of Gastroenterology and Hepatology. 2010;25:156-63.
  22. Foretz M, Viollet B. Regulation of hepatic metabolism by AMPK. J Hepatol. 2011;54(4):827-9.
  23. Lewis JR, Mohanty SR. Non-alcoholic fatty liver disease: a review and update. Digestive Diseases and Sciences. 2010;55:560-78.
  24. Shulpekova YuO. Patogeneticheskoe znachenie lipidov pri nealkogol’noy zhirovoy bolezni pecheni [Pathogenetic significance of lipids in non-alcoholic fatty liver disease]. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii. 2012;1:45-55.
  25. Tolman KG, Fonseca V, Dalpiaz A, Tan MH. Spectrum of liver disease in type 2 diabetes and management of patients with diabetes and liver disease. Diabetes Care. 2007;30:734-43.
  26. Ghouri N, Preiss D, Sattar N. Liver enzymes, nonalcoholic fatty liver disease, and incident cardiovascular disease: a narrative review and clinical perspective of prospective data. Hepatology. 2010;52:1156-61.
  27. Mekhtiev SN, Mekhtieva OA. Sovremennyy vzglyad na perspektivy terapii nealkogol’noy bolezni pecheni [Modern view on the prospects for therapy of non-alcoholic liver disease]. Effektivnaya farmakoterapiya. 2011;2:50-6.
  28. Targher G. Non-alcoholic fatty liver disease and cardiovascular disease risk. Curr Cardio Risk Rep. 2010;4:32-9.
  29. Geyvandova NI, Belova NG, Faleeva OV, Aleksandrovich GA. Vliyanie insulinovykh sensitayzerov na nekotorye pokazateli vospaleniya pri nealkogol’noy zhirovoy bolezni pecheni [Influence of insulin sensitizers on some inflammation indices in non-alcoholic fatty liver disease]. Meditsinskiy vestnik Severnogo Kavkaza. 2011;3(14):106-7.
  30. Sanyal AJ, Chalasani N, Kowdley KV. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. NEJM. 2010;362(18):1675-85.
  31. Souza O, Tadeu S, Cavaleiro А. Association of polymorphisms of glutamatecystein ligase and microsomal triglyceride transfer protein genes in nonalcoholic fatty liver disease. Journal of Gastroenterology and Hepatology. 2010;25:357-61.
  32. Chernyavskiy VV. Zhirovaya bolezn’ pecheni kak integral’naya problema vnutrenney meditsiny [Fatty liver disease as an integral problem of internal medicine]. Novosti meditsiny i farmatsii. 2011;4(354):11-4.
  33. Cheung O, Sanyal AJ. Recent advances in nonalcoholic fatty liver disease: Pathogenesis. Curr Opin Gastroenterol. 2010;26(3):202-8.
  34. Efimenko NV, Kaysinova AS, Metsaeva ZV, Fyodorova TE, Ortabaeva MKh. Mineral’nye vody v reabilitatsii bol’nykh s nealkogol’nymi porazheniyami pecheni na statsionarnom etape [Mineral water in the rehabilitation of patients with non-alcoholic liver damage at the inpatient stage]. Voprosy kurortologii, fizioterapii i lechebnoy fizkul’tury. 2012;1(89):17-20.
  35. Efimenko NV, Kaysinova AS, Metsaeva ZV. Mineral’naya voda Tib-2 v lechenii bol’nykh nealkogol’nym steatogepatitom [Mineral water Tib-2 in the treatment of patients with non-alcoholic steatohepatitis]. Meditsinskiy vestnik Yuga Rossii. 2012;3:67-9.
  36. Fyodorova TE, Efimenko NV, Kaysinova AS. Kurortnaya terapiya nealkogol’noy zhirovoy bolezni pecheni s primeneniem pit’evykh mineral’nykh vod essentukskogo tipa [Spa therapy of non-alcoholic fatty liver disease using drinking Essentuki mineral water]. Voprosy kurortologii, fizioterapii i lechebnoy fizkul’tury. 2012;6(89):21-3.
  37. Osipov YuS, Efimenko NV, Ereshova IG. Primenenie sul’fidnykh mineral’nykh vod v kompleksnom kurortnom lechenii bol’nykh, khronicheskim antral’nym gastritom, assotsiirovannogo s Helicobacter pylori, na stadii predrakovoy patologii zheludka [The use of sulfide mineral waters in complex spa treatment of patients, chronic antral gastritis associated with Helicobacter pylori, at the stage of precancerous pathology of the stomach]. Pyatigorsk, RF: Meditsinskaya tekhnologiya; 2008. 23 p.
  38. Fyodorova TE, Efimenko NV, Ledovskaya TI. Meditsinskaya reabilitatsiya bol’nykh s metabolicheskimi i toksiko-khimicheskimi porazheniyami pecheni na sanatorno-kurortnom etape [Medical rehabilitation of patients with metabolic and toxic-chemical lesions of the liver at the sanatorium-and-spa stage]. Kurortnaya meditsina. 2015;1:30-5.
  39. Fyodorova TE, Efimenko NV. Kurortnaya terapiya metabolicheskikh i toksikokhimicheskikh porazheniy pecheni s primeneniem magnitoforeza dalargina [Spa therapy of metabolic and toxic-chemical lesions of the liver with application of dalargin magnetophoresis]. Kurortnaya meditsina. 2013;4:12-5.

Authors' information:


Efimenko Natalia Viktorovna,
Doctor of Medical Sciences, Full Professor, Director of Pyatigorsk State Scientific Research Institute of Balneology

Ledovskaya Tatyana Ivanovna,
Candidate of Medical Sciences, Director of the Volgograd Medical Clinical Center

Fyodorova Tatyana Evgenievna,
Candidate of Medical Sciences, Leading Researcher of the Scientific Department of the Restorative Gastroenterology of Essentuki Branch of the Pyatigorsk State Scientific Research Institute of Balneology

Vakhaeva Zarema Adamovna,
Physician Therapist of the LLC «Diagnosticum»

Kaysinova Agnessa Sardoevna,
Doctor of Medical Sciences, Deputy Director for Curative Work, Pyatigorsk State Scientific Research Institute of Balneology

Conflicts of interest: No conflict

Address for correspondence:


Kaysinova Agnessa Sardoevna

Doctor of Medical Sciences, Deputy Director for Curative Work of Pyatigorsk State Scientific Research Institute of Balneology

357500, Russian Federation, Pyatigorsk, Kirova ave., 30

Tel: (+7) 8793 335766

E-mail: orgotdel@gniik.ru