Метаболічно-асоційована стеатотична хвороба печінки як причина і наслідок кардіометаболічних ускладнень: можливості патогенетичної гепатопротекції (Огляд літератури)
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Анотація
Метаболічно-асоційована стеатотична хвороба печінки (МАСХП) є глобальною медико-соціальною проблемою сучасності у зв’язку з великою поширеністю, захворюваністю і смертністю. Основною причиною смерті пацієнтів із МАСХП є не печінкові, а кардіометаболічні ускладнення, що свідчить про системний характер метаболічних порушень. У статті розглянуто сучасні уявлення про патогенез МАСХП, показано чіткий взаємозв’язок МАСХП з ожирінням, метаболічним синдромом, цукровим діабетом 2-го типу, серцево-судинними захворюваннями. Проаналізовано сучасні терапевтичні підходи до діагностики й лікування МАСХП. Основою лікування МАСХ є модифікація способу життя у поєднанні із застосуванням лікарських засобів метаболічної та гепатотропної дії з метою зменшення прогресування МАСХП й запобігання кардіометаболічним ускладненням. На основі аналізу сучасних клінічних і експериментальних досліджень висвітлено позитивні фармакологічні ефекти урсодеоксихолевої кислоти (УДХК) щодо зменшення стеатозу і фіброзу печінки, покращення глікемічного контролю, ліпідного профілю, зниження маси тіла. Акцентовано на численних плейотропних ефектах УДХК, які спрямовані на гепатопротекцію з реалізацією антиоксидантної, цитопротективної та антифібротичної дії. Особливу увагу приділено впливу УДХК на стан кишкової мікробіоти та підтримання цілісності кишкового бар’єра як фактора прогресування метаболічних порушень при МАСХП. З аналізу сучасних літературних даних можна зробити висновок, що найбільш доцільним підходом до лікування МАСХП є застосування УДХК, яка володіє достатнім терапевтичним потенціалом для захисту печінки й запобігання кардіометаболічним ускладненням.
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