Authors: A. V. Kuriata, M. M. Hrechanyk, DZ «Dnepropetrovsk Medical Academy of the Ministry of Health of Ukraine», Dnipro
The aim of the study was to estimate the effect of ursodeoxycholic acid (UDCA) on the lipid profile, endothelial dysfunction and insulin resistance in patients with coronary heart disease (CHD) in combination with non-alcoholic steatosis.
Materials and methods
The group 1 consisted of 24 patients with CHD and nonalcoholic hepatic steatosis, the group 2 included 18 patients with CHD without hepatic steatosis. The levels of triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol were detected by immunoassay using “Human” (Germany) reagents on the RT-1904C Chemistry Analyzer. The level of plasma insulin was measured by immunoassay using Insulin ELISA, “DRG” (Germany). The functional state of blood vessels endothelium was determined according to the results of reactive hyperemia test. The indicators of insulin resistance was calculated.
Significantly higher levels of TG, insulin resistance and more pronounced endothelial dysfunction indicators in the presence of correlation between the levels of TG with the indexes HOMA1-IR and HOMA2-IR in the group 1 in comparison to the group 2 were found. Decreased levels of TG by 13 % (P = 0.02), low-density lipoprotein cholesterol by 18 % (P = 0.02), very-low-density lipoprotein cholesterol by 42 % (P = 0.02), C-reactive protein by 33 % (P = 0.02) and increased reactive hyperemia index by 35 % (P < 0.05) were revealed in patients with CHD and non-alcoholic steatosis within 2 months of UDCA administration at a dose of 15 mg/kg compared to UDCA untreated patients.
It has been established that the use of UDCA in patients with coronary heart disease and non-alcoholic hepatic steatosis as secondary prevention in cases of statins intolerance can improve the lipid profile, endothelial function and reduce C-reactive protein.
Key words: coronary heart disease, non-alcoholic fatty liver, insulin resistance, lipids, vascular endothelium, ursodeoxycholic acid.
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