The role of ursodeoxycholic acid preparations in treatment regimens of hepatobiliary-pancreatic diseases associated with metabolic syndrome

Author: O. Prosolenko

Kharkiv National Medical University, Kharkiv, Ukraine


Summary

The article presents current data on the hepatobiliarypancreatic zone lesions in metabolic syndrome. The main unifying links in pathogenesis of these conditions are insulin resistance, carbohydrate and lipid metabolism disorders, pro-inflammatory status, oxidative stress, imbalance of adipose tissue hormones, genetic factors, etc. The main effects of ursodeoxycholic acid (UDCA ), namely litholytic, anticholestatic, choleretic, cytoprotective, antiapoptic, immunomodulatory, hypocholesterolemic, anti-inflammatory, antioxidant, have been analyzed. UDCA ability to inhibit the proliferation and differentiation of human subcutaneous adipocytes has been highlighted. It is important that the researchers associated this effect with drug’s ability to inactivate PPAR -γ and with activation of farnesoid receptors (FXR) and G-protein receptors (TGR5). The main data on the effectiveness of UDCA in patients with non-alcoholic fatty liver disease, biliary dysfunction, gallbladder cholesterosis, and gallstone disease have been analyzed and highlighted. The most effective treatment regimens in these diseases using UDCA have been discussed. Possibilities of including UDCA in separate schemes of combined therapy, its positive effect on  cardiovascular system abnormalities associated with metabolic syndrome were also considered. The current data proving that UDCA has better clinical and biochemical effect in long-term use have been highlighted. Treatment with using of UDCA is more effective against the background of patient’s weight loss.

Key words: ursodeoxycholic acid, metabolic syndrome, non-alcoholic fatty liver disease, non-alcoholic fatty pancreatic disease, biliary tract diseases

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