Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Клинический случай наблюдения пациента с ожирением и неалкогольной жировой болезнью печени
Клинический случай наблюдения пациента с ожирением и неалкогольной жировой болезнью печени
Комшилова К.А., Трошина Е.А. Клинический случай наблюдения пациента с ожирением и неалкогольной жировой болезнью печени. Consilium Medicum. 2015; 17 (4): 59–61.
________________________________________________
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Неалкогольная жировая болезнь печени (НАЖБП) – заболевание, тесно ассоциированное с ожирением, особенно абдоминальным, и разными метаболическими маркерами риска развития сердечно-сосудистых заболеваний и сахарного диабета типа 2, что, естественно, отражается на заболеваемости, прогнозе и продолжительности жизни лиц с ожирением. В статье приведен клинический случай наблюдения и лечения пациента с ожирением и НАЖБП, ассоциированных с характерным комплексом метаболических нарушений. Показано, что комбинированная терапия, включающая модификацию образа жизни и прием метформина у лиц с ожирением и НАЖБП, является безопасной и эффективной в отношении коррекции обнаруженных метаболических нарушений.
Ключевые слова: ожирение, неалкогольная жировая болезнь печени, инсулинорезистентность, метформин.
Key words: obesity, non-alcoholic fatty liver disease, insulin resistance, metformin.
Ключевые слова: ожирение, неалкогольная жировая болезнь печени, инсулинорезистентность, метформин.
________________________________________________
Key words: obesity, non-alcoholic fatty liver disease, insulin resistance, metformin.
Полный текст
Список литературы
1. Targher G et al. Risk of Cardiovascular Disease in Patients with Nonalcoholic Fatty Liver Disease. N Engl J Med 2010.
2. Misra VL, Khashab M, Chalasani N. Nonalcoholic Fatty Liver Disease and Cardiovascular Risk. Curr Gastroenterol Rep 2009; 11: 50–5.
3. Stefan N, Kantartzis K, Häring H. Causes and Metabolic Consequences of Fatty Liver. Endocr Rev 2008; 29 (7): 939–60.
4. Lazo M, Clark J. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis 2008; 28 (4): 339–50.
5. Musso G, Gambino R, Cassader M. Non-alcoholic fatty liver disease from pathogenesis to management: an update. Obesity Rev 2010; 11 (6): 430–45.
6. Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. QJM 2010; 103 (2): 71–83.
7. Festi D, Colecchia A, Sacco T et al. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev 2004; 5 (1): 27–42.
8. Adams L, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgraduate medical J 2006; 82: 315–22.
9. Marchesini G, Bianchi G, Tomassetti S et al. Metformin in non-alcoholic steatohepatitis. Lancet 2001; 358 (9285): 893–4.
10. Nair S, Diehl A, Wiseman M. Metformin in the triement of non- alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther 2004; 20: 23–8.
11. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and nonalcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34: 274–85.
12. Chalasani N, Younossi Z, Lavine JE et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol 2012;107: 811–26.
13. Kleiner DE, Brunt EM, Van Natta M et al. Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41 (6): 1313–21.
2. Misra VL, Khashab M, Chalasani N. Nonalcoholic Fatty Liver Disease and Cardiovascular Risk. Curr Gastroenterol Rep 2009; 11: 50–5.
3. Stefan N, Kantartzis K, Häring H. Causes and Metabolic Consequences of Fatty Liver. Endocr Rev 2008; 29 (7): 939–60.
4. Lazo M, Clark J. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis 2008; 28 (4): 339–50.
5. Musso G, Gambino R, Cassader M. Non-alcoholic fatty liver disease from pathogenesis to management: an update. Obesity Rev 2010; 11 (6): 430–45.
6. Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. QJM 2010; 103 (2): 71–83.
7. Festi D, Colecchia A, Sacco T et al. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev 2004; 5 (1): 27–42.
8. Adams L, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgraduate medical J 2006; 82: 315–22.
9. Marchesini G, Bianchi G, Tomassetti S et al. Metformin in non-alcoholic steatohepatitis. Lancet 2001; 358 (9285): 893–4.
10. Nair S, Diehl A, Wiseman M. Metformin in the triement of non- alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther 2004; 20: 23–8.
11. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and nonalcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34: 274–85.
12. Chalasani N, Younossi Z, Lavine JE et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol 2012;107: 811–26.
13. Kleiner DE, Brunt EM, Van Natta M et al. Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41 (6): 1313–21.
2. Misra VL, Khashab M, Chalasani N. Nonalcoholic Fatty Liver Disease and Cardiovascular Risk. Curr Gastroenterol Rep 2009; 11: 50–5.
3. Stefan N, Kantartzis K, Häring H. Causes and Metabolic Consequences of Fatty Liver. Endocr Rev 2008; 29 (7): 939–60.
4. Lazo M, Clark J. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis 2008; 28 (4): 339–50.
5. Musso G, Gambino R, Cassader M. Non-alcoholic fatty liver disease from pathogenesis to management: an update. Obesity Rev 2010; 11 (6): 430–45.
6. Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. QJM 2010; 103 (2): 71–83.
7. Festi D, Colecchia A, Sacco T et al. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev 2004; 5 (1): 27–42.
8. Adams L, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgraduate medical J 2006; 82: 315–22.
9. Marchesini G, Bianchi G, Tomassetti S et al. Metformin in non-alcoholic steatohepatitis. Lancet 2001; 358 (9285): 893–4.
10. Nair S, Diehl A, Wiseman M. Metformin in the triement of non- alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther 2004; 20: 23–8.
11. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and nonalcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34: 274–85.
12. Chalasani N, Younossi Z, Lavine JE et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol 2012;107: 811–26.
13. Kleiner DE, Brunt EM, Van Natta M et al. Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41 (6): 1313–21.
________________________________________________
2. Misra VL, Khashab M, Chalasani N. Nonalcoholic Fatty Liver Disease and Cardiovascular Risk. Curr Gastroenterol Rep 2009; 11: 50–5.
3. Stefan N, Kantartzis K, Häring H. Causes and Metabolic Consequences of Fatty Liver. Endocr Rev 2008; 29 (7): 939–60.
4. Lazo M, Clark J. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis 2008; 28 (4): 339–50.
5. Musso G, Gambino R, Cassader M. Non-alcoholic fatty liver disease from pathogenesis to management: an update. Obesity Rev 2010; 11 (6): 430–45.
6. Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. QJM 2010; 103 (2): 71–83.
7. Festi D, Colecchia A, Sacco T et al. Hepatic steatosis in obese patients: clinical aspects and prognostic significance. Obes Rev 2004; 5 (1): 27–42.
8. Adams L, Angulo P. Treatment of non-alcoholic fatty liver disease. Postgraduate medical J 2006; 82: 315–22.
9. Marchesini G, Bianchi G, Tomassetti S et al. Metformin in non-alcoholic steatohepatitis. Lancet 2001; 358 (9285): 893–4.
10. Nair S, Diehl A, Wiseman M. Metformin in the triement of non- alcoholic steatohepatitis: a pilot open label trial. Aliment Pharmacol Ther 2004; 20: 23–8.
11. Vernon G, Baranova A, Younossi ZM. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and nonalcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011; 34: 274–85.
12. Chalasani N, Younossi Z, Lavine JE et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol 2012;107: 811–26.
13. Kleiner DE, Brunt EM, Van Natta M et al. Nonalcoholic Steatohepatitis Clinical Research Network. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41 (6): 1313–21.
Авторы
К.А.Комшилова*, Е.А.Трошина
ФГБУ Эндокринологический научный центр Минздрава России. 117036, Россия, Москва, ул. Дмитрия Ульянова, д. 11
*komshilovaksenia@rambler.ru
Endocrinology Research Center of the Ministry of Health of the Russian Federation. 117036, Russian Federation, Moscow, ul. Dmitriia Ul'ianova, d. 11
*komshilovaksenia@rambler.ru
ФГБУ Эндокринологический научный центр Минздрава России. 117036, Россия, Москва, ул. Дмитрия Ульянова, д. 11
*komshilovaksenia@rambler.ru
________________________________________________
Endocrinology Research Center of the Ministry of Health of the Russian Federation. 117036, Russian Federation, Moscow, ul. Dmitriia Ul'ianova, d. 11
*komshilovaksenia@rambler.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.