Влияние таурина на уровень висцерального ожирения и выраженность дисфункции висцерального жира у пациентов с неалкогольной жировой болезнью печени
Влияние таурина на уровень висцерального ожирения и выраженность дисфункции висцерального жира у пациентов с неалкогольной жировой болезнью печени
Стаценко М.Е., Туркина С.В., Горбачева Е.Е. и др. Влияние таурина на уровень висцерального ожирения и выраженность дисфункции висцерального жира у пациентов с неалкогольной жировой болезнью печени. Consilium Medicum. 2019; 21 (12): 128–133. DOI: 10.26442/20751753.2019.12.190666
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Statsenko M.E., Turkina S.V., Gorbacheva E.E. et al. Influence of taurin at the degree of internal obesity and severity of visceral fat dysfunction in patients with non-alcoholic fatty liver disease. Consilium Medicum. 2019; 21 (12): 128–133. DOI: 10.26442/20751753.2019.12.190666
Влияние таурина на уровень висцерального ожирения и выраженность дисфункции висцерального жира у пациентов с неалкогольной жировой болезнью печени
Стаценко М.Е., Туркина С.В., Горбачева Е.Е. и др. Влияние таурина на уровень висцерального ожирения и выраженность дисфункции висцерального жира у пациентов с неалкогольной жировой болезнью печени. Consilium Medicum. 2019; 21 (12): 128–133. DOI: 10.26442/20751753.2019.12.190666
________________________________________________
Statsenko M.E., Turkina S.V., Gorbacheva E.E. et al. Influence of taurin at the degree of internal obesity and severity of visceral fat dysfunction in patients with non-alcoholic fatty liver disease. Consilium Medicum. 2019; 21 (12): 128–133. DOI: 10.26442/20751753.2019.12.190666
Цель. Оценка влияния 24-недельной терапии таурином на уровень висцерального ожирения и выраженность дисфункции висцерального жира у пациентов с неалкогольной жировой болезнью печени (НАЖБП). Материалы и методы. Проведено проспективное сравнительное рандомизированное исследование, в которое были включены 90 пациентов с НАЖБП. Диагноз НАЖБП поставлен по результатам ультразвукового исследования печени (на аппарате Siemens Sonoline G50, Германия, с допплеровским датчиком с оценкой эхогенности печеночной паренхимы, сосудистого рисунка, степени дистального затухания эхосигнала). Методом простой рандомизации пациенты были разделены на 2 группы: 1-я (основная) – пациенты с НАЖБП, которые получали препарат таурин 1000 мг/сут
(2-кратный прием по 500 мг/сут) дополнительно к ежедневной терапии сопутствующих заболеваний (сахарный диабет 2-го типа, ишемическая болезнь сердца, артериальная гипертензия); 2-я (контрольная) – пациенты с НАЖБП, которые принимали только препараты базисной терапии. Исходно и через 24 нед терапии проводили анализ состава тела с оценкой процентного содержания висцерального жира методом биоэлектрической импедансометрии (Omron BF508 52, Япония), рассчитывали индекс висцерального ожирения, определяли выраженность дисфункции висцерального жира. Состояние углеводного обмена контролировали согласно следующим показателям: по уровню глюкозы крови натощак, по базальному инсулину, расчетному индексу инсулинорезистентности HOMA-IR. Для исследования состояния липидного обмена крови определяли уровни общего холестерина, триглицеридов, липопротеидов низкой плотности, липопротеидов высокой плотности.
Результаты. У пациентов с НАЖБП обнаружены выраженное висцеральное ожирение и тяжелая дисфункция висцерального жира, усугубляющаяся по мере увеличения ожирения. Показано, что 24-недельное применение 1000 мг таурина в сутки в лечении пациентов с НАЖБП способствует достоверному уменьшению выраженности висцерального ожирения по данным биоимпедансометрии, показателя индекса висцерального ожирения, а также снижению дисфункции висцерального жира.
Aim. To evaluate influence of 24 weeks taurin therapy on level of internal obesity and severity of visceral fat dysfunction in patients with non-alcoholic fatty liver disease (NAFLD). Materials and methods. A prospective comparative randomized trial that included 90 patients with NAFLD was conducted. NAFLD was diagnosed according to liver ultrasound results (using Siemens Sonoline G50, Germany ultrasound system with Doppler device and evaluation of liver parenchyma echogenicity, vascular pattern, and degree of distal echo signal attenuation). Using simple randomization method the patients were divided into 2 groups: group 1 (study group) included patients with NAFLD receiving taurin 1000 mg per day (500 mg 2 times daily) in addition to daily therapy for coexisting disorders (type 2 diabetes mellitus, ischemic heart disease, arterial hypertension) and group 2 (control group) that included patients with NAFLD receiving only baseline therapy. Body composition analysis with evaluation of visceral fat percentage content using bioelectrical impedansometry (Omron BF508 52, Japan) was performed, internal obesity index and severity of visceral fat dysfunction were determined at baseline and after 24 weeks of treatment. Carbohydrate metabolism state was controlled according to following parameters: fasting glucose serum level, basal insulin level, and Homeostasis Model Assessment of Insulin Resistance HOMA-IR. Total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein levels were evaluated for lipids metabolism status evaluation.
Results. In patients with NAFLD severe internal obesity and severe visceral fat dysfunction worsening in proportion to obesity degree increase were observed. It was shown that use of 1000 mg taurin per day for 24 weeks in treatment of patients with NAFLD results in significant decrease of internal obesity degree according to bioimpedansometry, internal obesity index, and decrease of visceral fat dysfunction.
1. Еstes C, Anstee QM, Arias-Loste MT et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol 2018; 69: 896–904.
2. Lonardo A, Bellentani S, Argo CK et al.; Non-alcoholic Fatty Liver Disease Study Group. Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups. Dig Liver Dis 2015; 477: 997–1006.
3. Lonardo A, Sookoian S, Pirola CJ, Targher G. Non-alcoholic fatty liver disease and risk of cardiovascular disease. Metabolism 2015. DOI: 10.1016/j.metabol.2015.1009.1017
4. Bertolotti, M, Lonardo А, Mussi С et al. Nonalcoholic fatty liver disease and aging: epidemiology to management. World J Gastroenterol 2014; 20: 14185–204.
5. Wong RJ, Ahmed A. Obesity and non-alcoholic fatty liver disease: Disparate associations among Asian populations. World J Hepatol 2014; 6: 263–73.
6. Amarapurkar DN, Hashimoto E, Lesmana LA et al. How common is non-alcoholic fatty liver disease in the Asia? Pacific region and are there local differences? J Gastroenterol Hepatol 2007; 22: 788–93.
7. Tsuruta G, Tanaka N, Hongo M et al. Nonalcoholic fatty liver disease in Japanese junior high school students: its prevalence and relationship to lifestyle habits. J Gastroenterol 2010; 45: 666–72.
8. Berentzen TL, Gamborg M, Holst C et al. Body mass index in childhood and adult risk of primary liver cancer. J Hepatol 2014; 60: 325–30.
9. Long MT, Gurary EB, Massaro JM et al. Parental non-alcoholic fatty liver disease increases risk of non-alcoholic fatty liver disease in offspring. Liver Int 2019; 3 (4): 740–7.
10. Younossi ZM, Koenig AB, Abdelatif D et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016; 64: 73–84.
11. Rodella P, Takase L, dos Santos L et al. The Effect of Taurine on Hepatic Disorders [Version 2]. Curr Updates Hepatol Gastroenterol 2017; 1: 1.2.
12. Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism 2016; 65: 1038–48.
13. Kim SJ, Gupta RC, Lee HW. Taurine-diabetes interaction: from involvement to Protection. Curr Diabetes Rev 2007; 3: 165–75.
14. Lourenço R, Camilo ME. Taurine: a conditionally essential amino acid in humans? An overview in health and disease. Nutr Hosp 2002; 17: 262–70.
15. Marcinkiewicz J, Kontny E. Taurine and inflammatory diseases. Amino Acids 2014; 46: 7–20.
16. Ripps H, Shen W. Review: taurine: a “very essential” amino acid. Mol Vis 2012; 18: 2673–86.
17. Huxtable RJ. Physiological actions of taurine. Physiol Rev 1992; 72: 101–63.
18. Murakami S. Role of taurine in the pathogenesis of obesity. Mol Nutr Food Res 2015; 59 (7):
1353–63.
19. Murakami S. The physiological and pathophysiological roles of taurine in adipose tissue in relation to obesity. Life Sci 2017; 186: 80–6.
20. Kim KS, Jang MJ, Fang S et al. Amino Аcids 2019; 51: 245.
21. Murakami S, Kondo Y, Nagate T. Effects of long-term treatment with taurine in mice fed a high-fat diet: improvement of cholesterol metabolism and vascular lipid accumulation by taurine. Adv Exp Med Biol 2000; 483: 177–86.
22. De la Puerta C, Arrieta FJ, Balsa JA et al. Taurine and glucose metabolism: a review. Nutr Hosp 2010; 25: 910–9.
23. Murakami S, Yamagishi I, Asami Y et al. Hypolipidemic effect of taurine in stroke-prone spontaneously hypertensive rats. Pharmacology 1996; 52: 303–13.
24. Iwakir Y. Phatophysiology of Portal Hypertension. Clin Liver Dis 2014; 18: 281–91.
25. Saito M, Hirano H, Yano Y et al. Serum level of taurine would be associated with the amelioration of minimal hepatic encephalopathy in cirrhotic patients. Hepatol Res 2015; 46: 215–24.
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[Statsenko M.E., Turkina S.V., Shilina N.N. et al. Nonalcoholic fatty liver disease pharmacotherapy: accent on fibrosis. Consilium Medicum. 2018; 20 (8): 37–41. DOI: 10.26442/2075-1753_2018.8.37-41 (in Russian).]
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[Statsenkо M.E., Turkina S.V., Shilina N.N. Liver damage in patients with ischemic chronic heart and type 2 diabetes – a treacherous tandem: possible additional organoprotective therapy. Consilium Medicum. 2016; 18 (5): 103–9 (in Russian).]
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[Statsenko M.E., Turkina S.V., Gorbacheva E.E., Ermolenko A.A. Patogeneticheskie vozmozhnosti taurina v lechenii diabeticheskikh mikro- i makrososudistykh oslozhnenii. Rus. med. zhurn. Med. obozrenie 2018; 2 (5): 10–6 (in Russian).]
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[Statsenko M.E., Turkina S.V., Shilina N.N., Vinnikova A.A. Endoteliotropnye svoistva taurina u bol'nykh khronicheskoi serdechnoi nedostatochnost'iu i sakharnym diabetom 2 tipa. Kardiovask. terapiia i profilaktika. 2016; 15 (2): 38–44 (in Russian).]
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31. Amato MC, Giordano C, Galia M et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010; 33: 920–2.
32. Angulo P, Hui JM, Marchesini G et al. The NAFLD Fibrosis Score: A Noninvasive System That Identifies Liver Fibrosis in Patients with NAFLD. Hеpatology 2007; 45 (4): 846–54.
33. Bedogni G, Bellentani S, Miglioli L et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterology 2006; 6: 33–8.
34. Amato MC et al. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids Health Dis 2011; 10 (183): 1–8.
35. Mohammadreza B et al. Prognostic significance of the complex “Visceral Adiposity Index” vs. simple anthropometric measures: Tehran lipid and glucose study. Cardiovasc Diabetol 2012; 11: 20.
36. Cardona-Alvarado MI, Lopez-Moreno G, Aguilar-Zavala H et al. Relationship of Visceral Adiposity Index with the Metabolic Phenotype and Cardiovascular Markers in Non-Diabetic Subjects. Health Sci J 2018; 12 (5): 588.
37. Yang F, Wang G, Wang Z et al. Visceral Adiposity Index May Be a Surrogate Marker for the Assessment of the Effects of Obesity on Arterial Stiffness. PLoS ONE 2014; 9 (8): e104365.
38. Zhang Z, Shi D, Zhang Q et al. Visceral adiposity index (VAI), a powerful predictor of incident hypertension in prehypertensives. Intern Emerg Med 2018; 13: 509–15.
39. Chaonan Xu, Zhimin Ma, Yunfeng Wang et al. Visceral adiposity index as a predictor of NAFLD:
A prospective study with 4-year follow-up. Liver International 2018; 38 (12): 2294–300.
40. Petta S, Amato MC, Di Marco V et al. Visceral adiposity index is associated with significant fibrosis in patients with non‐alcoholic fatty liver disease. Aliment Pharmacol Ther 2012; 35: 238–47.
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________________________________________________
1. Еstes C, Anstee QM, Arias-Loste MT et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016–2030. J Hepatol 2018; 69: 896–904.
2. Lonardo A, Bellentani S, Argo CK et al.; Non-alcoholic Fatty Liver Disease Study Group. Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups. Dig Liver Dis 2015; 477: 997–1006.
3. Lonardo A, Sookoian S, Pirola CJ, Targher G. Non-alcoholic fatty liver disease and risk of cardiovascular disease. Metabolism 2015. DOI: 10.1016/j.metabol.2015.1009.1017
4. Bertolotti, M, Lonardo А, Mussi С et al. Nonalcoholic fatty liver disease and aging: epidemiology to management. World J Gastroenterol 2014; 20: 14185–204.
5. Wong RJ, Ahmed A. Obesity and non-alcoholic fatty liver disease: Disparate associations among Asian populations. World J Hepatol 2014; 6: 263–73.
6. Amarapurkar DN, Hashimoto E, Lesmana LA et al. How common is non-alcoholic fatty liver disease in the Asia? Pacific region and are there local differences? J Gastroenterol Hepatol 2007; 22: 788–93.
7. Tsuruta G, Tanaka N, Hongo M et al. Nonalcoholic fatty liver disease in Japanese junior high school students: its prevalence and relationship to lifestyle habits. J Gastroenterol 2010; 45: 666–72.
8. Berentzen TL, Gamborg M, Holst C et al. Body mass index in childhood and adult risk of primary liver cancer. J Hepatol 2014; 60: 325–30.
9. Long MT, Gurary EB, Massaro JM et al. Parental non-alcoholic fatty liver disease increases risk of non-alcoholic fatty liver disease in offspring. Liver Int 2019; 3 (4): 740–7.
10. Younossi ZM, Koenig AB, Abdelatif D et al. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology 2016; 64: 73–84.
11. Rodella P, Takase L, dos Santos L et al. The Effect of Taurine on Hepatic Disorders [Version 2]. Curr Updates Hepatol Gastroenterol 2017; 1: 1.2.
12. Buzzetti E, Pinzani M, Tsochatzis EA. The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD). Metabolism 2016; 65: 1038–48.
13. Kim SJ, Gupta RC, Lee HW. Taurine-diabetes interaction: from involvement to Protection. Curr Diabetes Rev 2007; 3: 165–75.
14. Lourenço R, Camilo ME. Taurine: a conditionally essential amino acid in humans? An overview in health and disease. Nutr Hosp 2002; 17: 262–70.
15. Marcinkiewicz J, Kontny E. Taurine and inflammatory diseases. Amino Acids 2014; 46: 7–20.
16. Ripps H, Shen W. Review: taurine: a “very essential” amino acid. Mol Vis 2012; 18: 2673–86.
17. Huxtable RJ. Physiological actions of taurine. Physiol Rev 1992; 72: 101–63.
18. Murakami S. Role of taurine in the pathogenesis of obesity. Mol Nutr Food Res 2015; 59 (7):
1353–63.
19. Murakami S. The physiological and pathophysiological roles of taurine in adipose tissue in relation to obesity. Life Sci 2017; 186: 80–6.
20. Kim KS, Jang MJ, Fang S et al. Amino Аcids 2019; 51: 245.
21. Murakami S, Kondo Y, Nagate T. Effects of long-term treatment with taurine in mice fed a high-fat diet: improvement of cholesterol metabolism and vascular lipid accumulation by taurine. Adv Exp Med Biol 2000; 483: 177–86.
22. De la Puerta C, Arrieta FJ, Balsa JA et al. Taurine and glucose metabolism: a review. Nutr Hosp 2010; 25: 910–9.
23. Murakami S, Yamagishi I, Asami Y et al. Hypolipidemic effect of taurine in stroke-prone spontaneously hypertensive rats. Pharmacology 1996; 52: 303–13.
24. Iwakir Y. Phatophysiology of Portal Hypertension. Clin Liver Dis 2014; 18: 281–91.
25. Saito M, Hirano H, Yano Y et al. Serum level of taurine would be associated with the amelioration of minimal hepatic encephalopathy in cirrhotic patients. Hepatol Res 2015; 46: 215–24.
26. Statsenko M.E., Turkina S.V., Shilina N.N. et al. Nonalcoholic fatty liver disease pharmacotherapy: accent on fibrosis. Consilium Medicum. 2018; 20 (8): 37–41. DOI: 10.26442/2075-1753_2018.8.37-41 (in Russian).
27. Statsenkо M.E., Turkina S.V., Shilina N.N. Liver damage in patients with ischemic chronic heart and type 2 diabetes – a treacherous tandem: possible additional organoprotective therapy. Consilium Medicum. 2016; 18 (5): 103–9 (in Russian).
28. Statsenko M.E., Turkina S.V., Gorbacheva E.E., Ermolenko A.A. Patogeneticheskie vozmozhnosti taurina v lechenii diabeticheskikh mikro- i makrososudistykh oslozhnenii. Rus. med. zhurn. Med. obozrenie 2018; 2 (5): 10–6 (in Russian).
29. Statsenko M.E., Turkina S.V., Shilina N.N., Vinnikova A.A. Endoteliotropnye svoistva taurina u bol'nykh khronicheskoi serdechnoi nedostatochnost'iu i sakharnym diabetom 2 tipa. Kardiovask. terapiia i profilaktika. 2016; 15 (2): 38–44 (in Russian).
30. Yilmaz Ergün. The diagnostic role of ultrasonograhyy in liver streatosis. Turk J Gastroenterol 1999; 2: 96–100.
31. Amato MC, Giordano C, Galia M et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 2010; 33: 920–2.
32. Angulo P, Hui JM, Marchesini G et al. The NAFLD Fibrosis Score: A Noninvasive System That Identifies Liver Fibrosis in Patients with NAFLD. Hеpatology 2007; 45 (4): 846–54.
33. Bedogni G, Bellentani S, Miglioli L et al. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterology 2006; 6: 33–8.
34. Amato MC et al. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids Health Dis 2011; 10 (183): 1–8.
35. Mohammadreza B et al. Prognostic significance of the complex “Visceral Adiposity Index” vs. simple anthropometric measures: Tehran lipid and glucose study. Cardiovasc Diabetol 2012; 11: 20.
36. Cardona-Alvarado MI, Lopez-Moreno G, Aguilar-Zavala H et al. Relationship of Visceral Adiposity Index with the Metabolic Phenotype and Cardiovascular Markers in Non-Diabetic Subjects. Health Sci J 2018; 12 (5): 588.
37. Yang F, Wang G, Wang Z et al. Visceral Adiposity Index May Be a Surrogate Marker for the Assessment of the Effects of Obesity on Arterial Stiffness. PLoS ONE 2014; 9 (8): e104365.
38. Zhang Z, Shi D, Zhang Q et al. Visceral adiposity index (VAI), a powerful predictor of incident hypertension in prehypertensives. Intern Emerg Med 2018; 13: 509–15.
39. Chaonan Xu, Zhimin Ma, Yunfeng Wang et al. Visceral adiposity index as a predictor of NAFLD:
A prospective study with 4-year follow-up. Liver International 2018; 38 (12): 2294–300.
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