Preview

Russian Journal of Gastroenterology, Hepatology, Coloproctology

Advanced search

Non-alcoholic fatty liver disease: comparative assessment of diagnostic and treatment approaches in the Russian Federation and People’s Republic of China

https://doi.org/10.22416/1382-4376-2017-27-6-63-70

Abstract

Aim of review. To present comparative assessment of diagnostic and treatment approaches at non-alcoholic fatty liver disease (NAFLD) in the Russian Federation and People’s Republic of China. Summary. NAFLD is the leading disease entity among the other chronic liver diseases in the countries of various regions of the world, at the present time it is considered to be one of the main causes for cryptogenic liver cirrhosis development. The pathogenesis of NAFLD closely correlates to both hepatic and cardiovascular involvement that significantly influences both treatment choice and life prognosis. According to the international clinical guidelines, NAFLD screening methods should include elastometry and serological tests to rule out severe liver fibrosis (F> 2). Liver biopsy is carried out at contradictory data of liver elastometry and serological fibrosis markers. Treatment of NAFLD should integrate the range of measures including correction of patients dietic habits and physical activity up to pharmacological treatment. Pharmacotherapy is recommended in the case of nonalcoholic steatohepatitis (NASH) progression (bridging fibrosis ³ F2 and cirrhosis), as well as the earlier stages of NASH with two and more fibrosis progression risk factors (age over 50 years, diabetes mellitus, metabolic syndrome, alanine transaminase elevation). Bicyclol is a drug developed in Materia Medica institute of Academy of medical sciences of China. The study is carried on by Chinese physicians have demonstrated efficacy of the drug for treatment of chronic liver diseases of various etiology, along with its antiinflammatory and antifibrotic properties. The drug registration studies conducted in the Russian Federation revealed high clinical performance of Bicyclol. Conclusion. Etiological and pathogenetic features of NAFLD require diverse therapeutic actions from dietic recommendations and physical activity correction of the prescription of various pharmacological agents. Results of clinical efficacy estimation of the new drug Bicyclol in the Russian market, that it was developed in the People’s Republic of China demonstrate reduction of severity of inflammation, steatosis, fibrosis and decrease of NAFLD activity scores.

About the Authors

M. Ch. Semenistaya
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University
Russian Federation


Fan Jian-Gao
Liver Cancer Institute
Russian Federation


O. B. Velichenko
GMP Bioscience
Russian Federation


Ye. A. Kuznetsova
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University
Russian Federation


Ch. S. Pavlov
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University
Russian Federation


References

1. Павлов Ч.С., Кузнецова Е.А., Арсланян М.Г., Семенистая М.Ч., Глушенков Д.В., Николенко В.Н. Неалкогольная жировая болезнь печени: современные концепции этиологии, патогенеза, диагностики и лечения. Медвестн Северного Кавказа 2017;12(2):230-4.

2. Ивашкин В.Т., Маевская М.В., Павлов Ч.С., Тихонов И.Н., Широкова Е.Н., Буеверов А.О., Драпкина О.М., Шульпекова Ю.О., Цуканов В.В., Маммаев С.Н., Маев И.В., Пальгова Л.К. Клинические рекомендации по диагностике и лечению неалкогольной жировой болезни печени Российского общества по изучению печени и Российской гастроэнтерологической ассоциации. Рос журн гастроэнтерол гепатол колопроктол 2016; 26(2):24-42.

3. Ивашкин В.Т., Драпкина О.М., Маев И.В., Трухманов А.С., Блинов Д.В., Пальгова Л.К., Цуканов В.В., Ушакова Т.И. Распространенность неалкогольной жировой болезни печени у пациентов амбулаторно-поликлинической практики в Российской Федерации: результаты исследования DIREG 2. Рос журн гастроэнтерол гепатол колопроктол 2015; 6: 31-41.

4. Thoma C., Day C.P., Trenell M.I. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: a systematic review. J Hepatol 2012; 56: 255-66.

5. NAFLD: Practical recommendation. J Hepatol 2015; 63: 174-82.

6. Belfort R., Harrison S.A., Brown K., Darland C., Finch J., Hardies J. et al. A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med 2006; 355: 2297-307.

7. Bugianesi E., Gentilcore E., Manini R., Natale S., Vanni E., Villanova N. et al. A randomized controlled trial of metformin versus vitamin E or prescriptive diet in nonalcoholic fatty liver disease. Am J Gastroenterol 2005; 100: 1082-90.

8. Hoofnagle J.H., Van Natta M.L., Kleiner D.E., Clark J.M., Kowdley K.V., Loomba R. et al. Vitamin E and changes in serum alanine aminotransferase levels in patients with non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2013; 38: 134-43.

9. Schurks M., Glynn R.J., Rist P.M., Tzourio C., Kurth T. Effects of vitamin E on stroke subtypes: metaanalysis of randomised controlled trials. Br Med J 2010; 341:5702.

10. Klein E.A., Thompson Jr. I.M., Tangen C.M., Crowley J.J., Lucia M.S., Goodman P.J. et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA 2011; 306: 1549-56.

11. Lindor K.D., Kowdley K.V., Heathcote E.J., Harrison M.E., Jorgensen R., Angulo P. et al. Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: results of a randomized trial. Hepatology 2004; 39: 770-8.

12. Leuschner U.F., Lindenthal B., Herrmann G., Arnold J.C., Rossle M., Cordes H.J. et al. Highdose ursodeoxycholic acid therapy for nonalcoholic steatohepatitis: a double-blind, randomized, placebocontrolled trial. Hepatology 2010; 52: 472-9.

13. Ying Han, Jun-Ping Shi, Gao Fan et al. Randomized, Vitamin E-Controlled Trial of Bicyclol Plus Metformin in Non-Alcoholic Fatty Liver Disease Patients with Impaired Fasting Glucose. Clin Drug Invest 2014; 34:1-7.

14. Xu Yun-Wen Xiaogangz-Wang Zhenyu-Li Jichang. Therapeutic effect of weight loss combining bicyclol on primary nonalcoholic fatty liver diseases. Liver Int 2005; 25(4): 872-9.


Review

For citations:


Semenistaya M.Ch., Jian-Gao F., Velichenko O.B., Kuznetsova Ye.A., Pavlov Ch.S. Non-alcoholic fatty liver disease: comparative assessment of diagnostic and treatment approaches in the Russian Federation and People’s Republic of China. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2017;27(6):63-70. (In Russ.) https://doi.org/10.22416/1382-4376-2017-27-6-63-70

Views: 26594


ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)