Ursodeoxycholic acid in the treatment of patients with non-alcoholic fatty liver disease and its effect on metabolic cardiovascular risk factors

Aim. To evaluate the efficacy of ursodeoxycholic acid (UDCA, Ursosan) in the complex treatment of patients with non-alcoholic fatty liver disease (NAFLD) based on abdominal magnetic resonance imaging data and its effect on metabolic cardiovascular risk factors.

Material and methods. This prospective, open-label, non-randomized study was conducted involving 53 patients with NAFLD. Subjects were divided into two groups. All patients were assigned to a hypocaloric diet and moderate physical activity. Patients in the first group received UDCA at a dose of 12 mg/kg of body weight per day for 6 months. Patients in the second group (the comparison group) did not receive medication and followed lifestyle modification recommendations. The study included clinical and laboratory examinations, including abdominal ultrasound and magnetic resonance imaging to determine liver fat fraction, alanine aminotransferase, aspartate aminotransferase, blood glucose, uric acid, and lipid profile levels. Statistical analysis was performed using the Wilcoxon signed-rank test and Spearman correlation analysis.

Results. Ursosan therapy resulted in a significant decrease in liver fat fraction (median from 11,4 to 9,2%; p=0,009), total cholesterol (from 6,6 to 5,3 mmol/L; p=0,001), triglycerides (from 1,9 to 1,6 mmol/L; p=0,010), uric acid (from 386 to 334 μmol/L; p=0,001), alanine aminotransferase (from 28,1 to 23,0 U/L; p=0,020), and aspartate aminotransferase (from 25,3 to 22,6 U/L; p=0,021). No side effects were observed.

Conclusion. Ursosan has a comprehensive hepatoprotective effect, which helps slow the progression of liver steatosis. UDCA reduces total cholesterol and triglyceride levels, which is important for the prevention of atherosclerosis. By improving metabolic processes, purine, carbo­hyd­rate, and lipid metabolism is normalized, which contributes to an improved metabolic profile. The safety and efficacy of UDCA allow it to be included in the complex therapy of not only NAFLD but also other metabolically associated diseases.

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