The influence of lifestyle on the course of non-alcoholic fatty liver disease in patients with stable coronary heart disease
Summary. The aim — to assess the impact of lifestyle modifications on the course of non-alcoholic fatty liver disease (NAFLD) in patients with stable coronary heart disease (CHD), depending on the severity of hepatic steatosis. Object — 72 patients with stable CHD, combined with NAFLD were observed. Depending on the applied diet, patients were divided into control (group I) and basic (group II) groups. In each group, patients with fatty liver index (FLI) 60–80 (subgroup A) and over 80 (subgroup B) were observed. General clinical examination, measuring of anthropometric parameters, electrocardiography, coronary angiography, echocardiography, assessment of liver functional state, serum lipid profile, calculation of FLI were conducted to all patients. Results. Increase of anthropometric, biochemical parameters that was dependent on the FLI levels was revealed in all patients. FLI was higher on 25.3% in group IB vs. group IA and on 24.0% in group IIB vs. group IIA (p<0.05). Body mass index had only a downward trend throughout the observation period in group I (p>0.05), in groups IIA and IIB — decreased by 13.7 and 11.4%, respectively (p<0.05). Improved of the liver functional state was observed in all patients, but it was most significant in group II (p<0.05). FLI decreased by 8.2% in the subgroup IA, on 5.9% — in subgroup IB, at 1.4 and 1.3 times — in subgroups IIA and IIB, respectively (p<0.05). Conclusions. Lifestyle modifications favorably affect the course of stable CHD, combined with NAFLD by the clinical and biochemical parameters. Individual approach to lifestyle modification causes weight loss, normalization of the liver functional state and serum lipid profile that, in general, inhibits progression of NAFLD on the background of stable CHD.