Purpose: to evaluate the effectiveness of use the Livodinol® hepatotropic complex in patients with steatosis and steatohepatitis by studying the characteristics of changes in fat metabolism and elastographic parameters of the liver.
Materials and methods. 40 patients with non-alcoholic fatty liver disease (NAFLD) were examined: 20 patients with steatohepatosis and 20 patients with steatohepatitis, 15 (37.5%) women and 25 (62.5%) men, the average age was 49.7±14.2 years old. All patients before and after receiving the complex were evaluated for the lipid spectrum of blood serum, chromatographic study of free fatty acids, the content of the product of lipid peroxidation, the degree of fibrosis and steatosis of the liver by fibroscanning.
Results. On the background of use of Livodinol®, the lipid profile had a tendency to improve with a greater effect in patients with a body mass index of up to 30 kg/m2. After use of Livodinol®, the number of patients with steatohepatitis with an elevated level of triglycerides decreased from 35 to 15%, with a simultaneous increase in the content of high-density lipoproteins in 30% of patients. An increase of the processes of lipid peroxidation was established by assessing the level of malondialdehyde (MDA), especially in steatohepatitis. After use of Livodinol®, the level of MDA significantly decreased (p<0.001). In 100% of patients, a probable increase in the total content of monounsaturated free fatty acids in the blood serum was established by 7.3 times due to cis-10-pentadecenoic, cis-10-heptadecenoic, cis-9-octadecenoic and cis-11-eicosenoic acids (p<0.001). After use of Livodinol® complex, there was a probable decrease in the level of monounsaturated free fatty acids by 3.9 times from the initial level (p<0.05) and a decrease in the total content of free fatty acids by 1.3 times (p>0.05). According to shear wave elastography, liver fibrosis in patients was determined at the level of 0–1 degree, which remained even after treatment, with a tendency to decrease according to average indicators. Steatosis was much more pronounced, according to fibroscan, before treatment: S1 — 15%, S2 — 67.5%, S3 — 17.5%, after treatment: S0 — 10%, S1 — 22.5%, S2 — 62.5%, S3 — 5.0%, with a decrease in the average value of the ultrasound attenuation coefficient (p<0.05). An inverse correlation between the level of MDA and high-density lipoproteins was established (r=–0.428; p<0.01), as well as a direct relationship with the atherogenicity coefficient (r=0.362, p<0.05). A direct correlation was found between the level of low-density lipoproteins and the stiffness index of the liver parenchyma according to elastography data (r=0.426; p<0.05), which corresponds to the pathogenesis of NAFLD. Tolerability and safety of Livodinol® was 97.5%.
Conclusion. Livodinol® is effective dietary supplement for patients with NAFLD, which is confirmed by the improvement of lipid metabolism indicators and structural changes of the liver. Livodinol® showed safety and good tolerability in patients with steatosis and steatohepatitis for 2 months.
