CHANGES IN CARBOHYDRATE METABOLISM AND ADIPOCYTOKINES UNDER THE INFLUENCE OF TREATMENT OF PATIENTS WITH ALCOHOLIC CIRRHOSIS OF THE LIVER IN COMBINATION WITH OBESITY USING ADAMETHIONINUM AND ARGININE GLUTAMATE
DOI:
https://doi.org/10.11603/mcch.2410-681X.2020.v.i3.11514Keywords:
alcoholic liver disease, liver cirrhosis, obesity, adipocytokines, carbohydrate metabolismAbstract
Introduction. Alcohol-related liver cirrhosis is one of the leading causes of hospitalization and disability in patients with gastrointestinal disease.
The aim of the study – to learn the effectiveness of treatment of patients with alcoholic liver cirrhosis (ALC) combined with obesity depending on the stage of decompensation using ademethionine and arginine glutamate.
Research Methods. 215 patients, diagnosed with ALC, took part in the study, including 66 women and 149 men. 109 people had ALC with obesity and 106 people had ALC without obesity. Patients were divided into subgroups depending on the stage of decompensation according to Child-Pugh. Depending on the treatment protocol (b protocol – basic therapy, h protocol – basic therapy in combination with ademethionine and arginine glutamate), all patients were divided into subgroups.
Results and Discussion. In this study, the values of carbohydrate metabolism, adiponectin and leptin were used to evaluate the effectiveness of a three-month treatment regimen with ademethionine and arginine glutamate in patients with ALC in combination with obesity. Obese patients with ALC have a more severe course of the disease, accompanied by more pronounced clinical manifestations, impaired carbohydrate metabolism and imbalance of leptin and adiponectin levels. The inclusion of ademethionine and arginine glutamate in the treatment regimen for 3 months allowed to improve the general condition of patients, their clinical and laboratory parameters and reduce the rate of disease progression, which is reflected in improved carbohydrate metabolism, leptin and adiponectin and reduced indicators of the severity scale according to Child-Pugh and the 3-month MELD mortality score.
Conclusions. Inclusion of ademethionine and arginine glutamate in the complex treatment of patients with ALC in combination with obesity helps to reduce insulin resistance, improve leptin and adiponectin. In patients with ALC in combination with obesity, the inclusion in the complex treatment of ademethionine and arginine glutamate helps to improve the course of the disease according to the indicators of the severity scale using the Child-Pugh and MELD scales.
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