EFFICACY OF ATORVASTATIN IN THE COMBINATION OF ALCOHOLIC LIVER DISEASE AND HYPERTENSION
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11188Keywords:
alcoholic liver disease, hypertension, endothelium, inflammation, oxidative stress, atorvastatinAbstract
Recently, the number of reports on the prospects for the use of statins in liver disease has increased. Due to its low toxicity and high level of safety, atorvastatin is most commonly used in clinical practice, so it is advisable to study the results of its use in patients with alcoholic liver disease (ALD) in combination with hypertension (AH).
The aim – to study the effectiveness of atorvastatin in the complex therapy of ALD combined with hypertension by determining in the blood indicators of the functional state of the endothelium, systemic inflammation, oxidative stress, lipid and carbohydrate metabolism.
Material and Methods. The study involved 62 patients with alcoholic liver disease. All subjects were divided into two groups. The first (control) group included 11 patients with chronic alcoholic hepatitis (CAH) and 20 patients with alcoholic liver cirrhosis (AlC), who received conventional treatment. The second (main group) consisted of 11 patients with CAH and 20 patients with ALC who received atorvastatin (20 mg once daily for 3 months) on the background of traditional treatment.
Serum levels of stable metabolites of nitrogen monoxide (nitrites/nitrates), endothelin-1, intercellular adhesion molecules-1 (ICAM-1), C-reactive protein, tumor necrosis factor-a, transforming growth factor-b1, interleukin-10, 8-isoprostane and ceruloplasmin were determined. Blood lipid spectrum and some indicators of carbohydrate metabolism were also studied.
Results. In patients with CAH and ALC combined with hypertension, under the influence of atorvastatin there was a decrease in serum levels of endothelin-1, nitrates/nitrites, ICAM-1, C-reactive protein, tumor necrosis factor-a, interleukin-10, transforming growth factor-b1, 8-isoprostane, ceruloplasmin, total cholesterol, low-density lipoprotein cholesterol, triglycerols with a simultaneous increase in high-density lipoprotein cholesterol.
Conclusion. The use of atorvastatin in the complex treatment of patients with alcoholic liver disease (chronic alcoholic hepatitis and alcoholic liver cirrhosis), combined with hypertension, improves the functional state of the endothelium, reduces the intensity of systemic inflammation and oxidative stress on the background of reduced dyslipoprotein.
References
Vargas JI, Arrese M, Shah VH, Arab JP. Use of Statins in Patients with Chronic Liver Disease and Cirrhosis: Current Views and Prospects. Curr Gastroenterol Rep. 2017 Sep;19(9):43. doi: 10.1007/s11894-017-0584-7. DOI: https://doi.org/10.1007/s11894-017-0584-7
Bosch J, Gracia-Sancho J, Abraldes JG. Cirrhosis as new indication for statins. Gut. 2020 May;69(5):953-962. doi: 10.1136/gutjnl-2019-318237. Epub 2020 Mar 5. DOI: https://doi.org/10.1136/gutjnl-2019-318237
Janicko M, Drazilova S, Pella D, Fedacko J, Jarcuska P. Pleiotropic effects of statins in the diseases of the liver. World J Gastroenterol. 2016 Jul 21; 22(27):6201-13. doi: 10.3748/wjg.v22.i27.6201. DOI: https://doi.org/10.3748/wjg.v22.i27.6201
Souk K, Al-Badri M, Azar ST. The Safety and Benefit of Statins in Liver Cirrhosis: a Review. Exp Clin Endocrinol Diabetes. 2015 Nov; 123(10):577-80. doi: 10.1055/s-0035-1564093. Epub 2015 Nov 24. PMID: 26600051 Review. DOI: https://doi.org/10.1055/s-0035-1564093
Simon TG, Duberg AS, Aleman S, Hagstrom H, Nguyen LH, Khalili H, Chung RT, Ludvigsson JF. Lipophilic Statins and Risk for Hepatocellular Carcinoma and Death in Patients With Chronic Viral Hepatitis: Results From a Nationwide Swedish Population. Ann Intern Med. 2019 Sep 3; 171(5):318-327. doi: 10.7326/M18-2753. Epub 2019 Aug 20.
Kockerling D, Nathwani R, Forlano R, Manousou P, Mullish BH, Dhar A. Current and future pharmacological therapies for managing cirrhosis and its complications. World J Gastroenterol. 2019 Feb 28;25(8):888-908. doi: 10.3748/wjg.v25.i8.888. DOI: https://doi.org/10.3748/wjg.v25.i8.888
Kimer N, Grønbæk H, Fred RG, Hansen T, Deshmukh AS, Mann M, Bendtsen F. Atorvastatin for prevention of disease progression and hospitalisation in liver cirrhosis: protocol for a randomised, double-blind, placebo-controlled trial. BMJ Open. 2020 Jan 23;10(1):e035284. doi: 10.1136/bmjopen-2019-035284. DOI: https://doi.org/10.1136/bmjopen-2019-035284
