Disorders of carbohydrate metabolism in patients with non-alcoholic steatohepatitis, obesity and chronic obstructive pulmonary disease

Abstract

Background. A significant increase in the incidence of non-alcoholic steatohepatitis (NASH) in obese patients with chronic obstructive pulmonary disease (COPD) in the world requires the study of the mechanisms of their mutual aggravation, and correction of the metabolic components of pathogenesis and the consequences of concomitant pathology. The purpose was determination of the state of glycemic parameters, regulation of carbohydrate metabolism and evaluation of the effectiveness of antral and the combination of antral with policosanol use in terms of the effect on the state of glycemia, the degree of insulin resistance in patients with non-alcoholic steatohepatitis against the background of obesity combined with chronic obstructive pulmonary disease. Mate­rials and methods. One hundred and sixty patients were screened and divided into 3 groups. Group I consisted of 35 people with NASH against the background of degree I obesity. Group II includes 90 patients with NASH, degree I obesity and COPD 2–3 D, group III — 35 individuals with COPD 2–3 D. According to the treatment received, group II of patients was divided into 3 subgroups, of which 25 people (subgroup 1t — control one) received NASH therapy (essential phospholipids 300 mg 2 capsules 3 times daily for 60 days) and baseline COPD therapy. Subgroup II (primary, 2t) — 35 patients, in addition to similar COPD therapy, for the treatment of NASH, instead of essential phospholipids, they received antral 200 mg 3 times a day for 60 days. Subgroup III (primary, 3t) — 30 patients, in addition to similar COPD therapy, for the treatment of NASH they received antral 200 mg 3 times daily and, additio­nally, policosanol 20 mg after the dinner for 60 days. Comparison group consisted of 30 apparently healthy individuals. Results. Before treatment, a slight insignificant increase in the level of fasting glycemia by 10.9 and 14.3 %, respectively (p 0.05). The content of postprandial blood glucose in patients of all groups decreased, respectively, in the subgroups 1t, 2t and 3t — by 10.6, 21.3 and 21.9 % compared to the data before treatment (p < 0.05). The maximum decrease in the blood insulin content (by 1.9 times) and the degree of insulin resistance (by 46.8 %) was also observed in the subgroup 3t (p < 0.05). Conclusions. The administration of antral for 60 days led to a significant correction of glycemia in NASH patients with obesity and COPD that was accompanied by a significant decrease in insulin levels (p < 0.05), postprandial glucose content and the insulin resistance degree (p < 0.05).

Keywords

• non-alcoholic steatohepatitis
• chronic obstructive pulmonary disease
• obesity
• antral
• policosanol