Gastroenterologìa (Nov 2016)
The Use of Essential Phospholipids for the Treatment of Fatty Liver Disease
Abstract
Background. Given the similarity of histopathological pattern of non-alcoholic fatty liver disease and alcoholic liver disease, it was proposed to combine these both diseases in one nosological form named «fatty liver disease». The purpose of this review was to evaluate the efficacy and safety of essential phospholipids for the treatment of fatty liver disease. Methodology. When performing this review, re-analysis of 25 studies included in the review K.J. Gundermann et al. (2016), has been made. In these studies, essential phospholipids were obtained from soybeans containing not less than 72 % phosphatidylcholine. Results. It was found that essential phospholipids reduce the severity of symptoms, including general malaise, fatigue, nausea, incidence of hepatic pain, abdominal distension, constipation, obesity index and skin-fold thickness when used in nonalcoholic fatty liver disease (20 studies). Essential phospholipids were found to improve biochemical blood plasma markers (liver function tests — alanine aminotransferase, serum glutamic oxalacetic transaminase, gamma-glutamyl transpeptidase, alkaline phosphatase, markers of lipid metabolism — total cholesterol, triglycerides, LDL cholesterol). Essential phospholipids improved the results of sonography and computed tomography of the liver in 60–75 % of patients. At the same time there observed the reverse of histopathological changes in the liver: decreased severity of steatosis, ballooning, intra-acinar and portal inflammation, leading to a decrease of the stage of steatohepatitis by Brunt classification. The total efficiency of the treatment with essential phospholipids was 80.5 %, while the total efficiency of the treatment in the placebo or «no treatment» groups was 27.9 % (p < 0.05). Similar results were obtained for the alcoholic liver disease (5 studies), but more researches are needed. Data from all the above cited studies suggest that the treatment of essential phospholipids was safe. Conclusion. In 25 clinical studies it was confirmed the effectiveness and safety of the essential phospholipids for the treatment of fatty liver disease.
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