Non-alcoholic fatty liver disease which is regarded as an independent predictor of cardiovascular diseases plays a significant role in the development of ischemic heart disease. In patients with verified ischemic heart disease, hyperleptinemia causes hypertrophy of vascular smooth muscle cells, increases the synthesis of endothelial growth factor as well as the accumulation of reactive oxygen species in the vascular wall and leads to elevated expression of endothelin-1, which is also an indicator of its influence on vascular remodeling. Leptin is a predictor of a higher functional class of angina pectoris and heart rhythm disorders; it may be used as an indirect marker of systemic inflammation as well. Pathogenic basis for ischemic heart disease treatment is hypolipidemic therapy with statins as the medications of choice; in addition to basic hypolipidemic action, they improve endothelial function increasing nitric oxide synthesis possessing anti-inflammatory, anti-ischemic, antiaggregatory, antithrombotic and profibrinolytic action, as well as antioxidant and antiproliferative effects.The objective of the research was to study changes in blood lipids and leptin levels in patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease after a course of atorvastatin. Materials and methods. 54 patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease were examined; there were 26 individuals who did not take atorvastatin and 28 individuals taking atorvastatin at a dose of 40 mg per day for 3 months. All the patients underwent anthropometry, determination of blood lipids, leptin and liver transaminase levels, electrocardiography, echocardiography, ultrasound of the internal organs.Results. A significant decrease in the average level of total cholesterol (p<0.01), concentration of low-density lipoproteins (p<0.01) and leptin level (p<0.01) was detected in patients after 3 months of atorvastatin use. Moreover, there was detected a direct correlation between leptin level and triglyceride concentration, leptin level and the body mass index, leptin level and waist circumference, leptin level and hip circumference, as well as a high correlation between total cholesterol and low-density lipoproteins, and total cholesterol and the body mass index.Conclusions. The administration of atorvastatin to patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease at a dose of 40 mg per day improves the patients’ general condition and promotes a significant decrease in the levels of pro-atherogenic fractions of blood lipids and leptin level, as well as promotes the reduction in risk factors for comorbid pathology and prevents the occurrence of its complications.
Effect of Combination Therapy with Atorvastatin and Ursodeoxycholic Acid on the Course of Ischemic Heart Disease with Co-Existent Non-Alcoholic Fatty Liver Disease and Obesity
