Background. The purpose of the study was to determine the probable effect of a complex of metformin, rosuvastatin, essential phospholipids, and quercetin on the clinical course of non-alcoholic steatohepatitis, diabetic kidney disease, type 2 diabetes mellitus, as well as on the state of blood lipid spectrum, parameters of carbohydrate metabolism compensation which are the factors of the progression of non-alcoholic steatohepatitis and diabetic kidney disease. Materials and methods. The dynamic of treatment was studied in 60 patients with non-alcoholic steatohepatitis with type 2 diabetes mellitus and stage I–III diabetic kidney disease, among whom 48 patients were diagnosed with mild non-alcoholic steatohepatitis and 12 with moderate activity. The comorbid disease in all patients with non-alcoholic steatohepatitis was type 2 diabetes mellitus of moderate severity, among which 15 people were at the stage of compensation, 45 were subcompensated. The state of carbohydrate metabolism was determined by fasting blood glucose and 2 hours after a meal by glucose oxidase method, fasting insulin content (DRG System) by enzyme-linked immunosorbent assay, blood glycosylated hemoglobin content using standard sets of reagents “Simko Ltd”. Results. One month after the start of therapy, asthenic syndrome of much lower intensity persisted only in 1 person (3.13 %) of the second group, while in the first group, it remained in 9 patients (32.1 %). At the same time in the majority of patients of the second group, the feeling of heaviness and pain in the right hypochondrium disappeared (in 31 (96.9 %) against 16 (57.1 %) in the first group (p < 0.05), respectively, and almost no dyspeptic symptoms disturbed (in 24 patients of group 2 (75.0 %) against 11 people (39.3 %) in group 1). A month after the start of treatment, no clinical manifestations of cholestasis were registered in 20 (62.5 %) patients of group 2 and only in 10 patients (35.7 %) in group 1 (p < 0.05). Quercetin in a complex treatment was found to have a positive effect on hepatomegaly regression, which remained in 5 patients (15.6 %) in group 2. Conclusions. The complex therapy with essential phospholipids, rosuvastatin, metformin in combination with quercetin in patients with comorbid non-alcoholic steatohepatitis, type 2 diabetes mellitus, and diabetic renal disease helps to eliminate the main clinical and laboratory symptoms of exacerbation of non-alcoholic steatohepatitis, helps to normalize blood glucose. The complex therapy with the addition of quercetin probably helped to increase the effectiveness of treatment of diabetic kidney disease against the background of type 2 diabetes mellitus, reduced the incidence of proteinuria, increased glomerular filtration rate, reduced hypercreatininemia.
Burden of non-alcoholic steatohepatitis among children with type 2 diabetes mellitus