According to the current views on non-alcoholic fatty liver disease, it potentiates rapidly progressing atherosclerotic processes with an increased risk of acute cardiovascular events onset. The aim of the study was to demonstrate the role of Ursodeoxycholic acid and L-carnitine combined therapy in potentiation of hypolipidemic effect of Rosuvastatin taken in a standard dose of 20 mg/day on the example of a patient with ischemic heart disease and comorbid non-alcoholic steatohepatitis. Materials and methods. The study presents the information on the clinical case of a patient K., 45 year old, with ischemic heart disease and non-alcoholic steatohepatitis. Laboratory and instrumental tests revealed increased levels of alanine aminotransferase activity – 93 U/L, aspartate aminotransferase – 42 U/L, gamma-glutamyltransferase – 87 U/L that corresponds to moderate non-alcoholic steatohepatitis. Changes in the patient’s lipid profile indicated atherogenic dyslipidemia ІІb phenotype according to Fredrickson classification: cholesterol reached up to 7.7 mmol/L, LDL cholesterol increased up to 4.99 mmol/L, triglycerides increased up to 1.78 mmol/L, atherogenic index grew up to 5.16. The level of HDL cholesterol was 1.25 mmol/L. The proposed therapeutic approach of co-administration of Ursodeoxycholic acid, L-carnitine and Rosuvastatin taken in an average therapeutic dose allows us to decrease liver function disturbances, characterized by 1.8 time decrease of alanine aminotransferase activity, 2.5 time decrease of gamma-glutamyltransferase and contributes to lipid indexes normalization, characterized by 1.7 time decrease in cholesterol, 1.9 time decrease in LDL cholesterol, 1.2 time decrease in triglycerides and up to 2.7 time decrease in atherogenic index. At the same time, the stable level of HDL cholesterol, 1.24 mmol/L, was observed that reduces the risk of cardiovascular diseases progression and their complications. The combination of Ursodeoxycholic acid and L-carnitine can be recommended as an additional therapy to the treatment with statins taken in average therapeutic doses for patients with ischemic heart disease and comorbid non-alcoholic steatohepatitis.
Bile Acid Metabolism is an Intermediary Factor between Non-Alcoholic Steatohepatitis and Ischemic Heart Disease in SHRSP5/Dmcr Rats