Коморбидность неалкогольной жировой болезни печени и сердечно-сосудистых заболеваний: фокус на адеметионин и урсодезоксихолевую кислоту

Изменение характера взаимодействия факторов риска и глобальное старение населения привели к стремительному росту пациентов с сочетанной патологией, возводимой в ранг новой неинфекционной эпидемии. Существовавшая ранее парадигма «одно заболевание – один пациент» теряет актуальность и больше не соответствует медицинским потребностям, поэтому пациенты с сочетанными заболеваниями нуждаются в более широком подходе и индивидуализированных схемах лечения, которые в настоящее время полностью не определены. Согласно современным представлениям сосуществование патогенетически и патофизиологически взаимосвязанных двух и более заболеваний у одного индивидуума определяется термином «коморбидность». Наиболее распространенным фенотипом коморбидности является кардиометаболический. Особый интерес представляет взаимосвязь сердечно-сосудистых заболеваний (ССЗ) и неалкогольной жировой болезни печени (НАЖБП), так как обе нозологии имеют высокую распространенность в популяции и общие факторы метаболического риска (ожирение, сахарный диабет, гипертония и дислипидемия). Кроме того, имеются сведения, что НАЖБП является независимым фактором риска развития ССЗ, что позволяет предположить не только наличие единых патогенетических механизмов, отличных от метаболических путей, но и вероятность того, что лечение заболевания печени может снизить бремя ССЗ. В связи с этим в настоящем обзоре всесторонне анализируется взаимосвязь НАЖБП и ССЗ и обсуждается возможная терапевтическая стратегия, включающая применение комбинации адеметионина с урсодезоксихолевой кислотой.

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