АКТУАЛЬНЫЕ ВОПРОСЫ СОВРЕМЕННОГО ЛЕЧЕНИЯ НЕАЛКОГОЛЬНОЙ ЖИРОВОЙ БОЛЕЗНИ ПЕЧЕНИ
Ключевые слова:
стеатоз печени, НАЖБП, НАСГ, инсулинорезистентность, противодиабетические препараты, ингибитор НГЛТ2.Аннотация
Неалкогольная жировая болезнь печени (НАЖБП), как один из факторов метаболического синдрома (МС), в настоящее время является наиболее распространенным заболеванием печени во всем мире. В настоящее время конкретной специфической медикаментозной терапии этого состояния не разработана, его лечение основано на терапии основных факторов риска. Первоначальное накопление триглицеридов в паренхиме печени, при наличии воспалительных процессов, митохондриальной дисфункции, липотоксичности, глюкозотоксичности и окислительного стресса может развиваться в неалкогольный стеатогепатит (НАСГ). Основная цель состоит в том, чтобы определить факторы, способствующие этой эволюции, поскольку нелеченный НАСГ может прогрессировать от фиброза до цирроза и, в конечном итоге, осложниться гепатоцеллюлярной карциномой (ГЦК). Несколько групп препаратов прошли клинические испытания для использования в качестве специфической терапии НАЖБП; большинство из них препараты, используемые для лечения сахарного диабета 2 типа (СД2), который является одним из основных факторов риска развития НАЖБП. Среди наиболее изученных из них — агонисты PPAR-γ так называемые тиазолидиндионы (пиоглитазон), агонисты рецепторов глюкагоноподобного пептида-1 (аГПП-1Р), ингибиторы дипептидилпептидазы-4 (иДПП-4). На самом деле, наиболее многообещающей категорией являются ингибиторы натрий-глюкозного котранспортера 2го типа (иНГКT2). Мы рассмотрим основные патогенетические механизмы, современные методы лечения НАЖБП, уделяя особое внимание на использование ингибиторов НГЛТ2
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