Differentiated approach to correction of metabolic disorders in chronic hepatitis С

Relevance. The combination of chronic hepatitis C (CHC) and metabolic syndrome (MS) represents a mutually aggravating condition that contributes to the progression of liver fibrosis and reduces the effectiveness of therapy. Investigating the influence of hepatoprotective therapy on metabolic parameters and quality of life in this patient category is a clinically significant task.
Objective. To evaluate the impact of different hepatoprotective therapy regimens on bioimpedance body composition analysis indicators and quality of life in patients with CHC and MS.
Materials and methods. A prospective randomized study included 120 patients with CHC, randomized into 4 groups: 1 — glycyrrhizic acid + essential phospholipids (n=30); 2 — ademetionine (n=30); 3 — ursodeoxycholic acid (n=30); 4 — comparison group (n=30). Therapy was administered for 4 weeks. Biochemical parameters (ALT, AST, ALP, GGT), bioimpedance analysis parameters (phase angle, fat mass percentage, waist-to-hip ratio), and quality of life using the SF-36 questionnaire were assessed before and after treatment. Statistical analysis was performed using Student's t-test, Mann-Whitney U test, and Wilcoxon test.
Results. All active therapy groups showed positive dynamics in biochemical parameters. The most pronounced reduction in ALT (65 %), AST (50 %), and cholestasis markers (70 %) was recorded in the ademetionine group. Statistically significant improvement in quality of life on the scales of vitality, emotional and social functioning was noted in groups 1 and 2. Bioimpedance analysis parameters demonstrated a significant increase in phase angle after treatment; however, no significant changes in fat mass percentage or waist-to-hip ratio were found. In the control group, the dynamics of the indicators were not significant.
Conclusions. The use of hepatoprotectors (glycyrrhizic acid + essential phospholipids, ademetionine, ursodeoxycholic acid) in patients with CHC and MS for 4 weeks leads to an improvement in biochemical parameters and quality of life. The most comprehensive positive effect, including a trend towards improved body composition parameters, was observed with the use of ademetionine. Bioimpedance analysis and quality of life assessment are promising screening tools for monitoring therapy effectiveness in this patient category.

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