MANAGEMENT OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE USING HYDROCARBONATE MINERAL WATERS
Оbjective. The aim was to study the effectiveness of hydrocarbonate mineral waters of different mineralization in the complex therapy of patients with non-alcoholic fatty liver disease (NAFLD).
Materials and methods. Sixty patients with NAFLD were examined. Non-alcoholic liver steatosis was diagnosed in 46 patients, steatohepatitis of a minimal degree of activity — in 14 patients. The concomitant pathologies were represented by the esophagogastroduodenal system diseases (gastroesophageal reflux disease, chronic non-atrophic gastritis and duodenal ulcer, inactive stage). At the beginning of the study, three groups were formed by randomization. Patients of group I (20 people, control group) received a standard treatment package (diet and dosed exercise regimen). The treatment in group II (20 persons) was supplemented with an internal course of a low-mineralized bicarbonate sodium mineral water (MW Luzhanskaya, Zakarpatiye) administration. Patients of group III ingested a medium-mineralized carbonic boric hydrocarbonate sodium mineral water (MW Polyana Kvasova, Zakarpatiye) in addition to the standard therapeutic complex. The groups of patients were representative for the main indicators. During the study the general clinical examinations were performed, the vital signs, the biochemical parameters of the liver function, i.e. bilirubin, transaminase, alkaline phosphatase, gamma-glutamyltranspeptidase, lipid metabolism, total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein, blood glucose, insulin levels were studied. The HOMA-IR index was used to quantify the insulin resistance (IR) degree, ultrasonography was performed, and statistical methods were used.
Conclusion. A course of drinking hydrocarbonate mineral waters of various mineralization may be used for correcting the carbohydrate metabolism, namely, the IR and an impaired glucose tolerance, the functional state of the liver including the patients’ with NAFDL blood lipid spectrum.