Blood Lipids and Leptin Levels in Patients with Ischemic Heart Disease and Concomitant Non-Alcoholic Fatty Liver Disease after Treatment with Atorvastatin

  • Yevgen Sklyarov Danylo Halytsky Lviv National Medical University
  • Nataliya Karpyshyn Danylo Halytsky Lviv National Medical University
Keywords: ischemic heart disease, atorvastatin, leptin, non-alcoholic fatty liver disease

Abstract

Non-alcoholic fatty liver disease which is regarded as an independent predictor of cardiovascular diseases plays a significant role in the development of ischemic heart disease. In patients with verified ischemic heart disease, hyperleptinemia causes hypertrophy of vascular smooth muscle cells, increases the synthesis of endothelial growth factor as well as the accumulation of reactive oxygen species in the vascular wall and leads to elevated expression of endothelin-1, which is also an indicator of its influence on vascular remodeling. Leptin is a predictor of a higher functional class of angina pectoris and heart rhythm disorders; it may be used as an indirect marker of systemic inflammation as well. Pathogenic basis for ischemic heart disease treatment is hypolipidemic therapy with statins as the medications of choice; in addition to basic hypolipidemic action, they improve endothelial function increasing nitric oxide synthesis possessing anti-inflammatory, anti-ischemic, antiaggregatory, antithrombotic and profibrinolytic action, as well as antioxidant and antiproliferative effects.

The objective of the research was to study changes in blood lipids and leptin levels in patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease after a course of atorvastatin. 

Materials and methods. 54 patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease were examined; there were 26 individuals who did not take atorvastatin and 28 individuals taking atorvastatin at a dose of 40 mg per day for 3 months. All the patients underwent anthropometry, determination of blood lipids, leptin and liver transaminase levels, electrocardiography, echocardiography, ultrasound of the internal organs.

Results. A significant decrease in the average level of total cholesterol (p<0.01), concentration of low-density lipoproteins (p<0.01) and leptin level (p<0.01) was detected in patients after 3 months of atorvastatin use. Moreover, there was detected a direct correlation between leptin level and triglyceride concentration, leptin level and the body mass index, leptin level and waist circumference, leptin level and hip circumference, as well as a high correlation between total cholesterol and low-density lipoproteins, and total cholesterol and the body mass index.

Conclusions. The administration of atorvastatin to patients with ischemic heart disease and concomitant non-alcoholic fatty liver disease at a dose of 40 mg per day improves the patients’ general condition and promotes a significant decrease in the levels of pro-atherogenic fractions of blood lipids and leptin level, as well as promotes the reduction in risk factors for comorbid pathology and prevents the occurrence of its complications.

References

Babak OYa, Kolesnikova EV. Nealkogolnaya zhirovaya bolezn pecheni i kardiovaskularnyy risk: sovremennyy vzglyad na problemu. Optimizatsiya terapii. Novosti meditsiny i farmatsii. 2012;8:33–38

Bazylevych AYa. Influence of ursodeoxycholic acid treatment upon ischemia and arrhythmia incidence, and autonomous nervous heart regulation in the patients with postinfarction cardiosclerosis after coronary arteries bypass graft combined with non-alcoholic fatty liver disease. Praktychna medytsyna. 2011;17(2):103–109

Ivachevska VV, Chopey IV. Otsinka yakosti zhyttia patsientiv iz poiednanym perebihom nealkoholnoii zhyrovoii khvoroby pechinky ta stabilnymy formamy ishemichnoii khvoroby sertsia. Hastroenterolohiia. 2014;3:35–37

Kovaleva YuO. Interaction activity of inflammatory process and leptin in patients with ischemic heart diseases associated with obesity. Experym klin med. 2010;3:93–97

Kolesnikova EV. Nonalcoholicfatty liver disease and hypertension: what have we achieved in the understanding of the problem. Ukr med chasopys. 2014;3:61–66

Kutayni AR, Taschuk VK. Dynamika rivniv leptynu ta stan koronarnoho i funktsionalnoho rezrviv y khvorykh na stabilnu stenokardiiu. Kiln eksperym patolohiia. 2012;2:76–80

Ognyeva OV. Relationship of the adipokines and their influence on the liver functional state in patients with nonalcoholic fatty liver disease, type 2 diabetes mellitus and at their combination. Suchasna hastroenterol. 2014;6:7–14

Perepelchenko NA, Zyryanov BN, Lvova IA, Matveeva EL. Chy vplyvaie porushennia vuhlevodnoho ta lipidnoho obminu na rozvytok kaltsynozu koronarnykh sudyn. Liky Ukraiiny. 2015;1:45–51

Urbanovych AM, Suslyk HI. Rol leptynu v rozvytku ishemichnoii khvoroby sertsia u khvorykh na tsukrovyi diabet 2-ho typu z ozhyrinniam. Eksperymentalna ta klinichna fiziolohiia i biokhimiia. 2014;2:56–62

Chumak AA, et al. Molecular mechanism features in development of nonalcoholic fatty liver disease. Ukraiinkyi medychnyi chasopys. 2013;6(98):33–40

Area M, Pigna G. Treating statin-intolerant patients. Diabets Metab Syndr Obes. 2011;4:155–166

Athyros VG, Tziomalos K, Gossios TD, et al. Safety and efficacy of long-term statin treatment for cardiovascular events in patients with coronary heart disease and abnormal liver tests in the Greek Atorvastatin and Coronary Heart Disease Evaluation (GREACE) Study: a post-hoc analysis. Lancet. 2010;376(9756):1916–1922. DOI: http://doi.org/10.1016/S0140-6736(10)61272-X

Kavalipati N, Shah J, Ramakrishan A, Vasnawala H. Pleiotropic effects of statins. Indian Journal of Endocrinology and Metabolism. 2015;19(5):554–562

Published
2016-12-27
Section
Original Research