title: The treatment with ursodeoxycholic acid in elderly patients affected by NAFLD and metabolic syndrome: a case-control study.
abstract: OBJECTIVE
  Evaluating the prevalence and the degree of steatosis in geriatric patients (65 to 85 years of age) with Metabolic Syndrome (defined by ATP III criteria); searching for metabolic factors which are predictive for the degree of steatosis; evaluating the efficacy of Ursodeoxycholic Acid (UDCA) for 6 months in the treatment of patients with NAFLD or NASH.
  
  
  METHODS
  We studied 87 geriatric patients with Metabolic Syndrome. Steatosis was diagnosed and graded by laboratory assessment and ultrasonography, method based on the determination of liver/kidney ratio through grey-scale intensity, which was calculated as an index of the severity of the steatosis: it could oscilates from 0 (none) to 3 (severe). We randomized the geriatric patients into two groups: Ursodeoxycholic Acid (UDCA)-treated group (n=43 pz) and diet-treated group (1200 Kcal/die for female, 1500 Kcal/die for male) (n=44 pz), for a period of 6 months. BMI, principal symptoms, liver function, blood lipids, ultrasonography liver were evaluated respectively before and after treatment.
  
  
  RESULTS
  The prevalence of steatosis was 100% (26 mild steatosis cases, 38 moderate cases and 23 severe cases) in our patients with Metabolic Syndrome. Of the 43 subjects assigned to receive 300-450 mg/d of UDCA and diet, the hepatic steatosis index decreased on the average, of the 75%. Serum AST, ALT and γ-GT decreased significantly at 3 months already (p<0.001).
  
  
  CONCLUSIONS
  UDCA improves liver enzymes and ultrasonography immaging in geriatric patients with NAFLD or NASH. Unexpectedly, UDCA has resulted in beneficial effects on glycemic control and insulin sensitivity.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological and Geriatric Sciences, Rome University Sapienza, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Troisi
authors.forename: F
authors.initials: F
authors.lastname: Crisciotti
authors.forename: V
authors.initials: V
authors.lastname: Gianturco
authors.forename: E
authors.initials: E
authors.lastname: D'Ottavio
authors.forename: C
authors.initials: C
authors.lastname: Lo Iacono
authors.forename: V
authors.initials: V
authors.lastname: Formosa
authors.forename: S
authors.initials: S
authors.lastname: Bernardini
authors.forename: A
authors.initials: A
authors.lastname: Bellomo
authors.forename: B
authors.initials: B
authors.lastname: Marigliano
authors.forename: V
authors.initials: V
authors.lastname: Marigliano
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005234:Fatty Liver / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy*; D065626:Non-alcoholic Fatty Liver Disease; D011446:Prospective Studies; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D014580:Ursodeoxycholic Acid