title: Effects of ursodeoxycholic acid therapy on carotid intima media thickness, apolipoprotein A1, apolipoprotein B, and apolipoprotein B/A1 ratio in nonalcoholic steatohepatitis.
abstract: BACKGROUND
  Nonalcoholic steatohepatitis (NASH) is a prevalent liver disease that is increasingly being associated with cardiovascular disease. Ursodeoxycholic acid (UDCA) may have antioxidant and anti-inflammatory activities, and may reduce liver injury in NASH. To date, no studies have assessed the efficacy of UDCA in carotid intima media thickness (CIMT), serum lipids, apolipoprotein A1 (apo A), apolipoprotein B (apo B), and apolipoprotein B/A1 (apo B/A1) ratios in patients with NASH.
  
  
  METHODS
  In this prospective study, 30 patients with biopsy-proven NASH and 25 healthy adults as a control group were evaluated. None of the participants had diabetes, hypertension, or hyperlipidemia. Patients with NASH received UDCA 15 mg/kg/day for 6 months. BMI, waist circumference, homeostasis model assessment, lipids, apo A1, apo B, apo B/A1 ratios, and CIMT were analyzed before and after the treatment period.
  
  
  RESULTS
  At the end of the study, there were no statistically significant changes in BMI or waist circumference. Liver enzymes decreased gradually. The homeostasis model assessment decreased from 3.4 ± 1.89 to 2.06 ± 1.68 (P < 0.001). No significant changes in the mean triglyceride, total cholesterol, low-density lipoprotein, or apo B levels were observed. The mean high-density lipoprotein (42.9 ± 7.1 vs. 45.5 ± 9.8; P = 0.037) and apo A1 (127.6 ± 17.7 vs. 135.9 ± 22.2; P = 0.02) increased significantly. Apo B/A1 ratios tended to decrease, but this decrease was not statistically significant. The mean CIMT decreased significantly (0.56 ± 0.15 vs. 0.47 ± 0.12; P = 0.001).
  
  
  CONCLUSIONS
  UDCA treatment in NASH patients resulted in statistically significant reductions in the mean CIMT over a 6-month period. We believe that this benefit of UDCA may have resulted from decreased insulin resistance and increased serum high-density lipoprotein-apo A1 levels. However, larger, longer-term studies are needed to confirm this effect of UDCA in NASH.
authors.affiliation: Departments of aGastroenterology bRadiology cBiochemistry, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Banu D
authors.initials: BD
authors.lastname: Ozel Coskun
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yucesoy
authors.forename: Sebnem
authors.initials: S
authors.lastname: Gursoy
authors.forename: Mevlut
authors.initials: M
authors.lastname: Baskol
authors.forename: Alper
authors.initials: A
authors.lastname: Yurci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yagbasan
authors.forename: Serap
authors.initials: S
authors.lastname: Doğan
authors.forename: Gulden
authors.initials: G
authors.lastname: Baskol
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D016632:Apolipoprotein A-I / Q000097:blood / Q000187:drug effects*; D001055:Apolipoproteins B / Q000097:blood / Q000187:drug effects*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D059168:Carotid Intima-Media Thickness; D002756:Cholagogues and Choleretics / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014580:Ursodeoxycholic Acid / Q000494:pharmacology* / Q000627:therapeutic use; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D015415:Biomarkers; D002756:Cholagogues and Choleretics; D014580:Ursodeoxycholic Acid