Влияние ингибиторов натрий-глюкозного котранспортера 2-го типа на неалкогольную жировую болезнь печени

Неалкогольная жировая болезнь печени является одним из наиболее распространенных заболеваний печени, морфологически представляя собой целый спектр патологических состояний, от стеатоза и стеатогепатита до фиброза, клиническими исходами которого может выступать цирроз печени и гепатоцеллюлярная карцинома. Частота неблагоприятных исходов течения неалкогольной жировой болезни печени значимо увеличивается на фоне сахарного диабета 2-го типа, что, вероятно, обусловлено патогенетическим синергизмом неалкогольной жировой болезни печени и сахарного диабета 2-го типа, ассоциированным с метаболическим синдромом. Общность патогенетических звеньев, как следствие, предполагает однонаправленность терапевтических подходов. В связи с чем был проведен поиск исследований и метаанализов в крупных электронных базах данных (MEDLINE, Scopus, UpToDate, КиберЛенинка) с целью изучения современных методов фармакотерапии неалкогольной жировой болезни печени и сахарного диабета 2-го типа. Результаты ряда экспериментальных и клинических исследований по оценке влияния сахароснижающих препаратов группы ингибиторов натрий-глюкозного котранспортера 2-го типа на неалкогольную жировую болезнь печени демонстрируют широкий спектр внутрипеченочных эффектов, влияющих на проявления стеатоза печени и фиброза посредством регуляции окислительного стресса, стресса эндоплазматического ретикулума, влияния на интрапеченочное воспаление, аутофагию и апоптоз, а также опосредованно влияя на печеночный метаболизм путем снижения массы тела. Кроме того, на сегодняшний день глифлозины стремятся занять совершенно новую терапевтическую нишу, демонстрируя в экспериментальных исследованиях противоканцерогенные эффекты. Таким образом, плейотропное действие ингибиторов натрий-глюкозного котранспортера 2-го типа предполагает потенциальный гепатопротективный эффект терапии неалкогольной жировой болезни печени и ее исходов.

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