REMEDIUMREMEDIUM1561-59362658-3534Joint-Stock Company Chicot100810.21518/1561-5936-2020-10-32-37Original ArticleComorbid patient with non-alcoholic fatty liver diseaseShirokovaElena N.noemail@neicon.ruI.M. Sechenov First Moscow State Medical University (Sechenov University)1012202010323718032022Copyright © 2020,2020The article reviews the evidence for an association between non-alcoholic fatty liver disease (NAFLD) and multiple cardiometabolic disorders, including ischemic stroke, insulin resistance, arterial hypertension, dyslipidemia, chronic kidney disease and cardiac arrhythmias and outlines the mechanisms that underpin this relationship. The role of ursodeoxycholic acid, a drug with pleiotropic properties, in the treatment of NAFLD has been shown.non-alcoholic fatty liver diseasecomorbiditymetabolic syndromecardiometabolic disordersursodeoxycholic acidнеалкогольная жировая болезнь печеникоморбидностьметаболический синдромкардиометаболические нарушенияурсодезоксихолевая кислота[Younossi Z., Anstee Q.M., Marietti M., Hardy T., Henry L., Eslam M. et al. Global burden of NAFLD and NASH: Trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15:11-20.][Ивашкин В.Т., Маевская М.В., Павлов Ч.С., Тихонов И.Н., Широкова Е.Н., Буеверов А.О. др. Клинические рекомендации по диагностике и лечению неалкогольной жировой болезни печени Российского общества по изучению печени и Российской гастроэнтерологической ассоциации. Рос. журн. гастроэнтерол. гепатол. колопроктол. 2016;26(2):24-42.][European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64(6):1388-1402.][Коморбидная патология в клинической практике. Алгоритмы диагностики и лечения. Клинические рекомендации. Кардиоваскулярная терапия и профилактика. 2019;18(1):5-66.][Byrne C.D., Targher G. NAFLD: a multisystem disease. J Hepatology. 2015;62:47-64.][Targher G., Byrne C.D., Lonardo A., Zoppini G., Barbui C. Non- alcoholic fatty liver disease and risk of incident cardiovascular disease: A meta-analysis. J Hepatol. 2016;65:589-600.][Vernon, G., Baranova, A., Younossi, Z.M. Systematic review: The epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther. 2011;34:274-285.][Широкова Е.Н. Неалкогольная жировая болезнь печени и кардиоваскулярный риск (обзор литературы). Фарматека. 2017;2:24-29.][Petäjä E.M., Yki-Järvinen H. Definitions of Normal Liver Fat and the Association of Insulin Sensitivity with Acquired and Genetic NAFLD-A Systematic Review. Int J Mol Sci. 2016;17:633.][Pais, R., Charlotte, F., Fedchuk, L., Bedossa, P., Lebray, P., Poynard, T., Ratziu, V. A systematic review of follow-up biopsies reveals disease progression in patients with non-alcoholic fatty liver. J Hepatol. 2013;59:550-556.][Ha Y., Seo, N., Shim J.H., Kim S.Y., Park J.A., Han S. et al. Intimate association of visceral obesity with non-alcoholic fatty liver disease in healthy Asians: A case-control study. J Gastroenterol. Hepatol. 2015;30:1666-1672.][Buzzetti E., Pinzani M., Tsochatzis E.A. The multiple-hit patho- genesis of non-alcoholic fatty liver disease (NAFLD). Metabolism. 2016;65:1038-1048.][Ying I., Saposnik G., Vermeulen M.J., Leung A., Ray J.G. Nonalcoholic fatty liver disease and acute ischemic stroke. Epidemiology. 2011;22:129- 130.][Bots M.L., Salonen J.T., Elwood P.C., Nikitin Y., Freire de Concalves A., Inzitari D. et al. Gamma-glutamyltransferase and risk of stroke: The EUROSTROKE project. J Epidemiol Community Health. 2002;56(Suppl.1):i25-i29.][Ndrepepa G., Colleran R., Kastrati A. Gamma-glutamyl transferase and the risk of atherosclerosis and coronary heart disease. Clin Chim Acta. 2018;476:130-138.][Hu J., Xu Y., He Z., Zhang H., Lian X., Zhu T. et al. Increased risk of cerebrovascular accident related to non-alcoholic fatty liver disease: A meta-analysis. Oncotarget. 2017;9:2752-2760.][Abdeldyem S.M., Goda, T., Khodeir, S.A., AbouSaif, S., Abd-Elsalam, S. Nonalcoholic fatty liver disease in patients with acute ischemic stroke is associated with more severe stroke and worse outcome. J Clin Lipidol. 2017;11:915-919.][Li H., Hu B., Wei L., Zhou L., Zhang L., Lin Y. et al. Non-alcoholic fatty liver disease is associated with stroke severity and progression of brainstem infarctions. Eur J Neurol. 2018;25:577-e34.][Ryoo J.H., Suh, Y.J., Shin H.C., Cho Y.K., Choi J.M., Park S.K. Clinical association between non-alcoholic fatty liver disease and the develop- ment of hypertension. J Gastroenterol Hepatol. 2014;29:1926-1931.]