Kreimeyer Henriette, Vogt Katharina, Götze Tobias, Best Jan, Götze Oliver, Weigt Jochen, Kahraman Alisan, Özçürümez Mustafa, Kälsch Julia, Syn Wing-Kin, Sydor Svenja, Canbay Ali, Manka Paul
Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, In der Schornau 23-25, 44892 Bochum, Germany.
Department of Gastroenterology and Hepatology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany.
J Pers Med. 2023 Jul 24;13(7):1180. doi: 10.3390/jpm13071180.
The prevalence of NAFLD and NASH is increasing worldwide, and there is no approved medical treatment until now. Evidence has emerged that interfering with bile acid metabolism may lead to improvement in NASH. In this study, 28 patients with elevated cholestatic liver function tests (especially GGT) were screened for bile acid gene polymorphisms and treated with UDCA. All patients had a bile acid gene polymorphism in or . Treatment with UDCA for 12 months significantly reduced GGT in all patients and ALT in homozygous patients. No difference in fibrosis was observed using FIb-4, NFS, and transient elastography (TE). and were the most common NASH-associated polymorphisms, and patients with showed a significant reduction in GGT and ALT with the administration of UDCA. In conclusion, NASH patients with elevated GGT should be screened for bile acid gene polymorphisms, as UDCA therapy may improve liver function tests. However, no difference in clinical outcomes, such as progression to cirrhosis, has been observed using non-invasive tests (NITs).
非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）在全球的患病率正在上升，并且迄今为止尚无获批的药物治疗方法。有证据表明，干扰胆汁酸代谢可能会改善NASH。在本研究中，对28例胆汁淤积性肝功能检查（尤其是γ-谷氨酰转移酶[GGT]）升高的患者进行了胆汁酸基因多态性筛查，并给予熊去氧胆酸（UDCA）治疗。所有患者在或存在胆汁酸基因多态性。给予UDCA治疗12个月后，所有患者的GGT均显著降低，纯合子患者的谷丙转氨酶（ALT）也显著降低。使用Fib-4、NFS和瞬时弹性成像（TE）未观察到纤维化有差异。和是与NASH相关最常见的多态性，携带的患者在给予UDCA后GGT和ALT显著降低。总之，GGT升高的NASH患者应进行胆汁酸基因多态性筛查，因为UDCA治疗可能会改善肝功能检查结果。然而，使用非侵入性检查（NITs）未观察到临床结局（如进展为肝硬化）有差异。
