Clinical and functional significance of biologically active substances extracted from Far East endemic species in combination with basic therapy for metabolic disorders in elderly patients with non-alcoholic fatty liver disease

Aim. To evaluate the therapeutic potential of biologically active substances extracted from the Far East endemic species in preventing the progression of non-alcoholic fatty liver disease (NAFLD) in elderly patients. Materials and methods. The study included 40 NAFLD patients aged 63.9 ± 3.9 years. Patients in the active control group ( n = 20) received standard therapy, which included a low-calorie diet, therapeutic gymnastics, moderate physical activity, and ursodeoxycholic acid 10–15 mg/kg in two doses per day during two months. Patients in the main group additionally received the “Kholesar” dietary supplement ( Maackia amurensis extract) one capsule per day (200 mg) and a dietary supplement made from Echinoidea sea urchin (“Sila Morya: Dolgoletie”, one capsule three times per day) for two months. The examination was performed prior to the onset and following two weeks after completion of therapy. The dynamics of clinical symptoms, biochemical parameters of liver function, data based on the NFS and FIB-4 scales were monitored. Statistical processing was performed using Student's t -test, Mann–Whitney, Wilcoxon, Spearman's rank correlation coefficient. Results. Examination of patients with NAFLD revealed ultrasound signs of steatosis and the presence of the following cardiometabolic risk factors: dyslipidemia in 75%, hypertension in 45%, obesity in 60%, and carbohydrate metabolism disorders in 55% of patients. The monotherapy using ursodeoxycholic acid during eight weeks led to a decrease in cytolysis, cholestasis, and glucose levels. In some patients with initially high values of FIB (40%) and NFS (45%), fibrosis also decreased. Over the same period, the applied combination therapy led to normalization of ALT and AST in patients with initially higher enzyme levels, ensuring a significant improvement in lipid profile (reduction in total cholesterol (TC), triglycerides (TG), increase in high-density lipoproteins (HDL), and apolipoprotein A (ApoA)), compared to monotherapy. In addition, the combination therapy contributed to a reduction in fibrosis indices in a larger number of patients with high FIB (70%) and NFS (55%) values, thus improving their overall well-being. Conclusion . Biologically active substances from the Far East terrestrial and marine biota contribute to stabilization of NAFLD and reduction of cardiometabolic risk factors in elderly patients.