L-ornithine-L-aspartate in patients with non-alcoholic fatty liver disease

E.A. Lyalyukova¹, M.A. Livzan¹, A.V. Lyalyukov², A.N. Sudakova¹

¹Omsk State Medical University, Omsk

²Maykop State Technical University, Maykop

Non-alcoholic fatty liver disease (NAFLD) is a prevalent chronic hepatic disorder marked by excessive lipid accumulation in hepatocytes. Current evidence underscores the multifactorial etiology of NAFLD, involving insulin resistance, lipotoxicity, neurohumoral alterations accompanied by elevated proinflammatory cytokine and adipokine release, activation of innate immunity, dysbiosis of the gut microbiota, increased intestinal permeability, and genetic susceptibility. Recent studies have identified hyperammonemia as a pivotal factor in NAFLD pathogenesis. Ammonia accumulation in the liver maintains inflammatory processes, stellate cell activation, and initiates fibrogenesis, heightening the risk of progression to cirrhosis and hepatocellular carcinoma. Furthermore, systemic hyperammonemia detrimentally impacts other organ systems, notably contributing to cognitive deficits and sarcopenia. Hence, it is pathophysiologically rational to administer L-ornithine-L-aspartate to individuals with NAFLD. This compound not only possesses hypoammonemic effects but also exhibits hepatoprotective, hypoazotemic, and detoxifying actions. The beneficial effects of L-ornithine-L-aspartate are also attributed to the metabolic conversion of L-ornithine and L-aspartate into L-glutamine, L-arginine, and glutathione, which are potent antioxidants safeguarding hepatocytes against lipid peroxidation and enhancing hepatic microcirculation. Collectively, these mechanisms contribute to the efficacy of L-ornithine-L-aspartate in mitigating the extent of steatosis, inflammation, and even hepatic fibrosis in NAFLD patients.

Keywords: non-alcoholic fatty liver disease, L-ornithine-L-aspartate, hyperammonemia, metabolic syndrome, oxidative stress.

For citation: Lyalyukova E.A., Livzan M.A., Lyalyukov A.V., Sudakova A.N. L-ornithine-L-aspartate in patients with non-alcoholic fatty liver disease. RMJ. 2024;10:–31. DOI: 10.32364/2225-2282-2024-10-5