Larnamin — «maintenance drug» in obese patients at the stage of weight loss

Abstract

The systemic effects of long-term hypocaloric diet in obese patients with nonalcoholic fatty liver disease (NAFLD) were studied as well as the influence of Larnamin medication, which possesses hepatoprotective, anabolic, detoxification properties on toleration of hypocaloric diet for a long period (6 months). A total of 52 middle-aged men (45-59 years) were examined, all of them were obese with signs of metabolic syndrome and confirmed NAFLD. Group A consisted of 27 patients on hypocaloric diet. Group B consisted of 25 patients who met dietary recommendations for 6 months and in the same time had taken Larnamin medication orally, sachets, dosage of 9 grams a day. The examination program included determination of serum levels of insulin, glucose (with the calculation of the HOMA-IR index), cortisol, thyroid-stimulating hormone, total cholesterol (TC), HDL cholesterol, LDL cholesterol, triglycerides, and microalbumin in the urine. An ultrasonography of the kidneys, liver, gall bladder, thyroid gland was performed along with the calculation of visceral fat thickness, preperitoneal fat thickness, subcutaneous fat thickness. The dynamics of body fat component was assessed by anthropometric lipid measuring — evaluation of the skinfold thickness at the standard indicator zones. The relative lean body mass was calculated according to the anthropometric data. Prolonged hypocaloric diet in obese patients with NAFLD is accompanied by worsening of the protein deficiency syndrome — reduction of the relative weight of muscle tissue and physical exercise tolerance, signs of atrophy of skeletal muscles, skin and its derivatives, development of «fasting encephalopathy» (weakness, malaise, negativism, decreased motivation, impaired physical and mental work capacity, insomnia). Also a persistent microalbuminuria, hypoalbuminemia, dyslipidemia, increased values of HOMA-IR index were found in such patients as well as elevated levels of cortisol and thyroid-stimulating hormone. Compliance with hypocaloric diet and simultaneous reception of the Larnamin sachets 9 g/day has a number of protective effects (neuro-, nephro-, hepato-, myocardio-, dermatoprotektive). Larnamin reduces the severity of insulin resistance with secondary hypercortisolemia and relative hypothyroidism. The usage of Larnamin improves patients’ adherence to dietary restrictions and physical exercise.