Alopurinol na prevenção da esteato-hepatite não alcoólica e hiperglicemia induzida por dieta rica em frutose em ratos wistar

Abstract

Nonalcoholic fatty liver disease (NAFLD) in the last two decades has been recognized as the most common chronic liver disease in Western countries, paralleling the epidemic of obesity and consumption of high-fructose diet. Researchers suggest that NAFLD may be the hepatic manifestation of metabolic syndrome. Although NAFLD and hyperuricemia are strongly related to metabolic syndrome, few scientists in the literature associated with both diseases. Allopurinol, a potent inhibitor of xanthine oxidase, with anti-inflammatory and antioxidant effects has been shown to prevent the metabolic syndrome induced by fructose. Thus, the main objective of the study is to evaluate the effects of allopurinol in the treatment of nonalcoholic steatohepatitis (NASH) and hyperglycemia in rats fed high-fructose water. Wistar rats were fed along with 20% fructose in drinking water with or without allopurinol (30mg/kg/day) for 14 weeks. A control group received a normal diet. Serum total cholesterol level (P<0,001) and glucose (P<0,05) in fructose group and of triglycerides (P<0,01) and creatinine (P<0,01) in allopurinol group were significantly increased compared to normal control. Significant correlations were found glucose with uric acid (r = 0.51, p <0.001) and creatinine with triglycerides (r = 0.354, p <0.05). Liver histopathology from fructose group showed mild to moderate, steatosis, necroinflammation and fibrosis. Allopurinol treatment decreases macrovesicular steatosis (27%, P<0,01), necroinflammation (72%, P<0,001) and fibrosis (26%, P<0,05) in hepatocytes. Therapy with allopurinol significantly prevented hyperglycemia and increased HDL cholesterol levels in rats and was effective in preventing necroinflammation and fructose-induced hepatic fibrosis. This is the first study to prove the action of a xanthine oxidase inhibitor as a treatment for NASH.