The efficacy and safety of statins for the treatment of non-alcoholic fatty liver disease

Abstract

Non-alcoholic fatty liver disease is an emerging liver disease in Western countries and the most frequent cause of incidental elevation of serum liver enzymes. Dyslipidaemia is frequently observed in patients with non-alcoholic fatty liver disease, and treatment of dyslipidaemia plays a critical role in the overall management of these patients. Moreover, coronary artery disease remains the most common cause of death. Statins are effective lipid-lowering agents, associated with a lowering the risk of cardiovascular events in several interventional randomized clinical trials. However, statins are often underused in patients with non-alcoholic fatty liver disease and many physicians are concerned about the prescription of statins to patients with unexplained persistent elevation of liver enzymes or active liver disease. Based on currently available data, statin therapy, at low-to-moderate doses, seems to be safe and has low liver toxicity. Treatment of dyslipidaemia in patients with non-alcoholic fatty liver disease is recommended and may also improve liver function tests. In these patients, the risks of not taking statins could outweigh the risks of taking the drug. Conversely, the usefulness of statins for the treatment of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis is still a matter of debate and randomized clinical trials of adequate size and duration are required.

To Study the Prevalence of Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes and to Correlate it with Lipid profile and Glycated Hemoglobin in a Hospital

“…Our study also showed that there is no significant elevation of liver enzymes in statin group as feared due to the rare and dose related hepatotoxicity of statin. Some studies also showed that statins can cause diabetes mellitus and glucose intolerance, but in our study group all were DM-2 and they did not show elevated HbA1c levels as compared to non statin group [27][28][29][30] .…”

Statins and Cholesterol: A Perspective Revisited

“…It was found that only 0.1% patients had severe ALT levels and most importantly severity was associated with drug-drug interactions. [49] Below Table 2 describes the relation between statins and liver abnormalities [48] Taking into account the anti-inflammatory and anti-thrombotic effects property of statins, it is believed that statins may exert beneficial effects in reducing liver cancer, decreasing fibrosis or fatty deposition and improvement of portal hypertension. In a recent Cochrane meta-analysis, statins were found to improve serum aminotransferase levels in NAFLD and NASH; however no effect was observed on histological level and liver-related mortality and morbidity.…”

“…In a recent Cochrane meta-analysis, statins were found to improve serum aminotransferase levels in NAFLD and NASH; however no effect was observed on histological level and liver-related mortality and morbidity. [48] Cholesterol, statins and steroid hormones: There are three classes of steroid hormones in mammals namely glucocorticoids, mineralocorticoids, and adrenal androgens. These can be further categorized as adrenal steroid hormones [like cortisol, aldosterone and DHEA(s)] and non-adrenal steroid hormones (like testosterone, progesterone and estradiol).…”

“…Two retrospective studies showed that statin therapy did not affect liver enzyme levels in patients suffering from steatohepatitis and nonalcoholic fatty liver disease compared with patients not taking statins. [48] A study was conducted over a 5-year period which included 23,000 patients on statins. It was found that only 0.1% patients had severe ALT levels and most importantly severity was associated with drug-drug interactions.…”

Lysosomes ‘in control’

“…In spite of its potential to drastically reduce lipid levels, the use of fibrates or statins in the clinic is still controversial for treating NASH. 149 30 In this view, anti-oxLDL antibodies can potentially be used as a diagnostic tool for NASH detection. However, it is important to note that the amount of anti-oxLDL antibodies naturally vary between people and can change over time.…”