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Abstract：
OBJECTIVE: Statin liver safety in non-alcoholic fatty liver disease (NAFLD) patients is not well defined. We analysed differences in liver function tests, including alanine transaminase aminotransferase (ALT), aspartate transaminase (AST) and gamma-glutamyl transpeptidase (GGT) in NAFLD patients treated or not treated with statins.
METHODS: We performed a systematic review of MEDLINE via PubMed and EMBASE databases and metanalysis of clinical studies investigating levels of ALT, AST and GGT in NAFLD according to statin treatment. Mean difference (MD) and percentage MD were calculated between the two groups.
RESULTS: We included 22 studies with 2345 NAFLD patients. Overall, 16 were before-after interventional, five were cross-sectional and one was combined cross-sectional/interventional study. In all interventional studies, except one, patients had raised ALT, AST and GGT at baseline. Interventional studies showed reduced ALT values with an MD reduction of -27.2 U/L (95% CI -35.25/-19.15) and a percentage MD reduction of -35.41% (95% CI -44.78/-26.04). Also, AST values were reduced after statin treatment in interventional studies with an MD of -18.82 U/L (95% CI -25.63/-12.02) (percentage -31.78%, 95% CI -41.45/-22.11). Similarly, GGT levels were reduced after statin treatment with an MD of -19.93 U/L (95% CI -27.10/-12.77) (percentage -25.57%, 95% CI -35.18/-15.97). Cross-sectional studies showed no difference in AST and GGT values between patients treated with and without statins.
CONCLUSIONS: In interventional studies, ALT, AST and GGT were reduced after statin treatment with a percentage mean difference of -35.41%, -31.78% and -25.57%, respectively, while observational studies showed a null effect, suggesting liver safety of statins in NAFLD patients.
METHODS: We performed a systematic review of MEDLINE via PubMed and EMBASE databases and metanalysis of clinical studies investigating levels of ALT, AST and GGT in NAFLD according to statin treatment. Mean difference (MD) and percentage MD were calculated between the two groups.
RESULTS: We included 22 studies with 2345 NAFLD patients. Overall, 16 were before-after interventional, five were cross-sectional and one was combined cross-sectional/interventional study. In all interventional studies, except one, patients had raised ALT, AST and GGT at baseline. Interventional studies showed reduced ALT values with an MD reduction of -27.2 U/L (95% CI -35.25/-19.15) and a percentage MD reduction of -35.41% (95% CI -44.78/-26.04). Also, AST values were reduced after statin treatment in interventional studies with an MD of -18.82 U/L (95% CI -25.63/-12.02) (percentage -31.78%, 95% CI -41.45/-22.11). Similarly, GGT levels were reduced after statin treatment with an MD of -19.93 U/L (95% CI -27.10/-12.77) (percentage -25.57%, 95% CI -35.18/-15.97). Cross-sectional studies showed no difference in AST and GGT values between patients treated with and without statins.
CONCLUSIONS: In interventional studies, ALT, AST and GGT were reduced after statin treatment with a percentage mean difference of -35.41%, -31.78% and -25.57%, respectively, while observational studies showed a null effect, suggesting liver safety of statins in NAFLD patients.
摘要：
目的：他汀类药物在非酒精性脂肪性肝病（NAFLD）患者中的肝脏安全性尚不明确。我们分析了肝功能检查的差异，包括丙氨酸转氨酶转氨酶（ALT），天冬氨酸转氨酶（AST）和γ-谷氨酰转肽酶（GGT）在NAFLD患者治疗或未治疗他汀类药物。
方法：我们通过PubMed和EMBASE数据库对MEDLINE进行了系统评价，并对研究ALT水平的临床研究进行了元分析，根据他汀类药物治疗NAFLD中的AST和GGT。计算两组之间的平均差异（MD）和MD百分比。
结果：我们纳入了22项研究，纳入2345例NAFLD患者。总的来说,16人是介入前后，5项为横断面研究,1项为横断面/介入联合研究.在所有的介入研究中,除了一个,患者ALT升高，基线时的AST和GGT。介入研究显示ALT值降低，MD降低-27.2U/L(95%CI-35.25/-19.15)，MD降低百分比为-35.41%(95%CI-44.78/-26.04)。此外，在介入研究中，他汀类药物治疗后AST值降低，MD为-18.82U/L（95％CI-25.63/-12.02）（百分比-31.78％，95%CI-41.45/-22.11）。同样，他汀类药物治疗后GGT水平降低，MD为-19.93U/L（95％CI-27.10/-12.77）（百分比-25.57％，95%CI-35.18/-15.97）。横断面研究显示，使用和不使用他汀类药物治疗的患者之间的AST和GGT值没有差异。
结论：在介入研究中，ALT,他汀类药物治疗后AST和GGT降低，百分比平均差异为-35.41%，-31.78%和-25.57%，分别,虽然观察研究显示无效，提示他汀类药物在NAFLD患者中的肝脏安全性。
方法：我们通过PubMed和EMBASE数据库对MEDLINE进行了系统评价，并对研究ALT水平的临床研究进行了元分析，根据他汀类药物治疗NAFLD中的AST和GGT。计算两组之间的平均差异（MD）和MD百分比。
结果：我们纳入了22项研究，纳入2345例NAFLD患者。总的来说,16人是介入前后，5项为横断面研究,1项为横断面/介入联合研究.在所有的介入研究中,除了一个,患者ALT升高，基线时的AST和GGT。介入研究显示ALT值降低，MD降低-27.2U/L(95%CI-35.25/-19.15)，MD降低百分比为-35.41%(95%CI-44.78/-26.04)。此外，在介入研究中，他汀类药物治疗后AST值降低，MD为-18.82U/L（95％CI-25.63/-12.02）（百分比-31.78％，95%CI-41.45/-22.11）。同样，他汀类药物治疗后GGT水平降低，MD为-19.93U/L（95％CI-27.10/-12.77）（百分比-25.57％，95%CI-35.18/-15.97）。横断面研究显示，使用和不使用他汀类药物治疗的患者之间的AST和GGT值没有差异。
结论：在介入研究中，ALT,他汀类药物治疗后AST和GGT降低，百分比平均差异为-35.41%，-31.78%和-25.57%，分别,虽然观察研究显示无效，提示他汀类药物在NAFLD患者中的肝脏安全性。
