背景:非酒精性脂肪性肝病(NAFLD)是心血管疾病(CVD)的独立危险因素。他汀类药物被推荐用于治疗血脂异常,以降低NAFLD患者的总体心血管风险。然而,在该患者人群中,他汀类药物治疗未得到充分利用,他汀类药物对肝酶的影响尚不清楚。
目的:本研究旨在为NAFLD患者使用他汀类药物的安全性和有效性提供真实证据。
方法:我们使用2009-2018年美国NHANES数据库的汇总数据对NAFLD成人进行了横断面调查研究。NAFLD定义为脂肪肝指数(FLI)≥60,美国脂肪肝指数(USFLI)≥30。对基线临床和人口统计学特征进行了多变量回归分析,以比较他汀类药物和非他汀类药物使用者之间的肝酶和脂质分布。
结果:该研究包括2,533名患有NAFLD的成年人,代表美国2260万人,27%的患者在2009年至2018年期间接受他汀类药物治疗。AST的肝酶的平均差异,ALT,ALP,他汀类药物和非他汀类药物使用者之间的GGT为-0.86(p=0.539),-3.49(p=0.042),-0.25(p=0.913),和0.57(p=0.901),分别。在患有NAFLD和血脂异常的个体中,他汀类药物使用者的总胆固醇和低密度脂蛋白水平显著低于非他汀类药物使用者(平均差异,-28.9;p<0.001和-27.7;p<0.001)。
结论:他汀类药物的使用与NAFLD患者肝酶升高无关。ALT水平明显降低,总胆固醇,他汀类药物使用者与非他汀类药物使用者相比,观察到LDL.
BACKGROUND: Non-alcoholic fatty liver disease (
NAFLD) is an independent risk factor for cardiovascular disease (CVD). Statins are recommended for treatment of dyslipidemia to reduce the overall cardiovascular risk in patients with
NAFLD. However, statin treatment was underutilized and the effect of statins on liver enzymes remained unclear in this patient population.
OBJECTIVE: This study aimed to provide real-world evidence of the safety and effect of statin use in patients with NAFLD.
METHODS: We conducted a cross-sectional survey study of adults with
NAFLD using pooled data from the US NHANES database 2009-2018.
NAFLD was defined by Fatty Liver Index (FLI) ≥ 60 and United States Fatty Liver Index (USFLI) ≥ 30. Multivariate regression analyses adjusted for baseline clinical and demographic characteristics were performed to compare the liver enzymes and lipid profile between statin and non-statin users.
RESULTS: The study included 2,533 adults with
NAFLD, representing 22.6 million individuals in the US, with 27% receiving statin treatment between 2009 and 2018. The mean differences of liver enzymes for AST, ALT, ALP, and GGT between statin and non-statin users were -0.86 (p=0.539), -3.49 (p=0.042), -0.25 (p=0.913), and 0.57 (p=0.901), respectively. In individuals with NAFLD and dyslipidemia, total cholesterol and LDL levels were significantly lower in statin users compared to non-statin users (mean difference, -28.9; p<0.001 and -27.7; p<0.001).
CONCLUSIONS: The use of statins was not associated with elevated liver enzymes in patients with NAFLD. Significantly lower levels of ALT, total cholesterol, and LDL were observed in statin users compared to non-statin users.