Statin use may protect against NASH, fibrosis in NAFLD

Last Updated: 2016-04-11

By Anne Harding

NEW YORK (Reuters Health) - Non-alcoholic fatty liver disease (NAFLD) patients who take statins are less likely to have non-alcoholic steatohepatitis (NASH) and significant fibrosis, new findings have shown.

Type 2 diabetes is a risk factor for NAFLD, and drugs that diabetes patients take may affect liver histology because they may interfere with insulin sensitivity and lipid metabolism, Dr. Fabio Nascimbeni of the University of Modena and Reggio Emilia in Modena, Italy, and colleagues noted in their report, published online March 18 in BMJ Open Gastroenterology.

To investigate, the researchers looked at statin and antidiabetic agent use and liver histology in 364 diabetic individuals with biopsy-proven NAFLD. Fifty-seven percent had NASH, and 48% had significant fibrosis. Eighty-four percent were taking antidiabetic drugs and 45% were on statins.

Multivariate analysis found that statin use was independently associated with a lower risk of both NASH (odds ratio 0.57) and significant fibrosis (OR 0.47). Insulin use was associated with a greater likelihood of NASH (OR 2.24), while sulfonylurea use was associated with significant fibrosis (OR 2.04).

Some clinicians are reluctant to prescribe statins because there have been reports linking statin use to increases in aminotransferases, coauthor Dr. Vlad Ratziu of the Service d'Hepatogastroenterologie in Paris, told Reuters Health in a telephone interview. "They do not induce real hepatotoxicity; however, increased liver function test keeps many physicians from prescribing statins," he added.

But the new findings confirm other recent research suggesting that statin use may actually be beneficial for patients with NAFLD, Dr. Ratziu said.

"Only half of these high-risk patients were on statins, and that number should have been much higher," he added. "There is a problem of under-treating here, and there is no rationale for this to continue."

The authors reported no funding or disclosures.

SOURCE: http://bit.ly/1N3Zc91

BMJ Open Gastroenterol 2016.