他汀类药物对非酒精性脂肪肝患者肝酶和血脂谱的影响

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY Journal of clinical lipidology Pub Date : 2024-07-01 DOI:10.1016/j.jacl.2024.03.003
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引用次数: 0

摘要

非酒精性脂肪肝(NAFLD)是心血管疾病(CVD)的独立风险因素。建议使用他汀类药物治疗血脂异常,以降低非酒精性脂肪肝患者的总体心血管风险。然而,他汀类药物的使用率并不高,而且他汀类药物对非酒精性脂肪肝患者肝酶的影响仍不明确。本研究旨在为非酒精性脂肪肝患者使用他汀类药物的安全性和效果提供实际证据。我们利用 2009-2018 年美国 NHANES 数据库的汇总数据,对患有非酒精性脂肪肝的成人进行了一项横断面调查研究。非酒精性脂肪肝的定义是脂肪肝指数 (FLI) > 60 和美国脂肪肝指数 (USFLI) > 30。研究人员对他汀类药物使用者和非他汀类药物使用者的肝酶和血脂状况进行了比较,并根据基线临床和人口统计学特征进行了多变量回归分析。该研究纳入了2533名患有非酒精性脂肪肝的成年人,代表了美国2260万名非酒精性脂肪肝患者,其中27%在2009年至2018年间接受了他汀类药物治疗。他汀类药物和非他汀类药物使用者的AST、ALT、ALP和GGT肝酶的平均差异分别为-0.86(p=0.539)、-3.49(p=0.042)、-0.25(p=0.913)和0.57(p=0.901)。在患有非酒精性脂肪肝和血脂异常的患者中,他汀类药物使用者的总胆固醇和低密度脂蛋白水平明显低于非他汀类药物使用者(平均差异为-28.9;p<0.001和-27.7;p<0.001)。使用他汀类药物与非酒精性脂肪肝患者的肝酶升高无关。与非他汀类药物使用者相比,他汀类药物使用者的谷丙转氨酶、总胆固醇和低密度脂蛋白水平明显较低。
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Effect of statin use on liver enzymes and lipid profile in patients with non-alcoholic fatty liver disease (NAFLD)

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.

OBJECTIVES

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).

CONCLUSION

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.

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来源期刊
CiteScore
7.00
自引率
6.80%
发文量
209
审稿时长
49 days
期刊介绍: Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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