STATINS are reported to be underutilised in nonalcoholic fatty liver disease (NAFLD) patients, according to a recent study by researchers at the New York-Presbyterian Hospital, New York City, New York, USA. Further educating providers regarding the benefits of statin prescription for NAFLD patients would markedly decrease cardiovascular disease in this population, which is the most common cause of mortality in this cohort.
Using data from the National Health and Nutrition Examination Survey (NHANES), researchers evaluated statin use in patients with hyperlipidaemia. Patients >18 years old, without viral hepatitis, non-excessive alcohol consumption, were not pregnant, and did not have transaminase levels >500 IU/L were included in the study.
A total of 136,833,627 patients were evaluated for their statin use: 74.6% had hyperlipidaemia (low density lipoproteins <130 mg/dL), and 93.5% of the patients were taking statins. Evaluation of the data highlighted that patients with hyperlipidaemia with abnormal alanine aminotransferase (ALT) levels were significantly less likely to be taking statins than those with normal ALT levels (86.3% versus 89.1%, respectively; p=0.001). Following multivariate analysis, and when sex and age of patients were controlled for, abnormal ALT significantly reduced the odds of a patient receiving statins if they had diabetes (odds ratio: 0.75; 95% confidence interval: 0.57–0.99).
These results are important to the field of hepatology because NAFLD, hyperlipidaemia, metabolic syndrome, and diabetes often occur together and are known to be involved in the development of cardiovascular disease. It is believed that furthering statin use in NAFLD patients will decrease the most common cause of mortality in NAFLD patients, cardiovascular disease. Dr Sonal Kumar, New York-Presbyterian Hospital, commented on the use of statins in NAFLD patients: “Statins are underutilised in patients with NAFLD and diabetes, patient groups in whom they could help control cardiovascular disease risk factors.” Dr Kumar went on to suggest that statin providers need to be educated on the safety of statins in these patients to help aid the increase in use of these revolutionary drugs.