To investigate the role of statins on the development of de novo NAFLD and progression of significant liver fibrosis, a study was carried out, including 11,593,409 subjects from the NHI database of the Republic of Korea. This was entered in 2010 and followed until 2016. NAFLD was diagnosed by calculating fatty liver index (FLI) and significant liver fibrosis was evaluated using the BARD score. Controls were randomly selected at a ratio of 1:5 from individuals who were at risk of becoming case subjects at the time of selection.
Among 5,339,901 subjects that had FLI less than 30 and included in the non-NAFLD cohort, a total of 164,856 subjects eventually had NAFLD develop. The use of statin was associated with a reduced risk of NAFLD development (adjusted odds ratio; AOR 0.66), and was independent of associated diabetes mellitus {DM}; AOR 0.44, without DM, AOR 7.1). From 712,262 subjects with FLI greater than 60 and selected in the NAFLD cohort, 111,257 subjects showed a BARD score greater than 2 and were defined as liver fibrosis cases.
The use of statins reduces the risk of significant liver fibrosis (AOR 0.43, independent of diabetes, with DM; AOR 0.31, without DM, AOR 0.52).
In this large population-based study, statin use decreased the risk of NAFLD occurrence and the risk of liver fibrosis once NAFLD developed.
Lee, J., Lee, H., Lee, K., Lee, H., Park, J. “Effects of Statin Use on the Development and Progression of Nonalcoholic Fatty Liver Disease: A Nationwide, Nested Case-Controlled Study.” American Journal of Gastroenterology, Vol. 116, January 2021, pp. 116-124.