Statins' efficacy in non-alcoholic fatty liver disease: A systematic review and meta-analysis

Background & aims: Non-alcoholic fatty liver disease (NAFLD) is closely related with the metabolic syndrome and cardiovascular disease. Currently there is no approved medication for NAFLD. Although it has been suggested that statins can be safely used by patients with elevated liver enzymes, their effect on NAFLD has not been clearly defined. The aim of this study is to evaluate the effectiveness of statins on biochemical and histological parameters in patients with NAFLD. Methods: We searched PubMed, Web of Science, and SCOPUS for clinical trials and observational studies concerning the effects of statins on the development and treatment of NAFLD, regardless of the type or dosage of statin, the duration of treatment or the methods used for the diagnosis of NAFLD (biopsy or imaging technique) up to November 2021. Results: We identified 13 studies. Liver function tests and lipid profile were significantly improved. There was a significant decrease in steatosis grade (standardized mean difference, SMD -1.73, 95% CI -2.11 to -1.35; p < 0.00001; I-2 = 98%) and in NAFLD activity score (NAS) (SMD -1.09 (95% CI -1.39 to -0.79; p < 0.00001; I-2 = 93%)). Conclusions: Statins effectively decrease liver enzymes and beneficially affect liver histology in NAFLD patients. (C) 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.