Evaluation of Statin Treatment for Nonalcoholic Fatty Liver Disease

Objective: To review if utilizing statin therapy in patients with nonalcoholic fatty liver disease (NAFLD) is safe and efficacious. Data Sources: A MEDLINE literature search was performed using the search terms statins, nonalcoholic fatty liver disease, NAFLD, safety, effectiveness, and efficacy. The literature search was not limited to a predetermined set of dates. The literature search included information from 2003 until February 2016. Additional references were identified from a review of literature citations. Study Selection and Data Extraction: All English-language randomized controlled trials, case reports, meta-analyses, and guidelines assessing the use of statins in patients with NAFLD were evaluated. Data Synthesis: Clinical data demonstrate that statins can increase serum transaminases; however, these effects appear to be dose dependent. Data show that statins do not exacerbate liver injury. The Statin Liver Safety Task Force indicates that statins are safe to use in patients with chronic liver diseases and compensated cirrhosis. Studies conducted to determine if statins are efficacious have been limited to small trials or case reports. However, data suggest that statins can reduce elevated serum transaminases and improve liver histology. Conclusions: Guidelines indicate that statins can be used to treat dyslipidemia in patients with NAFLD and nonalcoholic steatohepatitis. Statins may be a viable treatment option for NAFLD in patients who have an increased cardiovascular risk. Additional large, randomized controlled trials need to be conducted in order to confirm the beneficial effects of statins in NAFLD.