Efficacy of omega-3 fatty acids, atorvastatin and orlistat in non-alcoholic fatty liver disease with dyslipidemia.
OBJECTIVE
To evaluate the efficacy and safety of three hypolipidemic agents in patients with non-alcoholic fatty liver disease associated with hyperlipidemia.


METHODS
Patients with dyslipidemia (Fredrickson type IIb), asymptomatic persistent transaminasemia lasting 24 weeks, and evidence of hepatic fat infiltration on ultrasonography and liver biopsy were studied. Those with predominant hypertriglyceridemia received omega-3 fatty acids (5 mL thrice daily) (Group A), those with predominant hypercholesterolemia received atorvastatin 20 mg/daily (Group B), and overweight patients received orlistat 120 mg thrice daily before meals (Group C). After 24 weeks of treatment, serum transaminase and lipid levels and liver ultrasonography were repeated.


RESULTS
Serum transaminase levels decreased significantly (p< 0.001) in all groups but the decrease was more marked in Group C (AST 75 [16] to 31 [7] IU/L; ALT 120 [38] to 41 [10] IU/L) than in Group A (AST 70 [14] to 41 [6]; ALT 110 [20] to 68 [12]) or Group B (AST 68 [13] to 46 [9]; ALT 115 [22] to 76.6 [13]). After treatment, ultrasonography showed resolution of fatty liver in 35% of patients in Group A, 61% in Group B, and in 86% in Group C (p< 0.001, Group C vs. A).


CONCLUSIONS
A decline in transaminase levels and normalization of ultrasonographic evidence of fatty liver were observed on treatment with omega-3 fatty acids in patients with hypertriglyceridemia, with atorvastatin in those with hypercholesterolemia, and orlistat in overweight patients with hyperlipidemia.
Hatzitolios
Apostolos
A
First Propaedeutic Department of Internal Medicine, Ahepa General Hospital, Aristotelion University of Thessaloniki, Greece. aee@med.auth.gr
Savopoulos
Christos
C
Lazaraki
Georgia
G
Sidiropoulos
Ioannis
I
Haritanti
Persefoni
P
Lefkopoulos
Anastasios
A
Karagiannopoulou
Georgia
G
Tzioufa
Valentini
V
Dimitrios
Koliouskas
K
D000328:Adult; D000368:Aged; D000069059:Atorvastatin; D016009:Chi-Square Distribution; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005234:Fatty Liver / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007783:Lactones / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D000077403:Orlistat; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3; D006538:Heptanoic Acids; D007783:Lactones; D011758:Pyrroles; D000077403:Orlistat; D000069059:Atorvastatin