title: Lipid targets during statin treatment in dyslipidemic patients affected by nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is associated with both dyslipidemia and increased risk for cardiovascular disease. Despite the indication to treat in patients affected by both dyslipidemia and NAFLD, an undertreatment in statin therapy due to the potential liver damage is frequently observed. We sought to evaluate retrospectively the impact of statin on the lipid profile and on the achievement of low-density lipoprotein (LDL) cholesterol targets in relation to the National Cholesterol Education Program--Adult Treatment Panel III-cardiovascular risk in dyslipidemic patients presenting with a clinical--diagnosis of NAFLD and elevated liver enzymes before statin prescription. As a secondary endpoint, the authors investigated whether statin could be associated with changes of liver enzymes.
  
  
  METHODS
  Forty-three patients with dyslipidemic NAFLD presenting with increased values of aspartate aminotransferase and/or alanine aminotransferase and/or γ-glutamyl-transferase at baseline were analyzed retrospectively as regard the lipid profile and liver enzymes (values reported before statin and during statin therapy).
  
  
  RESULTS
  Total cholesterol, LDL and triglycerides were significantly reduced at follow-up (5.4 ± 5.4 months). The LDL target was achieved at the second visit in 30 patients (69.8%).The number of patients achieving the LDL target was significantly higher in low-risk group compared with moderate- and high-risk subjects. Liver enzyme levels showed no significant changes between baseline and follow-up.
  
  
  CONCLUSIONS
  Statin treatment was effective (without changes in liver enzymes) in patients with dyslipidemia and NAFLD and therefore, affected by a profound alteration in lipoprotein metabolism. The number of patients achieving LDL target was related to the Adult Treatment Panel III risk classification, being higher in patients with lower risk.
authors.affiliation: Department of Clinical Medicine, Research Center on Dyslipidemia, University of Insubria, Varese, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Maroni
authors.forename: Luigina
authors.initials: L
authors.lastname: Guasti
authors.forename: Luana
authors.initials: L
authors.lastname: Castiglioni
authors.forename: Franca
authors.initials: F
authors.lastname: Marino
authors.forename: Sara
authors.initials: S
authors.lastname: Contini
authors.forename: Valentina
authors.initials: V
authors.lastname: Macchi
authors.forename: Alessandra
authors.initials: A
authors.lastname: De Leo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gaudio
authors.forename: Matteo
authors.initials: M
authors.lastname: Tozzi
authors.forename: Anna M
authors.initials: AM
authors.lastname: Grandi
authors.forename: Marco
authors.initials: M
authors.lastname: Cosentino
authors.forename: Achille
authors.initials: A
authors.lastname: Venco
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology; D008076:Cholesterol, HDL / Q000187:drug effects / Q000378:metabolism; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000209:etiology*; D005234:Fatty Liver / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects*; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012189:Retrospective Studies
chemical_list: D008076:Cholesterol, HDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids