title: Statin use is not associated with presence of and severity of nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  There is concern that statin use may exacerbate nonalcoholic fatty liver disease (NAFLD). We aimed to assess the association of statin use with NALFD and severity of liver fibrosis among NAFLD individuals.
  
  
  METHODS
  We evaluated 6,385 cross-sectional healthy Brazilian subjects (43 ± 10 years, 79% males) without clinical coronary heart disease between November 2008 and July 2010. NAFLD was diagnosed by ultrasound. Severity of liver fibrosis was predicted by fatty liver index and FIB-4.
  
  
  RESULTS
  NAFLD prevalence was 36% (n = 2310). Overall 552 (9%) individuals were using statins of whom 49% had NAFLD. Statin users were more likely to be men, older age, and have higher burden of risk factors (p <0.05). In age gender adjusted analysis the odds ratio for NAFLD with statin use was 0.87 (0.61-1.25, p = 0.46) in the presence of metabolic syndrome and 1.08 (0.88-1.32, p = 0.56) in its absence. On further adjustment for metabolic risk factors, LDL and smoking the results remained unchanged (OR: 0.89, 95% CI: 0.65-1.32, p = 0.56 and 0.90 (0.69-1.18, p = 0.46). There was no significant association between statin use and fatty liver index in a subanalysis of NAFLD individuals (71 ± 18 vs. 69 ± 23, p = 0.18). Although FIB-4 was mildly elevated with statin use (1.20 ± 0.51 vs. 1.02 ± 0.46, p <0.001), a multivariate analysis adjusted for age, gender and risk factors revealed statin use was not associated with severe fibrosis (FIB >1.45) (OR 0.88, 95% CI: 0.60-1.29, p = 0.50).
  
  
  CONCLUSIONS
  The results of this study favor statin use in subjects with NAFLD as its use is not associated with the presence of NAFLD or increased fibrosis.
authors: Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida.
authors: Ebenezer T
authors: ET
authors: Oni
authors: Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida.
authors: Pragya
authors: P
authors: Sinha
authors: Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida.
authors: Adil
authors: A
authors: Karim
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland.
authors: Seth S
authors: SS
authors: Martin
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland.
authors: Michael J
authors: MJ
authors: Blaha
authors: Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida.
authors: Arthur S
authors: AS
authors: Agatston
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland.
authors: Roger S
authors: RS
authors: Blumenthal
authors: Preventive Medicine Center Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors: Romeu S
authors: RS
authors: Meneghelo
authors: Preventive Medicine Center Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
authors: Raquel D
authors: RD
authors: Conceiçao
authors: Lipid Clinic-Heart Institute (InCor) University of São Paulo Medical School Hospital, Sao Paulo-São Paulo, Brazil.
authors: Raul D
authors: RD
authors: Santos
authors: Center for Prevention and Wellness Research, Baptist Health Medical Group, Miami Beach, Florida; The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland; Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida. Electronic address: khurramn@baptisthealth.net.
authors: Khurram
authors: K
authors: Nasir
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: FIB-4 index; Fatty Liver Index; Fibrosis; NAFLD; Statins