Ikeda Suguru, Sugihara Takaaki, Hoshino Yoshiki, Matsuki Yukako, Nagahara Takakazu, Okano Jun-Ichi, Kitao Sonoko, Fujioka Youhei, Yamamoto Kazuhiro, Isomoto Hajime
Division of Medicine and Clinical Science, Department of Gastroenterology and Nephrology, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and.
Division of Medicine and Clinical Science, Department of Cardiovascular Medicine and Endocrinology and Metabolism, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Yonago Acta Med. 2020 Aug 7;63(3):188-197. doi: 10.33160/yam.2020.08.009. eCollection 2020 Aug.
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease related to metabolic syndrome, which can progress to liver cirrhosis. Standard medication has not been established. Pemafibrate is a selective peroxisome proliferator-activated receptor (PPAR) α modulator. We retrospectively evaluated the efficacy of pemafibrate in patients with NAFLD.
We retrospectively enrolled 17 patients (ten men, seven women; median age, 63 years; range, 27-81 years). They were all proven to have fatty liver through imaging and had little or no history of drinking (ethanol consumption of < 20 g/day for women and < 30 g/day for men). They were administered pemafibrate from October 2018 to June 2020.
After administration, serum triglyceride (TG) tended to be decreased (300.5 ± 22.5 to 239.5 ± 34.3 mg/dL, = 0.06). Serum high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol levels did not change. ALT was significantly decreased (-47.4%) for six months (57.5 ± 8.8 to 30.3 ± 5.8 U/L, < 0.01). The values of serum GGT significantly decreased (-48.7%) for sixth months (63.9 ± 10.3 to 32.8 ± 6.6 U/L, < 0.01). Aspartate aminotransferase (AST) to platelet ratio (APRI), a fibrosis marker, also was significantly decreased in the sixth month (0.7 ± 0.1 to 0.4 ± 0.1, < 0.05). Body mass index (BMI) and hemoglobin A1c (HbA1c) showed no significant change.
Pemafibrate dramatically ameliorated the values of liver function tests and APRI in patients with NAFLD.
非酒精性脂肪性肝病（NAFLD）是一种与代谢综合征相关的慢性肝病，可进展为肝硬化。目前尚未确立标准药物治疗方案。佩马贝特是一种选择性过氧化物酶体增殖物激活受体（PPAR）α调节剂。我们回顾性评估了佩马贝特对NAFLD患者的疗效。
我们回顾性纳入了17例患者（10例男性，7例女性；中位年龄63岁；范围27 - 81岁）。他们均通过影像学检查证实患有脂肪肝，且饮酒史很少或无饮酒史（女性乙醇摄入量<20克/天，男性<30克/天）。2018年10月至2020年6月期间给予他们佩马贝特治疗。
给药后，血清甘油三酯（TG）有下降趋势（从300.5±22.5降至239.5±34.3毫克/分升，P = 0.06）。血清高密度脂蛋白（HDL）胆固醇和低密度脂蛋白（LDL）胆固醇水平未发生变化。谷丙转氨酶（ALT）在6个月时显著下降（-47.4%）（从57.5±8.8降至30.3±5.8 U/L，P<0.01）。血清γ-谷氨酰转移酶（GGT）值在6个月时也显著下降（-48.7%）（从63.9±10.3降至32.8±6.6 U/L，P<0.01）。纤维化标志物天冬氨酸氨基转移酶（AST）与血小板比值（APRI）在第6个月时也显著下降（从0.7±0.1降至0.4±0.1，P<0.05）。体重指数（BMI）和糖化血红蛋白（HbA1c）无显著变化。
佩马贝特显著改善了NAFLD患者的肝功能检查值和APRI。
