Hatanaka Takeshi, Kosone Takashi, Saito Naoto, Takakusagi Satoshi, Tojima Hiroki, Naganuma Atsushi, Takagi Hitoshi, Uraoka Toshio, Kakizaki Satoru
Department of Gastroenterology Gunma Saiseikai Maebashi Hospital Maebashi Japan.
Department of Gastroenterology and Hepatology Kusunoki Hospital Fujioka Japan.
JGH Open. 2021 Aug 28;5(10):1183-1189. doi: 10.1002/jgh3.12650. eCollection 2021 Oct.
This retrospective study investigated the effect of 48-week pemafibrate therapy in non-alcoholic fatty liver disease (NAFLD) with hypertriglyceridemia, as evaluated by the FibroScan-aspartate aminotransferase (FAST) score.
A total of 31 NAFLD patients who were treated with pemafibrate in Gunma Saiseikai Maebashi Hospital and Kusunoki Hospital from September 2018 to April 2020 were included in the current study. We used the FAST score, which is a novel index of steatohepatitis that can be calculated based on the AST value, controlled attenuation parameter (CAP), and liver stiffness measurement (LSM), to evaluate the effect of pemafibrate treatment.
The median age was 64.0 (interquartile range [IQR] 55.0-75.0) years and 14 patients (45.2%) were male. Median body mass index was 26.8 (IQR 23.8-28.8). Hypertension and diabetes mellitus were detected in 14 (45.2%) and five (16.1%) patients, respectively. Fasting triglyceride and high-density lipoprotein cholesterol were significantly improved ( < 0.001 and 0.013, respectively) and the AST, alanine aminotransferase (ALT), alkaline phosphatase, and γ-glutamyl transpeptidase values were significantly decreased during pemafibrate treatment ( = 0.041, <0.001, <0.001, and <0.001, respectively). While the LSM value and CAP value did not differ to a statistically significant extent ( = 0.19 and 0.140, respectively), the FAST score was significantly improved during pemafibrate treatment ( = 0.029). The delta FAST score was found to be correlated with the variations of ALT (r = 0.504, = 0.005), which represents the effect of pemafibrate.
Pemafibrate improved the FAST score due to the hepatic anti-inflammatory effect, indicating that pemafibrate may prevent disease progression in NAFLD patients with hypertriglyceridemia.
本回顾性研究通过FibroScan-天冬氨酸转氨酶（FAST）评分评估了48周匹伐他汀治疗对非酒精性脂肪性肝病（NAFLD）合并高甘油三酯血症患者的疗效。
本研究纳入了2018年9月至2020年4月期间在群马县立前桥医院和楠木医院接受匹伐他汀治疗的31例NAFLD患者。我们使用FAST评分来评估匹伐他汀治疗的效果，FAST评分是一种新型的脂肪性肝炎指标，可根据天冬氨酸转氨酶（AST）值、受控衰减参数（CAP）和肝脏硬度测量值（LSM）计算得出。
患者的中位年龄为64.0岁（四分位间距[IQR]为55.0 - 75.0），14例（45.2%）为男性。中位体重指数为26.8（IQR为23.8 - 28.8）。分别有14例（45.2%）和5例（16.1%）患者检测出高血压和糖尿病。在匹伐他汀治疗期间，空腹甘油三酯和高密度脂蛋白胆固醇显著改善（分别为<0.001和0.013），AST、丙氨酸转氨酶（ALT）、碱性磷酸酶和γ-谷氨酰转肽酶值显著降低（分别为0.041、<0.001、<0.001和<0.001）。虽然LSM值和CAP值在统计学上没有显著差异（分别为0.19和0.140），但在匹伐他汀治疗期间FAST评分显著改善（为0.029）。发现FAST评分变化值与ALT的变化相关（r =
0.504， = 0.005），这代表了匹伐他汀的疗效。
匹伐他汀通过肝脏抗炎作用改善了FAST评分，表明匹伐他汀可能预防NAFLD合并高甘油三酯血症患者的疾病进展。
