Ikeda Suguru, Sugihara Takaaki, Kihara Takuya, Matsuki Yukako, Nagahara Takakazu, Takata Tomoaki, Kitao Sonoko, Okura Tsuyoshi, Yamamoto Kazuhiro, Isomoto Hajime
Department of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Department of Cardiovascular Medicine and Endocrinology and Metabolism, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Diagnostics (Basel). 2021 Dec 9;11(12):2316. doi: 10.3390/diagnostics11122316.
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease related to metabolic syndrome. No standard pharmacological treatment has yet been established. We retrospectively evaluated the efficacy of pemafibrate in 16 NAFLD patients (11 men and 5 women; median age, 59 years; range, 27-81 years) who had taken pemafibrate for at least one year. They were all diagnosed with fatty liver according to imaging and clinical criteria. They were administered pemafibrate from October 2018 to October 2021 (median, 94 weeks; range, 56-157 weeks). Serum triglyceride was significantly decreased by -41.9% (342.3 ± 54.0 to 198.9 ± 20.4 mg/dL, < 0.001). Aspartate aminotransferase (AST), alanine aminotransferase, and gamma-glutamyl transferase levels significantly decreased by -42.1% (49.6 ± 7.0 to 28.7 ± 3.4 U/L, < 0.001), -57.1% (65.1 ± 10.8 to 27.9 ± 3.7 U/L, < 0.001), and -43.2% (68.9 ± 10.9 to 39.1 ± 5.3 U/L, < 0.05), respectively. The AST to platelet ratio (APRI) (0.8 ± 0.1 to 0.4 ± 0.1, < 0.001) and fibrosis based on four factors (FIB-4) index (1.8 ± 0.3 to 1.4 ± 0.2, < 0.05) also significantly decreased. Liver attenuation (39.1 ± 1.2 to 57.8 ± 2.7 HU, = 0.028) and liver/spleen ratio (0.76 ± 0.04 to 1.18 ± 0.02, = 0.012) significantly improved in three patients, as assessed by computed tomography. In conclusion, pemafibrate significantly improves serum triglyceride levels, liver function, FIB-4 index, APRI, and fatty liver in NAFLD patients with hypertriglyceridemia.
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。目前尚未确立标准的药物治疗方法。我们回顾性评估了16例服用匹伐贝特至少一年的NAFLD患者（11例男性和5例女性；中位年龄59岁；范围27 - 81岁）中匹伐贝特的疗效。根据影像学和临床标准，他们均被诊断为脂肪肝。他们于2018年10月至2021年10月接受匹伐贝特治疗（中位时间94周；范围56 - 157周）。血清甘油三酯显著降低了-41.9%（从342.3±54.0降至198.9±20.4mg/dL，<0.001）。天冬氨酸转氨酶（AST）、丙氨酸转氨酶和γ-谷氨酰转移酶水平分别显著降低了-42.1%（从49.6±7.0降至28.7±3.4U/L，<0.001）、-57.1%（从65.1±10.8降至27.9±3.7U/L，<0.001）和-43.2%（从68.9±10.9降至39.1±5.3U/L，<0.05）。AST与血小板比值（APRI）（从0.8±0.1降至0.4±0.1，<0.001）以及基于四项因素的纤维化（FIB - 4）指数（从1.8±0.3降至1.4±0.2，<0.05）也显著降低。通过计算机断层扫描评估，3例患者的肝脏衰减（从39.1±1.2升至57.8±2.7HU，P = 0.028）和肝脾比值（从0.76±0.04升至1.18±0.02，P = 0.012）显著改善。总之，匹伐贝特可显著改善高甘油三酯血症的NAFLD患者的血清甘油三酯水平、肝功能、FIB - 4指数、APRI及脂肪肝情况。
