他汀类药物在非酒精性脂肪性肝病中的疗效：系统评价和荟萃分析。
Statins' efficacy in non-alcoholic fatty liver disease: A systematic review and meta-analysis.
机构信息
Second Propedeutic Department of Internal Medicine, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
First Department of Obstetrics and Gynaecology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki 56429, Greece.
出版信息
Clin Nutr. 2022 Oct;41(10):2195-2206. doi: 10.1016/j.clnu.2022.08.001. Epub 2022 Aug 8.
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is closely related with the metabolic syndrome and cardiovascular disease. Currently there is no approved medication for NAFLD. Although it has been suggested that statins can be safely used by patients with elevated liver enzymes, their effect on NAFLD has not been clearly defined. The aim of this study is to evaluate the effectiveness of statins on biochemical and histological parameters in patients with NAFLD.
METHODS
We searched PubMed, Web of Science, and SCOPUS for clinical trials and observational studies concerning the effects of statins on the development and treatment of NAFLD, regardless of the type or dosage of statin, the duration of treatment or the methods used for the diagnosis of NAFLD (biopsy or imaging technique) up to November 2021.
RESULTS
We identified 13 studies. Liver function tests and lipid profile were significantly improved. There was a significant decrease in steatosis grade (standardized mean difference, SMD -1.73, 95% CI -2.11 to -1.35; p < 0.00001; I = 98%) and in NAFLD activity score (NAS) (SMD -1.09 (95% CI -1.39 to -0.79; p < 0.00001; I = 93%)).
CONCLUSIONS
Statins effectively decrease liver enzymes and beneficially affect liver histology in NAFLD patients.
背景与目的
非酒精性脂肪性肝病（NAFLD）与代谢综合征和心血管疾病密切相关。目前尚无批准用于治疗 NAFLD 的药物。尽管有研究表明升高的肝酶患者可以安全使用他汀类药物，但他汀类药物对 NAFLD 的影响尚未明确。本研究旨在评估他汀类药物对 NAFLD 患者生化和组织学参数的疗效。
方法
我们检索了 PubMed、Web of Science 和 SCOPUS 中关于他汀类药物对 NAFLD 发生和治疗影响的临床试验和观察性研究，无论他汀类药物的类型或剂量、治疗持续时间或用于诊断 NAFLD 的方法（活检或影像学技术）如何，均截止至 2021 年 11 月。
结果
我们共确定了 13 项研究。肝功能试验和血脂谱明显改善。脂肪变性程度评分（标准化均数差，SMD -1.73，95%置信区间-2.11 至-1.35；p<0.00001；I=98%）和 NAFLD 活动评分（NAS）（SMD -1.09，95%置信区间-1.39 至-0.79；p<0.00001；I=93%）均显著降低。
结论
他汀类药物可有效降低肝酶，并对 NAFLD 患者的肝脏组织学产生有益影响。
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