Zhang Jie, Fu Shifeng, Liu Deliang, Wang Yongjun, Tan Yuyong
Department of Gastroenterology, the Second Xiangya Hospital of Central South University.
Research Center of Digestive Disease, Central South University, Changsha, China.
Eur J Gastroenterol Hepatol. 2023 Apr 1;35(4):353-358. doi: 10.1097/MEG.0000000000002517. Epub 2023 Jan 31.
Currently, nonalcoholic fatty liver disease (NAFLD) is the main cause of chronic liver disease and liver-related mortality worldwide. Hepatocellular carcinoma (HCC) is a fatal complication in patients with NAFLD. However, whether statins can reduce the risk of HCC in patients with NAFLD remains controversial. We aimed to determine the relationship between statin use and HCC occurrence among patients with NAFLD. We independently retrieved related studies from PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrial.gov (from 1 January 2000 to 27 February 2022). The main outcome was the development of HCC. A fixed-effects model was used to merge odds ratio (OR) in the meta-analysis. Five studies involving 684 363 patients were included. The results of the meta-analysis suggested a significantly lower risk of HCC among statin users with NAFLD [OR = 0.59; 95% confidence interval (CI), 0.39-0.89; I2 = 87.90%]. Additionally, a lower risk of HCC was observed among patients with NAFLD aged less than 65 years (OR = 0.59; 95% CI, 0.46-0.77; I2 = 20.50%). Statins can reduce the risk of HCC in patients aged less than 65 years with NAFLD.
目前,非酒精性脂肪性肝病(NAFLD)是全球慢性肝病及肝脏相关死亡率的主要原因。肝细胞癌(HCC)是NAFLD患者的一种致命并发症。然而,他汀类药物能否降低NAFLD患者发生HCC的风险仍存在争议。我们旨在确定NAFLD患者使用他汀类药物与HCC发生之间的关系。我们独立检索了来自PubMed、EMBASE、Cochrane图书馆、科学网和ClinicalTrial.gov(从2000年1月1日至2022年2月27日)的相关研究。主要结局是HCC的发生。在荟萃分析中使用固定效应模型合并比值比(OR)。纳入了五项涉及684363例患者的研究。荟萃分析结果表明,NAFLD患者中使用他汀类药物者发生HCC的风险显著降低[OR = 0.59;95%置信区间(CI),0.39 - 0.89;I2 = 87.90%]。此外,年龄小于65岁的NAFLD患者发生HCC的风险较低(OR = 0.59;95% CI,0.46 - 0.77;I2 = 20.50%)。他汀类药物可降低年龄小于65岁的NAFLD患者发生HCC的风险。