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长期使用匹伐他汀治疗血脂异常相关性非酒精性脂肪性肝病后对身体成分和肝功能的影响。

Effects of body composition and liver function after long-term pemafibrate treatment on dyslipidemia-associated non-alcoholic fatty liver disease.

作者信息

Ishikawa Toru, Terai Nanako, Igarashi Takanori, Yamazaki Shun, Kobayashi Takamasa, Sato Toshifumi, Iwanaga Akito, Sano Tomoe, Yokoyama Junji, Honma Terasu

机构信息

Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.

Department of Radiography, Saiseikai Niigata Hospital, Niigata, Japan.

出版信息

Clin Exp Hepatol. 2023 Jun;9(2):172-178. doi: 10.5114/ceh.2023.127813. Epub 2023 Jun 23.

Abstract

AIM OF THE STUDY

Owing to the association between non-alcoholic fatty liver disease (NAFLD) and dyslipidemia, there is a need for new treatment strategies to manage both conditions concomitantly. Our aim in this study was to evaluate the effectiveness of pemafibrate in alleviating dyslipidemia-associated NAFLD, including the evaluation of its effects on liver function and body composition.

MATERIAL AND METHODS

The study sample included 67 patients with dyslipidemia-associated NAFLD (29 males, mean age 65.7 years [range, 58.4-73.7]) who were administered pemafibrate continuously for a period of at least 12 months, between June 2019 and January 2022. Outcomes were the change in body composition indices (visceral adipose tissue index - VATI, subcutaneous adipose tissue index - SATI, and skeletal muscle index - SMI), lipid biochemistry, and liver function, reserve, and fibrosis score, from baseline to the 12-month time point of pemafibrate treatment.

RESULTS

Pemafibrate treatment improved liver function (alanine aminotransferase, aspartate aminotransferase, g-glutamyl transpeptidase, and alkaline phosphatase), and lipid biochemistry (triglycerides and total cholesterol). Improvements in ferritin and hepatic reserve (Mac-2 binding protein, albumin-to-bilirubin score, and NAFLD fibrosis score) were also observed, as well as a decrease in SATI.

CONCLUSIONS

Pemafibrate improved dyslipidemia, liver function, and hepatic reserve. The positive effects of pemafibrate on body composition likely contributed to the improvements in liver function. Longer-term treatment may be necessary to influence VATI and thus to further evaluate the relationship between improved body composition and NAFLD with pemafibrate treatment.

摘要

研究目的

鉴于非酒精性脂肪性肝病(NAFLD)与血脂异常之间的关联,需要新的治疗策略来同时管理这两种病症。本研究的目的是评估匹伐他汀在缓解与血脂异常相关的NAFLD方面的有效性,包括评估其对肝功能和身体成分的影响。

材料与方法

研究样本包括67例与血脂异常相关的NAFLD患者(29例男性,平均年龄65.7岁[范围58.4 - 73.7岁]),他们在2019年6月至2022年1月期间连续服用匹伐他汀至少12个月。观察指标为从基线到匹伐他汀治疗12个月时间点身体成分指数(内脏脂肪组织指数 - VATI、皮下脂肪组织指数 - SATI和骨骼肌指数 - SMI)、脂质生化指标、肝功能、储备和纤维化评分的变化。

结果

匹伐他汀治疗改善了肝功能(丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转肽酶和碱性磷酸酶)以及脂质生化指标(甘油三酯和总胆固醇)。还观察到铁蛋白和肝脏储备(Mac-2结合蛋白、白蛋白与胆红素比值评分和NAFLD纤维化评分)有所改善,以及SATI降低。

结论

匹伐他汀改善了血脂异常、肝功能和肝脏储备。匹伐他汀对身体成分的积极作用可能有助于肝功能的改善。可能需要更长时间的治疗来影响VATI,从而进一步评估匹伐他汀治疗改善身体成分与NAFLD之间的关系。

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