da Silva Pereira Evelyn Nunes Goulart, Franco Rafaela Luiza Costa, Santos Rafaele Dantas Cruz Dos, Daliry Anissa
Laboratory of Clinical and Experimental Physiopathology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Laboratory of Clinical and Experimental Physiopathology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Biomed Pharmacother. 2025 Feb;183:117805. doi: 10.1016/j.biopha.2024.117805. Epub 2025 Jan 3.
Non-alcoholic fatty liver disease (NAFLD) is a common hepatic manifestation of metabolic syndrome affecting 20-30 % of the adult population worldwide. This disease, which includes simple steatosis and non-alcoholic steatohepatitis, poses a significant risk for cardiovascular and metabolic diseases. Lifestyle modifications are crucial in the treatment of NAFLD; however, patient adherence remains challenging. As there is no specific treatment, drug repositioning is being researched as an alternative strategy. Statins, which are known for their cholesterol-lowering effects, are considered potential interventions for NAFLD. This review aimed to present the current understanding of the effects of statins on liver physiology in the context of NAFLD. The pathophysiology of NAFLD includes steatosis, inflammation, and fibrosis, which are exacerbated by dyslipidemia and insulin resistance. Statins, which inhibit 3-hydroxy-3-methylglutaryl-CoA reductase, have pleiotropic effects beyond cholesterol-lowering and affect pathways related to inflammation, fibrogenesis, oxidative stress, and microcirculation. Although clinical guidelines support the use of statins for dyslipidemia in patients with NAFLD, more studies are needed to demonstrate their efficacy in liver disease. This comprehensive review serves as a foundation for future studies on the therapeutic potential of statins in NAFLD.
非酒精性脂肪性肝病（NAFLD）是代谢综合征常见的肝脏表现，影响着全球20%至30%的成年人口。这种疾病包括单纯性脂肪变性和非酒精性脂肪性肝炎，会给心血管疾病和代谢疾病带来重大风险。生活方式的改变对NAFLD的治疗至关重要；然而，患者的依从性仍然具有挑战性。由于没有特效治疗方法，药物重新定位正在作为一种替代策略进行研究。他汀类药物以其降低胆固醇的作用而闻名，被认为是NAFLD的潜在干预措施。本综述旨在阐述在NAFLD背景下目前对他汀类药物对肝脏生理影响的认识。NAFLD的病理生理学包括脂肪变性、炎症和纤维化，血脂异常和胰岛素抵抗会使其加剧。抑制3-羟基-3-甲基戊二酰辅酶A还原酶的他汀类药物除了降低胆固醇外，还具有多效性作用，并影响与炎症、纤维生成、氧化应激和微循环相关的途径。尽管临床指南支持在NAFLD患者中使用他汀类药物治疗血脂异常，但仍需要更多研究来证明其在肝病中的疗效。这篇综述为未来关于他汀类药物在NAFLD治疗潜力的研究奠定了基础。
