Minireviews
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2014; 6(10): 738-744
Published online Oct 27, 2014. doi: 10.4254/wjh.v6.i10.738
Lipid-lowering agents in the management of nonalcoholic fatty liver disease
Konstantinos Tziomalos
Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, Greece
Author contributions: Tziomalos K solely contributed to this manuscript.
Correspondence to: Konstantinos Tziomalos, MD, PhD, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Kiriakidi 1, 54636 Thessaloniki, Greece. ktziomalos@yahoo.com
Telephone: +30-2310-994621 Fax: +30-2310-994773
Received: May 18, 2014
Revised: August 22, 2014
Accepted: September 6, 2014
Published online: October 27, 2014
Processing time: 170 Days and 18.2 Hours
Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in developed countries and is associated not only with increased risk for liver disease-related complications but also with higher cardiovascular morbidity. Accordingly, lipid-lowering agents are frequently considered in these patients to reduce cardiovascular risk. However, there have been concerns regarding the safety of these agents in patients with chronic liver diseases. In the present review, we discuss the safety of lipid-lowering agents in patients with NAFLD as well as their effects on both cardiovascular and liver disease in this population. Accumulating data suggest that statins are safe in patients with NAFLD and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se, since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD. Randomized controlled studies are needed to evaluate the role of lipid-lowering agents and particularly statins for the prevention of both cardiovascular and liver disease-related complications in this high-risk population.

Keywords: Nonalcoholic fatty liver disease; Statins; Fibrates; Ezetimibe; Colesevelam; Omega-3 fatty acids; Nicotinic acid; Cardiovascular disease; Transaminases; Nonalcoholic steatohepatitis

Core tip: Accumulating data suggest that statins are safe in patients with nonalcoholic fatty liver disease (NAFLD) and that they reduce the increased cardiovascular morbidity of this population. However, it is still unclear whether statins are also useful as a treatment for NAFLD per se, since there are very limited and conflicting data on their effects on liver histology. There is also very scarce evidence regarding the safety and efficacy of other lipid-lowering agents in patients with NAFLD.