1
|
Eslami Z, Aghili SS, Ghafi AG. Atorvastatin on Treatment of Nonalcoholic Fatty Liver Disease Patients. Chonnam Med J 2024; 60:13-20. [PMID: 38304133 PMCID: PMC10828082 DOI: 10.4068/cmj.2024.60.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat builds up in the liver, often related to obesity and insulin resistance, which can lead to inflammation and scarring of the liver tissue. While efforts have been made to develop effective treatments for NAFLD, the need for pharmaceutical interventions remains unmet. Large clinical trials investigating the association between statin use and NAFLD are scarce, leading to contradictory results. Statins play a crucial role in cholesterol synthesis in the liver. Several studies have demonstrated that statins possess anti-inflammatory, anti-thrombotic, and anti-fibrotic properties. These properties make statins potentially useful in preventing the progression of NAFLD from simple steatosis to more severe forms like non-alcoholic steatohepatitis (NASH) and fibrosis. The results indicate that statin use is associated with a lower prevalence of NASH and fibrosis and may have a preventive effect on NAFLD.
Collapse
Affiliation(s)
- Zahra Eslami
- Department of Clinical Biochemistry, Hamadan University of Medical Science, Hamadan, Iran
| | | | - Amir Ghaleh Ghafi
- Department of Biology, Islamic Azad University Damghan Branch, Semnan, Iran
| |
Collapse
|
2
|
Wan J, Chen M. Effects of statin on hypertension patients: A systematic review and meta-analysis. EUR J INFLAMM 2023. [DOI: 10.1177/1721727x221144454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective To conduct a systematic review and meta-analysis to compare the effects of statins and placebo on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension. Methods We used different databases such as MEDLINE and the Cochrane Library Central Register of Controlled Trials (CENTRAL) to search for randomized controlled trials published from 1 January 2000 to 1 January 2022 to retrieve relevant studies and full-text articles evaluating statins versus placebo in patients with hypertension. Data were taken from eligible studies. The included articles also performed Cochran’s Q statistics, forest plots, funnel plots, Egger’s test, and sensitivity analyses. Results This study included 8 studies with a total of 3086 patients. We sought to assess patients' SBP and DBP. The results were expressed as mean differences (MD) with 95% confidence intervals. There was no difference in DBP between the statin and placebo groups (MD = 2.48, 95% CI [−2.00, 6.96], p = .28, random effects model). In terms of SBP, the statin group was superior to the placebo group (MD = 4.37, 95% CI [0.72, 8.02], p = .02, random-effects model). Sensitivity analyses and funnel plots showed that our study was robust, with low publication bias. Conclusion The results show that statins could be clinically more effective than placebo in patients with hypertension.
Collapse
Affiliation(s)
- Jianwei Wan
- Department of Pharmacy, Shanghai Pudong New Area Zhoupu Hospital (Shanghai Health Medical College Affiliated Zhoupu Hospital), Shanghai, China
| | - Min Chen
- Department of Pharmacy, Shanghai Pudong New Area Zhoupu Hospital (Shanghai Health Medical College Affiliated Zhoupu Hospital), Shanghai, China
| |
Collapse
|
3
|
Jung HH. Statin use and outcome risks according to predicted CVD risk in Korea: A retrospective cohort study. PLoS One 2021; 16:e0245609. [PMID: 33450746 PMCID: PMC7810517 DOI: 10.1371/journal.pone.0245609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/04/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The validity of cardiovascular disease (CVD) risk calculators in decision for statin therapy has not been fully evaluated at a population level. This study aimed to examine the net benefits of statins according to predicted CVD risk. METHODS AND FINDINGS A cohort of 40 to 79-year-old Korean adults without CVD was generated from the National Health Information Database 2006-2017. Major CVD event rates and all-cause mortality in 58,265 users who initiated statins during 2007-2010 were compared with those in 58,265 nonusers matched on propensity scores, from January 1, 2012 through December 31, 2017. Additionally, simulation was performed for the population-based cohort of 659,759 adults. CVD risk was predicted using the 2018 revised Pooled Cohort Equations. In propensity score-matched cohort, the CVD hazard ratios (95% CIs) in occasional, intermittent, and regular statin users were 1.06 (0.93-1.20), 0.82 (0.70-0.97), and 0.57 (0.50-0.64), respectively. The corresponding mortality hazard ratios were 1.01 (0.92-1.10), 0.87 (0.78-0.98), and 0.71 (0.66-0.77), respectively. In stratified analyses, the relative risk reductions were similar, irrespective of age, sex, or predicted CVD risk. Accordingly, absolute risk reductions were greater in higher risk categories. In 6-year follow-up simulation cohorts, regular statin use could reduce 17 CVDs and 28 deaths in 1000 adults with a 10-year risk of ≥10.0% vs 10 CVDs and 14 deaths in 1000 with ≥2 major risk factors. However, in actual adults with a risk of ≥10%, statin use was insufficient and estimated to reduce 3 CVDs and 4 deaths in 1000. Limitations of this study include assessment of medication use based on the prescription data, lack of information on the intensity of statins, and limited generalizability to individuals with very old age or other ethnicity. CONCLUSIONS CVD risk calculators were valid in decision-making for primary prevention statin therapy. Proper risk assessment and regular statin use in patients at high predicted risk would reduce outcome risks much more than present in Asian populations.
Collapse
Affiliation(s)
- Hae Hyuk Jung
- Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea
- * E-mail:
| |
Collapse
|
4
|
Liu WT, Lin C, Tsai MC, Cheng CC, Chen SJ, Liou JT, Lin WS, Cheng SM, Lin CS, Tsao TP. Effects of Pitavastatin, Atorvastatin, and Rosuvastatin on the Risk of New-Onset Diabetes Mellitus: A Single-Center Cohort Study. Biomedicines 2020; 8:biomedicines8110499. [PMID: 33202854 PMCID: PMC7696728 DOI: 10.3390/biomedicines8110499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 01/20/2023] Open
Abstract
Statins constitute the mainstay treatment for atherosclerotic cardiovascular disease, which is associated with the risk of new-onset diabetes mellitus (NODM). However, the effects of individual statins on the risk of NODM remain unclear. We recruited 48,941 patients taking one of the three interested statins in a tertiary hospital between 2006 and 2018. Among them, 8337 non-diabetic patients taking moderate-intensity statins (2 mg/day pitavastatin, 10 mg/day atorvastatin, and 10 mg/day rosuvastatin) were included. The pitavastatin group had a higher probability of being NODM-free than the atorvastatin and rosuvastatin groups during the 4-year follow-up (log-rank test: p = 0.038). A subgroup analysis revealed that rosuvastatin had a significantly higher risk of NODM than pitavastatin among patients with coronary artery disease (CAD) (adjusted HR [aHR], 1.47, 95% confidence interval [CI], 1.05–2.05, p = 0.025), hypertension (aHR, 1.26, 95% CI, 1.00–1.59, p = 0.047), or chronic obstructive pulmonary disease (COPD) (aHR, 1.74, 95% CI, 1.02–2.94, p = 0.04). We concluded that compared with rosuvastatin, reduced diabetogenic effects of pitavastatin were observed among patients treated with moderate-intensity statin who had hypertension, COPD, or CAD. Additional studies are required to prove the effects of different statins on the risk of NODM.
Collapse
Affiliation(s)
- Wei-Ting Liu
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chin Lin
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Min-Chien Tsai
- Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Cheng-Chung Cheng
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-C.C.); (J.-T.L.); (W.-S.L.); (S.-M.C.)
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Jun-Ting Liou
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-C.C.); (J.-T.L.); (W.-S.L.); (S.-M.C.)
| | - Wei-Shiang Lin
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-C.C.); (J.-T.L.); (W.-S.L.); (S.-M.C.)
| | - Shu-Meng Cheng
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-C.C.); (J.-T.L.); (W.-S.L.); (S.-M.C.)
| | - Chin-Sheng Lin
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-C.C.); (J.-T.L.); (W.-S.L.); (S.-M.C.)
- Correspondence: (C.-S.L.); (T.-P.T.); Tel.: +886-2-6601-2656 (C.-S.L.); +886-2-2826-4400 (T.-P.T.)
| | - Tien-Ping Tsao
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (C.-C.C.); (J.-T.L.); (W.-S.L.); (S.-M.C.)
- Division of Cardiology, Cheng Hsin General Hospital, Taipei 11220, Taiwan
- Correspondence: (C.-S.L.); (T.-P.T.); Tel.: +886-2-6601-2656 (C.-S.L.); +886-2-2826-4400 (T.-P.T.)
| |
Collapse
|
5
|
Yandrapalli S, Malik A, Guber K, Rochlani Y, Pemmasani G, Jasti M, Aronow WS. Statins and the potential for higher diabetes mellitus risk. Expert Rev Clin Pharmacol 2019; 12:825-830. [PMID: 31474169 DOI: 10.1080/17512433.2019.1659133] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Introduction: 3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are widely used for cardiovascular disease (CVD) prevention. Long-term use of statins has been linked to the development of diabetes mellitus (DM) which increases CVD risk. Areas covered: We discussed the reported incidence of DM in statin users, various possible mechanisms responsible for the development of DM and the clinical implications of this association on CVD risk. Relevant supporting literature was identified using MEDLINE/EMBASE search. Expert opinion: Data from available RCTs and observational studies suggest a 10-45% higher risk of new-onset DM with statin use compared to nonusers. Several cellular, molecular, and genetic mechanisms, and lifestyle changes have been studied and discussed as potential underlying mechanisms responsible for this elevated DM risk with statin therapy. The mode of the diabetogenic action of statins is still unclear and an interplay of pancreatic and peripheral effects in the pathogenesis of DM is a possibility. Despite these observations, the CVD preventative benefit of statin treatment outweighs the CVD risk associated with of development of new DM. There is a need for further research to identify the exact mechanisms involved so as to specifically target causative factors and individualize treatment.
Collapse
Affiliation(s)
| | - Aaqib Malik
- Department of Medicine, Westchester Medical Center , Valhalla , NY , USA
| | - Kenneth Guber
- Department of Medicine, New York Medical College , Valhalla , NY , USA
| | - Yogitha Rochlani
- Division of Cardiology, Westchester Medical Center , Valhalla , NY , USA
| | - Gayatri Pemmasani
- Division of Cardiology, Westchester Medical Center , Valhalla , NY , USA
| | - Manasa Jasti
- Department of Medicine, MacNeal Hospital , Berwyn , IL , USA
| | - Wilbert S Aronow
- Division of Cardiology, Westchester Medical Center , Valhalla , NY , USA
| |
Collapse
|