A Meta-Analysis Of The Efficacy And Safety Of Statins In The Treatment Of Nonalcoholic Fatty Liver Disease

Objective:Nonalcoholic fatty liver disease is one of the most common causes of liver dysfunction.Coronary heart disease(CHD)and other cardiovascular diseases(CVD)are its the most common complications.The statins are hydroxymethylglutaryl coenzyme A(HMG-CoA)reductase inhibitors that improve lipid metabolism to reduce the risk of major coronary and vascular events.But because of its liver toxicity,increased muscle enzymes and incidence of type 2 diabetes,and other adverse reactions,limiting its application in patients with NAFLD.The efficacy and safety of statins in the treatment of nonalcoholic fatty liver disease were studied by meta-analysis of existing randomized controlled trials or controlled trials.Methods:This study was conducted by searching the English database:PubMed,EMBASE,Cochrane Library,and Chinese Database:CKNI,Wanfang Data,Chongqing Weipu.Retrieved the literature published in April 2016.Included randomized controlled/controlled trials.Two researchers independently extracted data,using Jadda score and NOS score to evaluate the quality of the literature.The literature data were expressed as mean difference(MD)and 95%Cl or relative risk(RR)and 95%CI.Statistical heterogeneity was analyzed by χ2 test.Experiments which heterogeneity I2>50%used the random effects model for statistical analysis,otherwise used the fixed effects model.parallel subgroup analysis and meta regression analysis of heterogeneity.The literature that can not be used for meta-analysis take a descriptive analysis.Applying sensitivity analysis to evaluate individual research influence.Egger’s test method and Begg test method quantification evaluation release bias.Results:1.Statins significantly reduced ALT and AST levels in patients with nonalcoholic fatty liver disease,and showed that the effect of single study on the overall conclusions was still controllable,suggesting that the results were stable.Egger’s test method suggests that there is no significant publication bias.Statins in patients with nonalcoholic fatty liver disease significantly reduced CRP levels,sensitivity analysis was no special.Less literature,unable to assess publication bias.Non-alcoholic fatty liver patients taking statins to reduce the level of GGT,sensitivity analysis showed results robust.Egger method P = 0.026,suggesting the existence of publication bias.2.Statin therapy significantly improved serum lipid levels(TC,TG,LDL-C)in patients with nonalcoholic fatty liver,and the sensitivity analysis showed robust results.TC index Egger method P = 0.042,on behalf of the existence of publication bias in this study.TG,LDL-C index Egger test table no obvious publication bias.3.Statin therapy significantly improved arterial elasticity and atherosclerotic plaque(PWV,IMT,plaque score).The literature included in the article to be further verified.4.The color effect of statin in the treatment of nonalcoholic fatty liver disease in fixed effects model P = 0.20,suggesting that statins had no significant difference in liver ultrasonography.5.A document NASH patients taking statins pathology showed liver steatosis and necrotizing inflammation no significant improvement.6.Adverse reactions are mostly tolerable.Conclusion:Statins can significantly decrease the lipid level and liver biochemical indicators such as ALT,AST and CRP in patients with NAFLD.There is no significant difference in ultrasonic index between the two groups before and after treatment.The pathological outcome is unknown.