Statins and prevention of stroke in patients with non-alcoholic fatty liver disease

Abstract

Non-alcoholic fatty liver disease （NAFLD） is an important type in chronic liver diseases. Its incidence is growing. It is regarded as the liver manifestation of metabolic syndrome, which is closely correlated with the onset of cardiocerebrovascular diseases. The prevention of stroke in patients with NAFLD is very important. Statins are the most important type of medications. They decrease cholesterol synthesis, upregulate low-density lipoprotein （LDL） receptor in the liver and lower the levels of low-density lipoprotein cholesterol （LDL-C） in circulation through inhibiting hydroxy-methyl-glutaryl coenzyme A （HMG-CoA） reductase, and thus effectively reduce the risks of stroke. Besides, the pleiotropy of statins and their effects on cholesterol-related cell signaling pathway may relieve or prevent the progression of NAFLD. There is greater controversy about whether statins can be used in patients with chronic liver diseases because they have some adverse reactions on liver. The evidence available has demonstrated that statins can be used safely in patients with NAFLD, and usually liver enzymes have no need to be monitored. Too much attention on the liver toxicity of statins may result in inappropriate drug withdrawal, and brings about the increased risk of cardiovascular events. So further evaluation is needed for the efficacy and safety of statins in patients with NAFLD. Key words: hydroxymethylglutaryl-CoA reductase inhibitors; fatty liver; stroke