Weight loss, dietary advice and statin therapy in non-alcoholic fatty liver disease: a retrospective

January 16, 2008

International Journal of Clinical Practice (OnlineEarly Articles).

doi:10.1111/j.1742-1241.2007.01666.x

Abstract

ORIGINAL PAPER

Weight loss, dietary advice and statin therapy in non-alcoholic fatty liver

disease: a retrospective study

P. Riley11Department of Gastroenterology, University Hospital ham, London,

UK, D. Sudarshi11Department of Gastroenterology, University Hospital ham,

London, UK, M. Johal11Department of Gastroenterology, University Hospital

ham, London, UK, A. Benedict11Department of Gastroenterology, University

Hospital ham, London, UK, J. Panteli22Department of Dietetics, University

Hospital ham, London, UK, M. Crook33Department of Biochemistry, University

Hospital ham, London, UK, J. O¡¯Donohue11Department of Gastroenterology,

University Hospital ham, London, UK1Department of Gastroenterology,

University Hospital ham, London, UK

2Department of Dietetics, University Hospital ham, London, UK

3Department of Biochemistry, University Hospital ham, London, UK

P. Riley,

Department of Gastroenterology, University Hospital ham, London, UK

Tel.: + 208 333 3000

Fax: + 208 333 3333

Email: paul.riley@...

Disclosures None.

Summary

Background: Studies have shown that weight loss can have a favourable effect

upon non-alcoholic fatty liver disease (NAFLD). However, the most effective

means of achieving weight loss and safety profile of lipid-lowering drugs in the

presence of NAFLD is unknown.

Aim: To investigate the effect of dietary advice and lipid-lowering drugs,

particularly statins, on patients with NAFLD and dyslipidaemia.

Design: Observational records based study.

Methods: We studied 71 patients with NAFLD and dyslipidaemia diagnosed and

treated between 1996 and 2002 at University Hospital ham. Some were

referred to a dietician for weight loss advice as part of their management.

After treatment all patients were assessed for changes in weight, serum alanine

transaminase (ALT) and serum lipids including serum cholesterol, serum high

density lipoprotein (HDL) and serum triglycerides.

Results: Thirty-seven male and 34 female patients with NAFLD and dyslipidaemia

were followed up for a mean period of 440 ¡¾ 374 days (median 335). Regression

analysis revealed a significant association between changes in weight and

changes in serum ALT (p < 0.039). Dietary advice failed to reduce body weight

but significantly lowered the serum cholesterol to HDL ratio (p = 0.05). Only

15.4% of patients taking statins experienced a rise in serum ALT ¡Ã 40 U/l, and

in each case the rise was transient, returning near baseline or below without

discontinuation of statin treatment.

Conclusions: Weight loss appears to improve NAFLD, and dietary advice and

lipid-lowering drugs may be beneficial for patients with NAFLD and dyslipidaemia

even if weight loss is not achieved. Statins appear to be safe and efficacious

in this group.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1742-1241.2007.01666.x

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January 16, 2008