Weight loss, Dietary Advice and Statin Therapy in Non-Alcoholic Fatty Liver Disease

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International Journal of Clinical Practice

Weight loss, Dietary Advice and Statin Therapy in Non-Alcoholic Fatty

Liver Disease: A Retrospective Study

Posted 04/06/2008

P. Riley; D. Sudarshi; M. Johal; A. Benedict; J. Panteli; M. Crook; J.

O'Donohue

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 ± 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 ≥ 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.

--

ne Holden, MS, RD

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