Statins for Patients with Fatty Liver Disease and Mildly Elevated Transaminases

Patients with hyperlipidemia often have elevated transaminase levels, usually caused by nonalcoholic fatty liver disease (NAFLD), an independent predictor of mortality. Small studies have suggested that statins lower transaminase levels and improve liver histology in patients with NAFLD, but many clinicians are reluctant to start or continue statins in such patients. In two recent studies, investigators examined the effects of statins in patients with NAFLD who were enrolled in trials with cardiovascular primary endpoints.

In a Greek study, researchers randomized 1600 patients with coronary heart disease and hyperlipidemia to receive either structured care including atorvastatin (titrated to achieve LDL cholesterol level <100 mg/dL) or usual…