Holly A.R. Wiesinger, J. Shah, A. White, E.M. Yoshida, J. Frohlich, S. Sirrs, S. Gill, M.F. Byrne
Background: The metabolic syndrome and non-alcoholic fatty liver disease are increasing at alarming rates. Aims: To determine the effect of HMG-CoA reductase inhibitors (statins) on elevated liver enzymes in patients with hyperlipidemia. Patients: Patients with AST above 60 U/L prior to or during treatment with statin therapy at a quaternary care lipid clinic were reviewed. Methods: A retrospective analysis was conducted. Patients were separated into two groups: Group 1 – elevated AST prior to statin therapy; and Group 2 – elevated AST during statin therapy. Results: Forty six patients with one or more measurements of AST >60 U/L remained after exclusion criteria were applied. Ten of 13 (77%) group 1 patients had reduced AST levels after initiation of statin therapy. Thirty two of 33 patients (97%) in group 2 had transient AST elevations while on statin therapy; one patient had persistently elevated AST after initiation of treatment. There were no significant adverse events reported. Conclusion: Use of HMG-CoA reductase inhibitors in patients with elevated AST resulted in normalization of AST levels. HMG-CoA reductase inhibitors were safe in patients with mildly elevated AST. This may translate to use of HMG-CoA reductase inhibitors in diseases such as non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.
Key words. Non-alcoholic fatty liver disease, HMGCoA reductase inhibitor, hyperlipidemia