NASH resolution is associated with improvements in HDL and triglyceride levels but not improvement in LDL or non-HDL-C levels

作者：Corey K E^*; Vuppalanchi R; Wilson L A; Cummings O W; Cha****ni N

来源：Alimentary Pharmacology and Therapeutics, 2015, 41(3): 301-309.

DOI：10.1111/apt.13035

BackgroundNonalcoholic steatohepatitis (NASH) is associated with dyslipidemia and cardiovascular disease (CVD).
AimTo determine the relationship between resolution of NASH and dyslipidemia.
MethodsIndividuals in the Pioglitazone vs. Vitamin E vs. Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis (PIVENS) trial with paired liver biopsies and fasting lipid levels were included (N=222). In the PIVENS trial individuals were randomised to pioglitazone 30mg, vitamin E 800IU or placebo for 96weeks. Change in lipid levels at 96weeks was compared between those with and without NASH resolution.
ResultsDyslipidemia at baseline was frequent, with low high-density lipoprotein (HDL) (<40mg/dL in men or <50mg/dL in women) in 63%, hypertriglyceridaemia (150mg/dL) in 46%, hypercholesterolaemia (200mg/dL) in 47% and triglycerides (TG)/HDL >5.0 in 25%. Low-density lipoprotein (LD) 160mg/dL was found in 16% and elevated non-HDL cholesterol (non-HDL-C) (130mg/dL) in 73%. HDL increased with NASH resolution but decreased in those without resolution (2.9mg/dL vs. -2.5mg/dL, P<0.001). NASH resolution was associated with significant decreases in TG and TG/HDL ratio compared to those without resolution (TG: -21.1 vs. -2.3mg/dL, P=0.03 and TG/HDL: -0.7 vs. 0.1, P=0.003). Non-HDL-C, LDL and cholesterol decreased over 96weeks in both groups, but there was no significant difference between groups. Treatment group did not impact lipids.
ConclusionsNASH resolution is associated with improvements in TG and HDL but not in other cardiovascular disease risk factors including LDL and non-HDL-C levels. Individuals with resolution of NASH may still be at increased risk of cardiovascular disease. identifier: NCT00063622.

• 出版日期2015-2