The efficacy and safety of statins for the treatment of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease is an emerging liver disease in Western countries and the most frequentcause of incidental elevation of serum liver enzymes.Dyslipidaemia is frequently observed in patients with non-alcoholic fatty liver disease, and treatmentof dyslipidaemia plays a critical role in the overall management of these patients. Moreover, coronaryartery disease remains the most common cause of death. Statins are effective lipid-lowering agents,associated with a lowering the risk of cardiovascular events in several interventional randomized clinicaltrials.However, statins are often underused in patients with non-alcoholic fatty liver disease and many physi-cians are concerned about the prescription of statins to patients with unexplained persistent elevationof liver enzymes or active liver disease.Based on currently available data, statin therapy, at low-to-moderate doses, seems to be safe andhas low liver toxicity. Treatment of dyslipidaemia in patients with non-alcoholic fatty liver disease isrecommended and may also improve liver function tests. In these patients, the risks of not taking statinscould outweigh the risks of taking the drug. Conversely, the usefulness of statins for the treatment ofnon-alcoholic fatty liver disease/non-alcoholic steatohepatitis is still a matter of debate and randomizedclinical trials of adequate size and duration are required.