PMID- 27110380
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160425
LR  - 20220318
IS  - 2054-4774 (Print)
IS  - 2054-4774 (Electronic)
IS  - 2054-4774 (Linking)
VI  - 3
IP  - 1
DP  - 2016
TI  - Statins, antidiabetic medications and liver histology in patients with diabetes 
      with non-alcoholic fatty liver disease.
PG  - e000075
LID - 10.1136/bmjgast-2015-000075 [doi]
LID - e000075
AB  - BACKGROUND: Type-2 diabetes mellitus (T2DM) is a risk factor for progressive 
      non-alcoholic fatty liver disease (NAFLD). Drugs commonly prescribed in patients 
      with T2DM may affect liver histology by interfering with lipid metabolism and 
      insulin resistance/secretion. AIM: We studied if statins or antidiabetic agents 
      were associated with non-alcoholic steatohepatitis (NASH) and significant 
      fibrosis (SF). METHODS: We performed a cross-sectional study of 346 diabetics 
      with biopsy-proven NAFLD. T2DM was defined as fasting glucose >/=7 mmol/L or 
      glycated haemoglobin >/=6.5% and/or use of antidiabetics. NASH was defined 
      according to the FLIP algorithm and SF as F2-4 Kleiner's stages. RESULTS: 84% of 
      patients were on antidiabetic therapy and 45% on statins. NASH and SF were 
      present in 57% and 48% of patients. Statin-treated patients were older, more 
      frequently male and with poorer glycaemic control despite more frequent 
      antidiabetic therapy than those without statins; however, the prevalence of NASH 
      (57%vs56%, p=0.868) and SF (48%vs48%, p=0.943) was not different between statin 
      users and non-users. NASH was more common in patients on metformin or insulin 
      than in those not treated with these drugs (60%vs47%, p=0.026; 68%vs53%, 
      p=0.017). SF was more common in those treated with sulfonylureas (57%vs44%, 
      p=0.030). Multivariate analyses confirmed that use of statins was independently 
      and negatively associated with both NASH (OR (95% CI) 0.57 (0.32 to 1.01), 
      p=0.055) and SF (OR (95% CI) 0.47 (0.26 to 0.84), p=0.011). Moreover, we found 
      independent associations between insulin use and NASH (OR (95% CI) 2.24 (1.11 to 
      4.54), p=0.025) and sulfonylureas use and SF (OR (95% CI) 2.04 (1.11 to 3.74), 
      p=0.022). CONCLUSIONS: Several medications used in patients with diabetes are 
      differently associated with NAFLD histology. Statin use is negatively associated, 
      while insulin and sulfonylureas are positively associated with NASH and SF. A 
      wider use of statins may be warranted in this high-risk population.
FAU - Nascimbeni, Fabio
AU  - Nascimbeni F
AD  - Department of Biomedical, Metabolic and Neural Sciences, University of Modena and 
      Reggio Emilia, Modena, Italy; Service d'Hepatogastroenterologie, Paris, France.
FAU - Aron-Wisnewsky, Judith
AU  - Aron-Wisnewsky J
AD  - Institute for Cardiometabolism and Nutrition (ICAN) , Paris , France.
FAU - Pais, Raluca
AU  - Pais R
AD  - Service d'Hepatogastroenterologie , Paris , France.
FAU - Tordjman, Joan
AU  - Tordjman J
AD  - Institute for Cardiometabolism and Nutrition (ICAN) , Paris , France.
FAU - Poitou, Christine
AU  - Poitou C
AD  - Institute for Cardiometabolism and Nutrition (ICAN) , Paris , France.
FAU - Charlotte, Frederic
AU  - Charlotte F
AD  - Department of Pathology , Hopital Pitie Salpetriere, Assistance Publique Hopitaux 
      de Paris, Universite Pierre et Marie Curie , Paris , France.
FAU - Bedossa, Pierre
AU  - Bedossa P
AD  - Pathology Department , Beaujon Hospital, University Paris Diderot , Paris , 
      France.
FAU - Poynard, Thierry
AU  - Poynard T
AD  - Service d'Hepatogastroenterologie , Paris , France.
FAU - Clement, Karine
AU  - Clement K
AD  - Institute for Cardiometabolism and Nutrition (ICAN) , Paris , France.
FAU - Ratziu, Vlad
AU  - Ratziu V
AD  - Service d'Hepatogastroenterologie , Paris , France.
CN  - LIDO study Group
LA  - eng
PT  - Journal Article
DEP - 20160318
PL  - England
TA  - BMJ Open Gastroenterol
JT  - BMJ open gastroenterology
JID - 101660690
PMC - PMC4838660
OTO - NOTNLM
OT  - DIABETES MELLITUS
OT  - FATTY LIVER
OT  - FIBROSIS
OT  - LIPIDS
OT  - NONALCOHOLIC STEATOHEPATITIS
EDAT- 2016/04/26 06:00
MHDA- 2016/04/26 06:01
PMCR- 2016/03/18
CRDT- 2016/04/26 06:00
PHST- 2015/12/20 00:00 [received]
PHST- 2016/01/18 00:00 [revised]
PHST- 2016/01/19 00:00 [accepted]
PHST- 2016/04/26 06:00 [entrez]
PHST- 2016/04/26 06:00 [pubmed]
PHST- 2016/04/26 06:01 [medline]
PHST- 2016/03/18 00:00 [pmc-release]
AID - bmjgast-2015-000075 [pii]
AID - 10.1136/bmjgast-2015-000075 [doi]
PST - epublish
SO  - BMJ Open Gastroenterol. 2016 Mar 18;3(1):e000075. doi: 
      10.1136/bmjgast-2015-000075. eCollection 2016.