TABLE 1.
Characteristics of studies included in the metanalysis
| Year/Author | Study design | NAFLD diagnosis | Setting/indication to statin | Type and dose of statin | Age (y) | Women (%) | Total patients |
|---|---|---|---|---|---|---|---|
| Panel A: Observational studies | |||||||
| 2003 Kiyici 26 | Before‐after interventional study | Liver biopsy | NAFLD treatment; ALT elevation | Atorvastatin 10 mg | 50.2 | 55.56 | 27 |
| 2004 Hatzitolios 27 | Before‐after interventional study | Liver biopsy, ultrasound and CT scan | Mixed dyslipidaemia (Fredrickson type IIb); ALT elevation | Atorvastatin 20 mg | 53.0 | 53.57 | 28 |
| 2006 Antonopoulos 28 | Before‐after interventional study | Liver ultrasound | Hyperlipidaemic patients | Rosuvastatin 10 mg | 56.0 | 28.30 | 23 |
| 2006 Athyros 29 | Before‐after interventional study | Liver ultrasound | Non‐diabetic | Atorvastatin 20 mg | 60.0 | 35.00 | 63 |
| 2008 Hyogo 30 | Before‐after interventional study | Liver biopsy | ‐ | Atorvastatin 10 mg | 52.5 | 35.48 | 31 |
| 2009Abel 31 | Before‐after interventional study | ALT >40 U/L or AST > 37 U/L in men; ALT or AST > 31 U/L in women | Well‐controlled diabetes | Simvastatin 20 mg | 58.6 | 46.15 | 26 |
| 2010 Kimura 32 | Before‐after interventional study | Liver biopsy | Dyslipidaemia | Atorvastatin 10 mg | 50.2 | 32.56 | 43 |
| 2010 GREACE 33 | Post‐hoc analysis RCT | ALT >45 and <135 U/L or AST > 37 and <101 U/L | Secondary prevention | Atorvastatin 10 to 80 mg | 60 | 21 | 227 |
| 2011 Hyogo 34 | Before‐after interventional study | Liver biopsy | ‐ | Pitavastatin 2 mg | 50.6 | 55.00 | 20 |
| 2011 Maroni 35 | Retrospective | Liver ultrasound and abnormal liver enzyme values (AST ≥ 33 U/L and/or ALT ≥33 U/L; and/or GGT ≥ 49 U/L). | Dyslipidaemia |
Atorvastatin (n = 19) Simvastatin (n = 11) Rosuvastatin (n = 10) Fluvastatin (n = 2) Lovastatin (n = 1) |
54.5 | 30.23 | 43 |
| 2012 Han‐1 36 | Before‐after interventional study | ALT elevation ≥1.25 times and ≤2.5 times 40 IU/L | Hyperlipidaemic patients | Atorvastatin 10–20 mg | 54.9 | 46.03 | 85 |
| 2012 Han‐2 36 | Before‐after interventional study | ALT elevation ≥1.25 times and ≤2.5 times 40 IU/L | Hyperlipidaemic patients | Pitavastatin 2–4 mg | 55.8 | 46.97 | 88 |
| 2012 Hyogo 37 | Before‐after interventional study | Liver biopsy | Hyperlipidaemic patients | Atorvastatin 10 mg | 50.0 | 33.30 | 42 |
| 2012 Nakahara 38 | Before‐after interventional study | Liver biopsy | Hyperlipidaemic patients | Rosuvastatin 2.5 mg | 46.3 | 57.89 | 19 |
| 2015 Derosa 39 | Before‐after interventional study | Liver ultrasound | Hypertensive normo‐cholesterolemic patients | Simvastatin 20 mg | ‐ | 49.6 | 139 |
| 2017 Bril 40 | Before‐after interventional study | Liver biopsy | Prediabetes/diabetes | Simvastatin (67%) Rosuvastatin (21%) Atorvastatin and Pravastatin (12%) | ‐ | ‐ | 19 |
| 2017 Cioboatǎ 41 | Before‐after interventional study | Liver biopsy | Hyperlipidaemic patients | Atorvastatin 20 mg | ‐ | ‐ | 57 |
| 2018 Hadzi‐Petrushev 42 | Before‐after interventional study | Liver ultrasound | ‐ | Atorvastatin 20 mg | 43.0 | 0.00 | 20 |
| Panel B: Cross‐sectional studies | ||||||||
|---|---|---|---|---|---|---|---|---|
| Year/Author | NAFLD diagnosis | Setting/indication to statin | Type and dose of statin | Age (y) | Women (%) | Total patients | On statin (n) | Not on statin (n) |
| 2006 Dallas Heart Study 43 | MR spectroscopy | General population screened for the presence of liver steatosis | Simvastatin (48%) Atorvastatin (32%) Pravastatin (12%) Fluvastatin (6%) Cerivastatin (1%) Lovastatin (1%) | 45.7 | ‐ | 638 | 54 | 584 |
| 2007 Ekstedt 44 | Liver biopsy | Chronic elevation of ALT and AST | Simvastatin (n = 11) Atorvastatin (n = 5) Pravastatin (n = 1) | 60.7 | 29.41 | 68 | 17 | 51 |
| 2016 Nascimbeni 45 | Liver biopsy | Diabetes |
Atorvastatin (n = 82) Rosuvastatin (n = 24) Simvastatin (n = 23) Pravastatin (n = 10) Fluvastatin (n = 3) Statin + ezetimibe (n = 10) |
53.0 | 60.00 | 343 | 154 | 192 |
| 2017 Bril 40 | Liver biopsy | Prediabetes/diabetes | 8% on high‐intensity and 79% on moderate intensity therapy. | 50.6 | 29.70 | 101 | 38 | 63 |
| 2017 Del Ben 21 | Liver ultrasound | ASCVD | Not reported | 59.9 | 35.29 | 442 | 230 | 212 |
| 2020 Khoo 46 | Liver ultrasound/CT/MR | NAFLD |
Simvastatin (68.6%) Atorvastatin (21.6%) Rosuvastatin (8.6%) Lovastatin (0.5%) Pravastatin (0.5%) |
54.3 | 47.90 | 428 | 185 | 243 |
ALT: alanine aminotransferase; ASCVD: atherosclerotic cardiovascular disease; AST: aspartate transaminase; CT: computed tomography; GGT: gamma‐glutamyl transferase; MR: magnetic resonance; NAFLD: non‐alcoholic fatty liver disease.