Long-term liver-related outcomes and liver stiffness progression of statin usage in steatotic liver disease
Long-term liver-related outcomes and liver stiffness progression of statin usage in steatotic liver disease
Background Statins have multiple benefits in patients with metabolic-associated steatotic liver disease (MASLD). Aim To explore the effects of statins on the long-term risk of all-cause mortality, liver-related clinical events (LREs) and liver stiffness progression in patients with MASLD. Methods This cohort study collected data on patients with MASLD undergoing at least two vibration-controlled transient elastography examinations at 16 tertiary referral centres. Cox regression analysis was performed to examine the association between statin usage and long-term risk of all-cause mortality and LREs stratified by compensated advanced chronic liver disease (cACLD): baseline liver stiffness measurement (LSM) of ≥10 kPa. Liver stiffness progression was defined as an LSM increase of ≥20% for cACLD and from <10 kPa to ≥10 or LSM for non-cACLD. Liver stiffness regression was defined as LSM reduction from ≥10 kPa to <10 or LSM decrease of ≥20% for cACLD. Results We followed up 7988 patients with baseline LSM 5.9 kPa (IQR 4.6–8.2) for a median of 4.6 years. At baseline, 40.5% of patients used statins, and cACLD was present in 17%. Statin usage was significantly associated with a lower risk of all-cause mortality (adjusted HR=0.233; 95% CI 0.127 to 0.426) and LREs (adjusted HR=0.380; 95% CI 0.268 to 0.539). Statin usage was also associated with lower liver stiffness progression rates in cACLD (HR=0.542; 95% CI 0.389 to 0.755) and non-cACLD (adjusted HR=0.450; 95% CI 0.342 to 0.592), but not with liver stiffness regression (adjusted HR=0.914; 95% CI 0.778 to 1.074). Conclusions Statin usage was associated with a relatively lower long-term risk of all-cause mortality, LREs and liver stiffness progression in patients with MASLD.
1883-1892
Zhou, Xiao-Dong
2f9a2320-c119-4929-a308-a54817ae631e
Kim, Seung Up
df26e5f8-b1b1-4a03-a738-3af00f2cb7dd
Cheuk-Fung Yip, Terry
2bd90906-fae3-4865-9ade-1c645b968d2e
Byrne, Chris
1370b997-cead-4229-83a7-53301ed2a43c
The VCTE-Prognosis Study Group
1 August 2024
Zhou, Xiao-Dong
2f9a2320-c119-4929-a308-a54817ae631e
Kim, Seung Up
df26e5f8-b1b1-4a03-a738-3af00f2cb7dd
Cheuk-Fung Yip, Terry
2bd90906-fae3-4865-9ade-1c645b968d2e
Byrne, Chris
1370b997-cead-4229-83a7-53301ed2a43c
Zhou, Xiao-Dong, Kim, Seung Up and Cheuk-Fung Yip, Terry
,
The VCTE-Prognosis Study Group
(2024)
Long-term liver-related outcomes and liver stiffness progression of statin usage in steatotic liver disease.
Gut, 73 (11), , [gutjnl-2024-333074].
(doi:10.1136/gutjnl-2024-333074).
Abstract
Background Statins have multiple benefits in patients with metabolic-associated steatotic liver disease (MASLD). Aim To explore the effects of statins on the long-term risk of all-cause mortality, liver-related clinical events (LREs) and liver stiffness progression in patients with MASLD. Methods This cohort study collected data on patients with MASLD undergoing at least two vibration-controlled transient elastography examinations at 16 tertiary referral centres. Cox regression analysis was performed to examine the association between statin usage and long-term risk of all-cause mortality and LREs stratified by compensated advanced chronic liver disease (cACLD): baseline liver stiffness measurement (LSM) of ≥10 kPa. Liver stiffness progression was defined as an LSM increase of ≥20% for cACLD and from <10 kPa to ≥10 or LSM for non-cACLD. Liver stiffness regression was defined as LSM reduction from ≥10 kPa to <10 or LSM decrease of ≥20% for cACLD. Results We followed up 7988 patients with baseline LSM 5.9 kPa (IQR 4.6–8.2) for a median of 4.6 years. At baseline, 40.5% of patients used statins, and cACLD was present in 17%. Statin usage was significantly associated with a lower risk of all-cause mortality (adjusted HR=0.233; 95% CI 0.127 to 0.426) and LREs (adjusted HR=0.380; 95% CI 0.268 to 0.539). Statin usage was also associated with lower liver stiffness progression rates in cACLD (HR=0.542; 95% CI 0.389 to 0.755) and non-cACLD (adjusted HR=0.450; 95% CI 0.342 to 0.592), but not with liver stiffness regression (adjusted HR=0.914; 95% CI 0.778 to 1.074). Conclusions Statin usage was associated with a relatively lower long-term risk of all-cause mortality, LREs and liver stiffness progression in patients with MASLD.
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Accepted/In Press date: 21 July 2024
e-pub ahead of print date: 1 August 2024
Published date: 1 August 2024
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© Author(s) (or their employer(s)) 2024.
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Local EPrints ID: 492815
URI: http://eprints.soton.ac.uk/id/eprint/492815
ISSN: 1468-3288
PURE UUID: 06aa05d9-6cc4-4e0e-9b6a-28341839b91a
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Date deposited: 15 Aug 2024 16:31
Last modified: 15 Oct 2024 01:36
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Author:
Xiao-Dong Zhou
Author:
Seung Up Kim
Author:
Terry Cheuk-Fung Yip
Corporate Author: The VCTE-Prognosis Study Group
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