Is there a role of lipid-lowering therapies in the management of fatty liver disease?

Core Tip

Core Tip: Statins may be beneficial against non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) in association with their cholesterol-lowering efficacy as well as their anti-inflammatory, antioxidant and anti-fibrotic actions. Elimination of hepatic steatosis, inflammation and fibrosis was noted with statin use in the clinical setting of NAFLD/NASH. Experimental evidence suggests that ezetimibe has similar benefits to statins against NAFLD/NASH. However, ezetimibe was beneficial only against hepatic steatosis, but not against inflammation or fibrosis in NAFLD patients. Despite their promising mechanistic potential against NAFLD/NASH through PPARα activation benefits of fibrates on liver outcomes have not been established in clinical studies. Ample heterogeneous evidence suggests benefits of ω-3 fatty acids against hepatic steatosis, but not inflammation or fibrosis.