Suboptimal treatment of dyslipidemia in patients with nonalcoholic fatty liver disease

Abstract

Background & Aims: NAFLD patients often have dyslipidemia, and optimal treatment of dyslipidemia lowers the risk of cardiovascular disease and mortality. We aimed to study the prescription of statin and low‐density lipoprotein (LDL) cholesterol treatment targets in NAFLD patients.

Methods: Consecutive NAFLD patients attending five clinics in Asia were included in this study. The 10‐year cardiovascular disease risk was calculated based on the Framingham Heart Study, and patients were categorized as moderate, high or very high risk for cardiovascular disease based on the American Association of Clinical Endocrinologist 2017 Guidelines. The LDL‐cholesterol treatment goal for each of the risk groups was 2.6 mmol/l, 2.6 mmol/l and 1.8 mmol/l, respectively.

Results: The data for 428 patients were analyzed (mean age 54.4 ± 11.1 years, 52.1% males). Dyslipidemia was seen in 60.5% (259/428) but only 43.2% (185/428) were on a statin. The percentage of patients who were at moderate, high and very high risk for cardiovascular disease was 36.7% (157/428), 27.3% (117/428) and 36.0% (154/428), respectively. Among patients who were on a statin, 58.9% (109/185) did not achieve the treatment target. Among patients who were not on a statin, 74.1% (180/243) should be receiving statin therapy. The percentage of patients who were not treated to target or who should be on statin was highest among patients at very high risk of cardiovascular disease at 79.6% (78/98) and 94.6% (53/56), respectively.

Conclusions: This study highlights the suboptimal treatment of dyslipidemia and calls for action to improve the treatment of dyslipidemia in NAFLD patients.