Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2022; 14(1): 119-139
Published online Jan 27, 2022. doi: 10.4254/wjh.v14.i1.119
Is there a role of lipid-lowering therapies in the management of fatty liver disease?
Ismini Tzanaki, Aris P Agouridis, Michael S Kostapanos
Ismini Tzanaki, School of Medicine, European University Cyprus, Nicosia, Cyprus, Nicosia 2404, Cyprus
Aris P Agouridis, School of Medicine, European University Cyprus, Nicosia 2404, Cyprus
Michael S Kostapanos, General Medicine, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge CB20QQ, United Kingdom
Author contributions: All authors contributed equally in the drafting and revising this manuscript and approve its final content.
Conflict-of-interest statement: IT, AA and MK have no relevant conflict of interest in relation to the content of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Michael S Kostapanos, MD, MRCP, PhD, Consultant Physician-Scientist, General Medicine, Addenbrooke's Hospital, Cambridge University Hospitals, Hill's Road, Cambridge CB20QQ, United Kingdom. mk828@medschl.cam.ac.uk
Received: June 17, 2021
Peer-review started: June 17, 2021
First decision: August 18, 2021
Revised: August 30, 2021
Accepted: December 7, 2021
Article in press: December 7, 2021
Published online: January 27, 2022
Processing time: 217 Days and 17.3 Hours
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.