Statins and NAFLD/NASH, a lipid-related pathology present a complex relationship. As a matter of fact, some statins are known to be hepatotoxic, even though it seems clinically significant hepatic injury caused by lipid-lowering medications remains rare.
A question can be asked: is it possible that statins prove to be a promising solution due to their pleiotropic properties in addition to the cholesterol-lowering effect?
A review of the literature through PubMed by F. Ahsan et al. (Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA) aims to assess the effectiveness of statins in NAFLD/NASH treatment and prevention of associated adverse outcomes.
In various animal studies, statins were found to improve hepatic lipotoxicity, oxidative stress, inflammatory responses, and fibrosis associated with NASH through multiple pathways. Statins exert these protective effects by recovering the gene expression level of peroxisomal proliferator-activated receptor alpha (PPARα) and therefore restore the mitochondrial and peroxisomal fatty acid oxidation.
NASH and NAFLD could be treated and prevented with statins owing to their pleiotropic properties. Of course, large clinical trials on humans are needed. However, this is a field of investigation regarding the treatment of NASH.