I read with pleasure the paper by Zhou et al 1 analysing the long-term clinical outcomes and changes in liver elastography associated with statin usage in patients with metabolic-associated steatotic liver disease (MASLD). This is a population-based study of 7988 patients selected from a total of 17 849 MASLD patients seen in 16 centres in Europe, America and Asia and who had also transient elastography measurements of liver stiffness (LSM). The final cohort included patients >18 years that had at least two LSM, a controlled attenuation parameter denoting steatosis (over ≥248 dB/m), a prolonged follow-up (over 1 year, median 4.6 years), and no other cause of liver disease or excessive alcohol intake. Usage of statins was defined as the consistent use of statins on most days for more than 1 month within a year, which occurred in 3233 patients (40.4%). Patients were considered to have compensated advanced chronic liver disease (cACLD) if the first LSM was >10 kPa, which occurred in 17.2%. The primary outcome was a composite of all-cause death and liver-related events (LREs) (developing cirrhosis decompensation, hepatocellular carcinoma (HCC) or liver-related mortality). In addition, a secondary outcome was the change in LSM, categorised as progression, regression or stable based on observing or not changes in LSM of at least 20% or crossing the threshold of 10 kPa. The authors did Cox regression analysis for examining the association between statin …

中文翻译：

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MAFLD/MASH 的他汀类药物：等待最终答案时的另一块障碍


我很高兴地阅读了 Zhou 等人的论文 1，该论文分析了代谢相关脂肪性肝病 (MASLD) 患者与他汀类药物使用相关的长期临床结果和肝脏弹性成像的变化。这是一项基于人群的研究，从欧洲、美洲和亚洲 16 个中心的总共 17 849 名 MASLD 患者中选出了 7988 名患者，这些患者还进行了肝脏硬度 (LSM) 的瞬时弹性成像测量。最终队列包括>18岁的患者，这些患者至少有两次LSM，一个表示脂肪变性的受控衰减参数（超过≥248 dB/m），长期随访（超过1年，中位4.6年），并且没有其他原因导致脂肪变性。肝脏疾病或过量饮酒。他汀类药物的使用被定义为一年内大多数日子持续使用他汀类药物超过1个月，这种情况发生在3233名患者中（40.4%）。如果患者首次 LSM 为 >10 kPa（发生率为 17.2%），则认为患者患有代偿性晚期慢性肝病 (cACLD)。主要结局是全因死亡和肝脏相关事件（LRE）（发生肝硬化失代偿、肝细胞癌（HCC）或肝脏相关死亡率）的综合结果。此外，次要结果是 LSM 的变化，根据是否观察到 LSM 变化至少 20% 或超过 10 kPa 的阈值，分为进展、回归或稳定。作者进行了 Cox 回归分析，以检查他汀类药物之间的关联……