Abstract

Recent evidence suggests potential clinical benefits of statin in cancer chemoprevention and treatment. Non-alcoholic fatty liver disease (NAFLD) is expected to become the leading cause of hepatocellular carcinoma (HCC). We aimed to investigate the association between statin initiation and the risk of HCC among patients with NAFLD.In this study using the Optum de-identified Clinformatics® database, cox proportional-hazards regression model was performed to determine the risk of HCC in statin initiators versus nonusers. We incorporated inverse probability of treatment weighting (IPTW) to minimize potential confounding.Among 272,431 adults with NAFLD diagnosis, IPTW model shows that statin initiators had a 53% less risk of developing HCC compared to nonusers (HR: 0.47, 95% confidence interval: 0.36-0.60). In the sub-cohort with FIB-4 data available, statin initiation was associated with a 56% hazard reduction of developing HCC in NAFLD after adjusting for FIB-4 score (HR: 0.44; 0.30-0.65). The association between statin initiation and lower risk of HCC development was observed for both lipophilic statin (HR: 0.49; 0.37-0.65) and hydrophilic statin (HR: 0.40; 0.21-0.76). Moreover, we observed a greater hazards reduction as the dose and duration of statin use increased. NAFLD patients with more than 600 cDDDs of statin had a 70% reduction in hazards of developing HCC (HR: 0.30; 0.20-0.43).Our study provides strong evidence for the association between statin initiation and reduced risk of HCC development in NAFLD patients. These findings imply that statin can be used as a protective medication for NAFLD patients to reduce the risk of HCC.

View details for DOI 10.1016/j.cgh.2022.01.057

View details for PubMedID 35158055