Among patients with nonalcoholic fatty liver disease (NAFLD), the use of statins is associated with reduced cancer-related mortality, according to a study published in the Journal of Clinical Gastroenterology.
Cardiovascular disease (CVD) is common among patients with NAFLD and is the leading cause of morbidity and mortality. However, rates of malignancy-related mortality have increased dramatically in recent years. While epidemiologic studies have suggested a possible association between statin use and a decreased risk for various malignancies, this association remains debatable given the observational nature of the available evidence and the risk for confounders.
Therefore, researchers evaluated the effects of statin use on cancer mortality in patients with NAFLD among a cohort of patients within the United States that participated in the National Health and Nutrition Examination Survey (NHANES).
In total, 10,821 participants were included in the study. Mean patient age was 48 and 64 years, 56% and 51% were women, and 38% and 78% had hypertension, among patients not using statins vs those using statins, respectively. Patients using statins were more likely to be men, classified as obese, and have diabetes; statin users were less likely to be current smokers.
Of the patients with NAFLD included in the study, 23% used statins (n=2523). In a multivariable analysis, the researchers found that statin use was associated with a 43% lower risk for cancer mortality (P <.001). While statin use for <1 year did not show a significant effect on cancer mortality, statin use for 1 to 5 years decreased cancer mortality by 35% (P =.46), and statin use for more than 5 years decreased cancer mortality by 56% (P <.001). In addition, statin use was associated with a significant decrease in the risk for cancer mortality in patients with NAFLD at both low and high risk for liver fibrosis.
In an analysis that excluded patients with cancer, compared with patients who don’t use statins, stain users were associated with a 38% lower risk for cancer mortality (P =.006).
When stratified by sex, statin use among men was associated with a 51% decreased risk for cancer-related mortality (P <.001). This trend also seen among women, though it did not reach statistical significance.
This study was limited by its observational nature. Additionally, investigators were unable to assess the effects of statin use on different types of cancer due to a lack of data.
The researchers concluded, “These results are important for clinical decision making, as statin indications are prevalent among NAFLD patients, but many do not receive benefit in the event that the statin is discontinued due to liver test abnormalities.”
Hajifathalian K, Tafesh Z, Rosenblatt R, et al. Effect of statin use on cancer-related mortality in nonalcoholic fatty liver disease. a prospective United States cohort study. J Clin Gastroenterol. 2022;56(2):173-80. doi: 10.1097/MCG.0000000000001503