Statins may positively affect hepatocellular carcinoma risk in NAFLD patients

Use of statins appears to reduce the risk of developing hepatocellular carcinoma (HCC) in patients with nonalcoholic fattly liver disease (NAFLD), whereas hypertension conferred a risk increase, according to a retrospective case-control study.

Researchers reviewed the medical records of 102 NAFLD patients (mean age, 69 years; 65 percent male) who underwent at least two computed tomography scans. Of these patients, 34 were HCC patients and 68 were matched non-HCC controls. NAFLD-HCC cases were confirmed on contrast imaging and/or biopsy.

The majority of the population had cirrhosis (91 percent). Multivariate logistic regression analysis showed statin use to be protective against HCC (odds ratio [OR], 0.20, 95 percent CI, 0.07–0.60; p=0.004), while hypertension was associated with a greater likelihood of HCC (OR, 5.80, 2.01–16.75; p=0.001).

On further analysis, visceral adipose tissue in males was higher before HCC development and decreased upon diagnosis in 86 percent, which was significantly different compared with controls (OR, 2.78, 1.10–7.44; p=0.04). Visceral adiposity at baseline was not a risk factor for HCC.

In a separate study, statins also exerted a beneficial inhibitory effect on HCC development, with the effect more pronounced in patients with liver cirrhosis or diabetes mellitus—conditions that are associated with a higher risk of HCC. [J Hepatol 2018;68:476-484]