他汀类药物的使用减少了乙肝病毒肝硬化的风险，失代偿

StephenW

Statin use reduces risk for cirrhosis, decompensation in HBV

Huang Y-W, et al. Am J Gastroenterol. 2016;doi:10.1038/ajg.2016.179.
May 18, 2016

Statin use was associated with a decreased risk for developing cirrhosis and decompensation in Taiwanese patients with chronic hepatitis B virus infection, according to published findings.

    Complications of cirrhosis led to increased mortality risk


“This large population-based study in a hepatitis B virus endemic country suggested that statins independently protect [chronic hepatitis B] patients from the development of cirrhosis, its complications and its decompensation according to a dose–response relationship,” Yi-Wen Huang, MD, PhD, of the Liver Center, Cathay General Hospital Medical Center, Taiwan, and colleagues wrote.

Yi-Wen Huang, MD, PhD

Yi-Wen Huang

The researchers analyzed data of 298,761 patients with chronic HBV found in the Taiwanese National Health Insurance Research Database between 1997 and 2009. Of these, 6,543 were using statins and were matched in a 1 to 1 ratio propensity score and inception point-matched patients in a cohort of non-statin users. Researchers followed these patients from the start of statin use until cirrhosis or decompensation developed, until a patient withdrew from insurance or through December 2009.

After adjustment for competing mortality, researchers found that patients with chronic HBV using statins had a lower cumulative incidence of cirrhosis (RR = 0.43; 95% CI, 0.34–0.51) and decompensated cirrhosis (RR = 0.46; 95% CI, 0.34–0.63) compared with patients who did not use statins.

Further analysis using a Cox proportional hazard model indicated statins were still independently associated with lower risk for cirrhosis (adjusted HR = 0.51; 95% CI, 0.41–0.63) and decompensation (adjusted HR = 0.53; 95% CI, 0.43–0.65), after adjusting for numerous variables including age, sex, comorbidity index and obesity.

The adjusted HRs for cirrhosis was also lower in patients receiving triglyceride-lowering drugs; 0.46 for between 91 and 365 cumulative daily doses and 0.2 for greater than 365 daily doses; and the adjusted HRs for decompensated cirrhosis were 0.61 between 91 and 365 cumulative daily doses and 0.23 for greater than 365 daily doses. The cumulative defined daily doses of triglyceride lipid-lowering drugs showed a dose–response relationship at greater than 365 cumulative defined daily doses.

The researchers concluded: “Statins independently reduce cirrhosis and its decompensation in chronic hepatitis B patients. This protective effect was stronger with higher dosage and longer duration of statin use,” the researchers concluded. – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.

StephenW

他汀类药物的使用减少了乙肝病毒肝硬化的风险，失代偿

黄的Y W，等人。牛J Gastroenterol。 2016年，DOI：10.1038 / ajg.2016.179。
5月18日，2016年

他汀类药物的使用与在台湾的慢性乙肝病毒感染者发展为肝硬化失代偿降低风险，根据公布调查结果。

    肝硬化的并发症导致死亡率风险增加


“在乙肝病毒流行国家的这种大规模人群研究表明，他汀类药物单独保护[慢性乙型肝炎]患者发展为肝硬化，其并发症和失代偿根据剂量 - 反应关系，”忆黄文，医学博士，肝脏中心，国泰医院医疗中心，台湾和同事写道。

忆黄文博士

忆黄文

研究人员分析了298761慢性HBV 1997年和2009年这之间在台湾全民健康保险研究数据库中的数据，进行了6,543使用他汀类药物，并在1比1的比例倾向得分和点以来匹配的患者在被匹配非他汀类药物的用户人群。直至肝硬化失代偿或开发，直到病人从保险或通过2009年12月退出了研究人员跟踪调查这些患者使用他汀类药物的开始。

调整竞争死亡后，研究人员发现，患有慢性乙肝使用他汀类药物有肝硬化较低的累积发生率（RR = 0.43; 95％CI，0.34-0.51）和失代偿期肝硬化（RR = 0.46; 95％CI，0.34-0.63 ）谁没有使用他汀类药物的患者相比。

使用Cox比例风险模型进一步分析表明，他汀类药物仍然独立与肝硬化风险较低（调整后HR = 0.51; 95％CI，0.41-0.63）和失代偿（调整后HR = 0.53; 95％CI，0.43-0.65）调整后为众多变量，包括年龄，性别，合并症指数和肥胖。

肝硬化调整后的HR也是在接受降低甘油三酯的药物治疗的患者低; 0.46为91和每日累计剂量和0.2每日剂量大于365之间365;和失代偿性肝硬化的调整的HR 91和365，每天累计剂量和0.23之间分别为0.61每日剂量大于365。累计限定日剂量的甘油三酯降脂药物则表现在大于365累计限定日剂量的剂量 - 反应关系。

研究人员得出结论：“他汀类药物降低独立肝硬化及其在慢性乙型肝炎患者代偿。这种保护作用与高剂量他汀类药物和使用的持续时间较长做强“的研究人员得出结论。 - 通过梅林达·史蒂文斯

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