Ezetimibe decreased nonalcoholic fatty liver disease activity score but not hepatic steatosis = Ezetimibe decreased nonalcoholic fatty liver disease activity score but not hepatic steatosis

다국어 초록 (Multilingual Abstract)

Background/Aims: A number of clinical trials reported varying effects of cho-lesterol lowering agents in nonalcoholic fatty liver disease (NAFLD) patients. We, therefore, assessed the changes in hepatic steatosis and NAFLD activity score (NAS) after treatment with cholesterol lowering agents in NAFLD patients by meta-analysis. Methods: The Cochrane Library, the MEDLINE, and the Embase databases were searched until May 2015, without any language restrictions, for randomized con-trolled trials (RCTs) and nonrandomized studies (NRSs). Additional references were obtained from review of bibliography of relevant articles. The quality of ev-idence was assessed using the grading of recommendations assessment, develop-ment and evaluation guidelines. Results: Three RCTs (n = 98) and two NRSs (n = 101) met our study inclusion cri-teria (adult, NAFLD, liver biopsy). Liver biopsy was performed in all five studies, but only the three studies reported NAS. Ezetimibe significantly decreased NAS (standardized mean difference [SMD], -0.30; 95% confidence interval [CI], -0.57 to -0.03) but not hepatic steatosis in RCT (SMD, -0.1; 95% CI, -0.53 to 0.32), while the effect was significant for both NAS and intrahepatic content in NRSs (SMD, -3.0; 95% CI, -6.9 to 0.91). Conclusions: Ezetimibe decreased NAS without improving hepatic steatosis.