NASH resolution is associated with improvements in HDL and triglyceride levels but not improvement in LDL or non‐HDL‐C levels

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Abstract
Summary: Background: Nonalcoholic steatohepatitis (NASH) is associated with dyslipidemia and cardiovascular disease (CVD).Aim: To determine the relationship between resolution of NASH and dyslipidemia.Methods: Individuals in the Pioglitazone vs. Vitamin E vs. Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis (PIVENS) trial with paired liver biopsies and fasting lipid levels were included (N = 222). In the PIVENS trial individuals were randomised to pioglitazone 30 mg, vitamin E 800 IU or placebo for 96 weeks. Change in lipid levels at 96 weeks was compared between those with and without NASH resolution.Results: Dyslipidemia at baseline was frequent, with low high‐density lipoprotein (HDL) (P < 0.001). NASH resolution was associated with significant decreases in TG and TG/HDL ratio compared to those without resolution (TG: −21.1 vs. −2.3 mg/dL, P = 0.03 and TG/HDL: −0.7 vs. 0.1, P = 0.003). Non‐HDL‐C, LDL and cholesterol decreased over 96 weeks in both groups, but there was no significant difference between groups. Treatment group did not impact lipids.Conclusions: NASH resolution is associated with improvements in TG and HDL but not in other cardiovascular disease risk factors including LDL and non‐HDL‐C levels. Individuals with resolution of NASH may still be at increased risk of cardiovascular disease. ClinicalTrials.gov identifier: NCT00063622.
Funding Information
  • NIH (K23DK099422-0)
  • National Institute of Diabetes and Digestive and Kidney Diseases (U01DK061713, U01DK061718, U01DK061728, U01DK061731, U01DK061732, U01DK061734, U01DK061737, U01DK061738, U01DK061730)
  • National Center for Advancing Translational Sciences (UL1TR000439, UL1TR000077, UL1TR000436, UL1TR000150, UL1TR000424, UL1TR000006, UL1TR000448, UL1TR000040, UL1TR000100, UL1TR000004, UL1TR000423, UL1TR000058, UL1TR000067, UL1TR000454)

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