The prognostic impact of statin exposure in metabolic dysfunction-associated steatotic liver disease: a cohort study

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an increasing global health concern associated with metabolic syndromes such as obesity and type 2 diabetes. While statins are widely used to manage hypercholesterolemia, their potential protective effects against liver-related outcomes in MASLD have not been thoroughly explored. This study aims to evaluate the prognostic impact of statin use on clinical outcomes, including mortality, hepatocellular carcinoma (HCC) incidence, and hepatic decompensation, in patients with MASLD.

This study investigates the impact of statin use on outcomes in patients with MASLD. A population-based study cohort was analyzed using data from the UK Biobank, which included 402,476 participants after exclusions. Inverse probability of treatment weighting (IPTW) was utilized to balance baseline characteristics. The primary outcomes included all-cause mortality and liver-related mortality, with secondary outcomes covering the incidence of HCC and hepatic decompensation. Subgroup analyses were conducted to assess the effects of specific statin types and gender differences.

Statin use correlated with a 19% reduction in all-cause mortality and a 37% reduction in liver-related mortality in the MASLD cohort. Notably, atorvastatin was significantly effective in reducing all-cause mortality, liver-related mortality, hepatic decompensation, and HCC risk. Gender-specific analyses demonstrated that female statin users experienced the most significant reductions in mortality and HCC incidence. Statin use significantly improved survival and decreased liver-related outcomes in MASLD patients, with gender-specific analyses showing enhanced effects for female users.

The findings suggest the importance of statin selection and highlight that gender-specific strategies may enhance treatment efficacy in the MASLD cohort.