NASH resolution is associated with improvements in HDL and triglyceride levels but not improvement in LDL or non-HDL-C levels
K E Corey, R Vuppalanchi, L A Wilson, O W Cummings, N Chalasani, NASH CRN, Srinivasan Dasarathy, Jaividhya Dasarathy, Carol Hawkins, Arthur J McCullough, Srinivasan Dasarathy, Arthur J McCullough, Mangesh Pagadala, Ruth Sargent, Manal F Abdelmalek, Mustafa Bashir, Stephanie Buie, Anna Mae Diehl, Cynthia Guy, Christopher Kigongo, Yi-Ping Pan, Dawn Piercy, Naga Chalasani, Oscar W Cummings, Samer Gawrieh, Marwan Ghabril, Smitha Marri, Linda Ragozzino, Kumar Sandrasegaran, Raj Vuppalanchi, Debra King, Pat Osmack, Joan Siegner, Susan Stewart, Brent A Neuschwander-Tetri, Susan Torretta, Brandon Ang, Cynthia Behling, Archana Bhatt, Rohit Loomba, Michael Middleton, Heather Patton, Claude Sirlin, Bradley Aouizerat, Nathan M Bass, Danielle Brandman, Linda D Ferrell, Ryan Gill, Bilal Hameed, Claudia Ramos, Norah Terrault, Ashley Ungermann, Pradeep Atla, Brandon Croft, Rebekah Garcia, Sonia Garcia, Muhammad Sheikh, Mandeep Singh, Sherry Boyett, Laura Carucci, Melissa J Contos, Kenneth Kraft, Velimir A C Luketic, Puneet Puri, Arun J Sanyal, Jolene Schlosser, Mohhamad S Siddiqui, Ben Wolford, Sarah Ackermann, Shannon Cooney, David Coy, Katie Gelinas, Kris V Kowdley, Maximillian Lee, Tracey Pierce, Jody Mooney, James E Nelson, Cheryl Shaw, Asma Siddique, Chia Wang, Elizabeth M Brunt, Kathryn Fowler, David E Kleiner, Gilman D Grave, Edward C Doo, Jay H Hoofnagle, Patricia R Robuck, Averell Sherker, Patricia Belt, Jeanne M Clark, Michele Donithan, Erin Hallinan, Milana Isaacson, Kevin P May, Laura Miriel, Alice Sternberg, James Tonascia, Aynur Unalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates, K E Corey, R Vuppalanchi, L A Wilson, O W Cummings, N Chalasani, NASH CRN, Srinivasan Dasarathy, Jaividhya Dasarathy, Carol Hawkins, Arthur J McCullough, Srinivasan Dasarathy, Arthur J McCullough, Mangesh Pagadala, Ruth Sargent, Manal F Abdelmalek, Mustafa Bashir, Stephanie Buie, Anna Mae Diehl, Cynthia Guy, Christopher Kigongo, Yi-Ping Pan, Dawn Piercy, Naga Chalasani, Oscar W Cummings, Samer Gawrieh, Marwan Ghabril, Smitha Marri, Linda Ragozzino, Kumar Sandrasegaran, Raj Vuppalanchi, Debra King, Pat Osmack, Joan Siegner, Susan Stewart, Brent A Neuschwander-Tetri, Susan Torretta, Brandon Ang, Cynthia Behling, Archana Bhatt, Rohit Loomba, Michael Middleton, Heather Patton, Claude Sirlin, Bradley Aouizerat, Nathan M Bass, Danielle Brandman, Linda D Ferrell, Ryan Gill, Bilal Hameed, Claudia Ramos, Norah Terrault, Ashley Ungermann, Pradeep Atla, Brandon Croft, Rebekah Garcia, Sonia Garcia, Muhammad Sheikh, Mandeep Singh, Sherry Boyett, Laura Carucci, Melissa J Contos, Kenneth Kraft, Velimir A C Luketic, Puneet Puri, Arun J Sanyal, Jolene Schlosser, Mohhamad S Siddiqui, Ben Wolford, Sarah Ackermann, Shannon Cooney, David Coy, Katie Gelinas, Kris V Kowdley, Maximillian Lee, Tracey Pierce, Jody Mooney, James E Nelson, Cheryl Shaw, Asma Siddique, Chia Wang, Elizabeth M Brunt, Kathryn Fowler, David E Kleiner, Gilman D Grave, Edward C Doo, Jay H Hoofnagle, Patricia R Robuck, Averell Sherker, Patricia Belt, Jeanne M Clark, Michele Donithan, Erin Hallinan, Milana Isaacson, Kevin P May, Laura Miriel, Alice Sternberg, James Tonascia, Aynur Unalp-Arida, Mark Van Natta, Ivana Vaughn, Laura Wilson, Katherine Yates
Abstract
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) (<40 mg/dL in men or <50 mg/dL in women) in 63%, hypertriglyceridaemia (≥150 mg/dL) in 46%, hypercholesterolaemia (≥200 mg/dL) in 47% and triglycerides (TG)/HDL >5.0 in 25%. Low-density lipoprotein (LD) ≥160 mg/dL was found in 16% and elevated non-HDL cholesterol (non-HDL-C) (≥130 mg/dL) in 73%. HDL increased with NASH resolution but decreased in those without resolution (2.9 mg/dL vs. -2.5 mg/dL, 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.
© 2014 John Wiley & Sons Ltd.
Source: PubMed