Statins use and the risk of liver dysfunction: A Chinese cohort study in real world clinical practice

The risk of liver injury is greatly of concern in China due to higher prevalence of hepatitis. In this study, we evaluated the association between the use of statins and the elevation of aminotransferase (ALT) in "real-world" clinical practice. 4489 patients were divided into statins group (62%) and no statins group (38%) according to their status of medications. Detections of ALT were performed within 24 h after admission. The association of elevation of ALT and statins was analyzed. The percentage of patients with ALT > 1 × ULN(Upper Limit of Normal), was higher in statins group than that in no statins group (OR = 1.27, 95%CI 1.08–1.493), but after adjusting risk factors the OR value was 1.043(95%CI 0.851–1.278) with no statistical difference. Similarly, no differences were found regarding percentages of patients with ALT > 3 × ULN. Types of statins were usual in clinical practice and dosages of statins used were moderate in > 90% of patient. We failed to find differences among the types and the dosage of statins except lovastatin. In addition, the relation of statin use duration to elevated ALT was evaluated. The higher proportion of elevated ALT in patients with stain use < 1 month was detected compared those with stain use ≥ 3 months (OR = 1.408, 95%CI 1.111–1.783). The data, firstly, provided two important information regarding the real status of liver dysfunction in Chinese patients who used moderate statins: 1) no relations between statin variety and ALT elevation; 2)statin-induced liver dysfunction frequently found in < 1 month. Further study may be needed to confirm our findings.