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<p>Statins are widely used for cardiovascular prevention, yet their hepatic benefits in older adults with steatotic liver disease (SLD) remain uncertain, particularly regarding liver-related events (LREs) and the modifying role of cardiometabolic risk factors (CMRFs). This retrospective cohort study used data from the Korean National Health Insurance Service-Senior cohort, comprising 125,926 adults aged ≥ 60 years with fatty liver index ≥ 30, followed from 2011 to 2019. Participants with prior liver disease or LREs at baseline were excluded. Cumulative statin exposure quantified as cumulative defined daily dose (cDDD) and categorized as non-use, 1 cDDD to 89 cDDD, 90 cDDD to 364 cDDD, and ≥ 365 cDDD; statin intensity classified as low, moderate, or high. The primary outcomes were incident LREs (primary liver cancer, liver cirrhosis, and decompensated cirrhosis) identified using validated ICD-10 codes. Associations were assessed using Fine and Gray competing-risk models and expressed as subdistribution hazard ratios (SHRs). During a median follow-up of 9 years, 3,445 LREs occurred over 1,054,343 person-years. Statin use was associated with a dose-dependent reduction in LRE risk. Compared with non-users, participants with ≥ 365 cDDD had the lowest risk of total LREs (SHR, 0.69; 95% CI, 0.61–0.78), primary liver cancer (SHR, 0.63; 95% CI, 0.52–0.76), and liver cirrhosis (SHR, 0.66; 95% CI, 0.57–0.77). Moderate- to high-intensity statin conferred greater protection than low-intensity statin. Statin therapy was associated with a significant and dose-dependent reduction in the risk of LREs among older adults with SLD, including those aged ≥ 75 years.</p>

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Statin use and the risk of liver-related events in older adults with steatotic liver disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月8日

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  • Eun Seok Kang,
  • Hye Jun Kim,
  • Sun Jae Park,
  • Ju Hyun Kang,
  • Sangwoo Park,
  • Meng Sha,
  • Seong Hee Kang,
  • Seogsong Jeong,
  • Sang Min Park

摘要

Statins are widely used for cardiovascular prevention, yet their hepatic benefits in older adults with steatotic liver disease (SLD) remain uncertain, particularly regarding liver-related events (LREs) and the modifying role of cardiometabolic risk factors (CMRFs). This retrospective cohort study used data from the Korean National Health Insurance Service-Senior cohort, comprising 125,926 adults aged ≥ 60 years with fatty liver index ≥ 30, followed from 2011 to 2019. Participants with prior liver disease or LREs at baseline were excluded. Cumulative statin exposure quantified as cumulative defined daily dose (cDDD) and categorized as non-use, 1 cDDD to 89 cDDD, 90 cDDD to 364 cDDD, and ≥ 365 cDDD; statin intensity classified as low, moderate, or high. The primary outcomes were incident LREs (primary liver cancer, liver cirrhosis, and decompensated cirrhosis) identified using validated ICD-10 codes. Associations were assessed using Fine and Gray competing-risk models and expressed as subdistribution hazard ratios (SHRs). During a median follow-up of 9 years, 3,445 LREs occurred over 1,054,343 person-years. Statin use was associated with a dose-dependent reduction in LRE risk. Compared with non-users, participants with ≥ 365 cDDD had the lowest risk of total LREs (SHR, 0.69; 95% CI, 0.61–0.78), primary liver cancer (SHR, 0.63; 95% CI, 0.52–0.76), and liver cirrhosis (SHR, 0.66; 95% CI, 0.57–0.77). Moderate- to high-intensity statin conferred greater protection than low-intensity statin. Statin therapy was associated with a significant and dose-dependent reduction in the risk of LREs among older adults with SLD, including those aged ≥ 75 years.