Six-month statin therapy and short-term MASLD progression: a prospective cohort study adjusted for abdominal obesity and glycemic control.

Despite the proven cardiovascular efficacy and safety of statins in patients with MASLD, their effect on short-term disease progression remains poorly understood. A prospective observational cohort study was conducted in 54 patients with metabolic syndrome and MASLD, with a 6-month follow-up. Multivariate logistic regression was used to assess the association between statin use and progression of MASLD, adjusting for waist-to-hip ratio (WHR) and glycated hemoglobin (HbA1c). Noninvasive liver injury markers, including CAP, FIB-4, and NAFLD Fibrosis Score, were beneficial, with no evidence of clinically significant hepatotoxicity. In the adjusted logistic model, statin use was independently associated with a reduced risk of adverse progression of MASLD (adjusted odds ratio 0.16; 95% CI 0.03-0.75; p = 0.020), whereas higher baseline WHR and HbA1c were associated with an increased risk. The model had good discriminatory power (AUC = 0.83). Exploratory immunoassays revealed changes in lymphocyte subpopulations. In patients with metabolic syndrome and MASLD, short-term statin therapy was associated with a lower risk of disease progression after adjustment for WHR and HbA1c. The findings support the metabolic and hepatic safety of statins and emphasize the importance of abdominal obesity and glycemic control in determining MASLD progression.