The effect of lipid-lowering treatment on indices of MASLD in familial hypercholesterolemia patients.
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Boutari Chrysoula, Rizos Christos V, Liamis George, Skoumas Ioannis, Rallidis Loukianos, Garoufi Anastasia, Kolovou Genovefa, Sfikas George, Tziomalos Konstantinos, Skalidis Emmanouil, Kotsis Vasileios, Doumas Michalis, Stamatelopoulos Kimon, Lambadiari Vaia, Anagnostis Panagiotis, Boufidou Amalia, Giannakopoulou Vasiliki, Anastasiou Georgia, Petkou Ermioni, Vlachopoulos Charalambos, Dima Ioanna, Fakas Georgios, Papathanasiou Konstantinos A, Attilakos Achilleas, Kolovou Vana, Koumaras Charalambos, Agapakis Dimitrios, Zacharis Evangelos, Antza Christina, Milionis Haralampos, Liberopoulos Evangelos, Mantzoros Christos S
Аннотация
METHODS: Patients with at least possible diagnosis of FH were included into the Hellenic FH Registry (HELLAS-FH) registry. We analyzed the effect of statin monotherapy, statin/ezetimibe and statin/ezetimibe/proprotein convertase subtilisin/kexin 9 inhibitors (PCSK9i) on MASLD indices, i.e., original triglyceride-glucose index (TyGO) and triglyceride-glucose index (TyG). We compared changes of TyG and TyGO before any treatment and after at least one year of stable LLT.
RESULTS: We included 1289 patients: n = 569 in the statin monotherapy group (mean age = 51 ± 15 years, 52.7 % males), n = 629 in the statin/ezetimibe group (52 ± 14 years, 51.8 %), and n = 91 in the statin/ezetimibe/PCSK9i group (54 ± 13 years, 58.2 %). Compared with baseline, TyGO and TyG decreased significantly following statin monotherapy (8.61 vs 8.49 and 4.65 vs 4.59, respectively, both p < 0.01), statin/ezetimibe (8.59 vs 8.41 and 4.64 vs 4.55, respectively, both p < 0.01) and statin/ezetimibe/PCSK9i (8.79 vs 8.55 and 4.74 vs 4.62, respectively, both p < 0.01). There was no difference regarding the change of TyGO and TyG between groups after adjusting for baseline levels. A greater percentage of patients in the statin/ezetimibe and statin/ezetimibe/PCSK9i groups exhibited TyGO-defined MASLD resolution compared with statin monotherapy (p < 0.05). After adjustment for possible confounders, LLT was significantly associated with MASLD resolution.
CONCLUSIONS: MASLD indices were significantly improved in all LLT groups in FH patients. Statin/ezetimibe and statin/ezetimibe/PCSK9i were associated with greater TyGO-defined MASLD resolution compared with statin monotherapy.