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LIVER BIOCHEMISTRY ABNORMALITIES IN A QUATERNARY CARE LIPID CLINIC DATABASE

J Shah, H Wiesinger, A White, MF Byrne, EM Yoshida, J Frolich
The Divisions of Gastroenterology and Endocrinology, the University of British Columbia, Vancouver, British Columbia

BACKGROUND: The metabolic syndrome and non-alcoholic fatty liver disease are increasing at alarming rates. We reviewed liver biochemical abnormalities in patients treated at a quaternary care lipid clinic. Specifically, we investigated patients with elevated aspartate transaminase levels who were treated with HMG-CoA reductase inhibitors (statins).
METHODS: A retrospective analysis of all patients in a lipid clinic database of a quaternary care centre was conducted. We identified patients with AST above 60 U/L who were on treatment with a statin. Exclusion criteria: excessive alcohol consumption and incomplete or inaccessible baseline or follow up data. Baseline characteristics: patient demographics, AST, lipid levels, alcohol consumption. Patients were separated into two groups: (1) patients with elevated AST on commencement of statin therapy, and (2) patients with elevated AST during statin therapy.
RESULTS: There were 516 patients with one or more measurements of AST >60 U/L. Forty six patients remained after exclusion criteria were applied. Eleven of 12 (91.7%) group 1 patients had normal AST levels after initiation of statin therapy. Thirty two of 34 patients (94%) in group 2 had transient AST elevations while on statin therapy; two patients had persistently elevated AST after initiation of treatment. There were no significant adverse events reported.
CONCLUSIONS: Use of HMG-CoA reductase inhibitors in patients with elevated AST resulted in normalization of AST levels in our patient population. The use of HMG-CoA reductase inhibitors was found to be safe in patients with mildly elevated AST. This data may translate to use of HMG-CoA reductase inhibitors in diseases such as non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.

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