{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:18:10Z","timestamp":1792793890044,"version":"4.5.0"},"reference-count":26,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010alcoholic fatty liver disease (NAFLD) has high morbidity and mortality related to cardiovascular disease (CVD), but statins have been historically underutilised in these patients due to concern for hepatotoxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To characterise trends in statin use among individuals with NAFLD and to determine predictors of statin utilisation in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Individuals with NAFLD were identified from 2005 to 2018 continuous National Health and Nutrition Examination Survey. Trends in statin use over time were assessed, and predictors of statin under\u2010utilisation for primary prevention were identified. The roles of a known diagnosis of liver disease and disease severity were examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 14\u00a0113 individuals; 34.6% had NAFLD, of whom 5.4% reported a liver disease diagnosis. There was a significant increase in statin use for primary prevention between 2005 and 2018 (18.1%\u201025.0%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), but guideline\u2010indicated use for this purpose was low (54.5% between 2005 and 2012; 48.6% between 2013 and 2018). A known NAFLD diagnosis was a negative predictor of statin use during the earlier time period but not more recently. Utilisation did not decrease with increasing liver disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a nationally representative population with NAFLD, statin use for primary prevention has increased over time, but guideline\u2010concordant use remains low. A known liver disease diagnosis was associated with lack of statin use in the earlier time period but not more recently, suggesting a changing perspective of underlying liver disease impacting statin utilisation. Further work to improve guideline\u2010indicated statin use in this high\u2010risk population is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16646","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T04:05:56Z","timestamp":1634529956000},"page":"1481-1489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Trends in statin utilisation in US adults with non\u2010alcoholic fatty liver disease"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5496-0590","authenticated-orcid":false,"given":"Jacqueline B.","family":"Henson","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Duke University Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4362-3983","authenticated-orcid":false,"given":"Yuval A.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Duke University Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Muir","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Duke University Durham NC USA"},{"name":"Duke Clinical Research Institute Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30251"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.05.013"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-320622"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91755-8"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-015-4000-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.03.031"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.02.015"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.02.013"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.12.014"},{"key":"e_1_2_8_11_1","unstructured":"Center for Drug Evaluation Research.Important safety label changes to cholesterol\u2010lowering statin drugs.https:\/\/www.fda.gov\/drugs\/drug\u2010safety\u2010and\u2010availability\/fda\u2010drug\u2010safety\u2010communication\u2010important\u2010safety\u2010label\u2010changes\u2010cholesterol\u2010lowering\u2010statin\u2010drugs"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61272-X"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.06.024"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.04.039"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.005"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437741.48606.98"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/circ.106.25.3143"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21178"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21496"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.07.001"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05340-9"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-018-1103-x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.08.005"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010241"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.1511"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000401"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13012"}],"container-title":["Alimentary Pharmacology &amp; 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