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Pemafibrate, a selective peroxisome proliferator activated receptor \u03b1 modulator (SPPARM\u03b1), has been shown to improve liver function among patients with DL. The aim of this single\u2010arm prospective study is to evaluate the efficacy of pemafibrate in NAFLD patients with DL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty NAFLD patients with DL who received pemafibrate (0.1\u00a0mg) twice a day for 12\u00a0weeks were prospectively enrolled in this study. The primary end\u2010point was change in serum alanine aminotransferase (ALT) levels from baseline to week 12.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serum ALT levels decreased from 75.1\u00a0IU\/L at baseline to 43.6\u00a0IU\/L at week 12 (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). Significant improvements in triglyceride, high\u2010density lipoprotein cholesterol, total fatty acid, saturated fatty acid (SFA), and unsaturated fatty acid were also noted. The serum level of remnant\u2010like protein cholesterol, SFA, and polyunsaturated\u00a0\/\u00a0saturated fatty acid ratio (PUFA\u00a0\/\u00a0SFA ratio) at baseline were correlated with change in ALT level (r\u2009=\u2009\u22120.53, r\u2009=\u2009\u22120.57, and r\u2009=\u20090.46, respectively). Change in PUFA and change in PUFA\u00a0\/\u00a0SFA ratio were negatively correlated with change in ALT level (r\u2009=\u2009\u22120.49 and r\u2009=\u2009\u22120.53). No hepatic or renal adverse events were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Selective peroxisome proliferator activated receptor \u03b1 could be a promising novel agent for treatment of NAFLD patients with DL by regulating fatty acid composition. A further long\u2010term large\u2010scale trial is warranted to confirm the efficacy of SPPARM\u03b1 on NAFLD with DL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.13571","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T07:39:55Z","timestamp":1600241995000},"page":"1328-1336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Effect of pemafibrate on fatty acid levels and liver enzymes in non\u2010alcoholic fatty liver disease patients with dyslipidemia: A single\u2010arm, pilot study"],"prefix":"10.1111","volume":"50","author":[{"given":"Yuya","family":"Seko","sequence":"first","affiliation":[{"name":"Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science Kyoto Prefectural University of Medicine  Kyoto 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