Combined use of rosuvastatin and ezetimibe improves hepatic steatosis in patients with dyslipidemia

Background and aims Rosuvastatin plus ezetimibe are beneficial for the management of dyslipidemia. We investigated whether rosuvastatin plus ezetimibe improves hepatic steatosis in patients with dyslipidemia. Methods Between January and August 2018, 114 patients with dyslipidemia treated for 6 months with rosuvastatin plus ezetimibe were analyzed in this retrospective cohort study. The degree of hepatic steatosis was assessed using the hepatic steatosis index (HSI). Hepatic steatosis improvement and presence of fatty liver were defined as a ≥5% reduction in HSI score and HSI ≥36, respectively. Results The mean age of the study population (50 males and 64 females) was 57.4 years. At baseline, the mean BMI total cholesterol level, low-density lipoprotein cholesterol level, high-density lipoprotein cholesterol level, triglyceride level, and HSI were 25.1 kg/m², 207.4 mg/dL, 126.1 mg/dL, 52.9 mg/dL, 146.4 mg/dL, and 36.1, respectively. During the 6-month treatment, hepatic steatosis burden was constant (mean HSI = 36.3 and 36.4 at 3 and 6 months, respectively). On multivariate analyses, ultrasonographic fatty liver and HSI ≥36 were selected as independent predictors of hepatic steatosis improvement. However, when 53 (46.5%) patients with fatty liver (HSI ≥ 36) were selected, hepatic steatosis burden was significantly improved (mean HSI = 40.8, 39.3, and 39.7 at baseline, 3 months, and 6 months, respectively). Conclusions The use of rosuvastatin plus ezetimibe for the management of dyslipidemia did not improve hepatic steatosis burden in all patients with dyslipidemia, but it improved hepatic steatosis burden in the subgroup with fatty liver.