8697 Effects of Fibrate Combination Therapy on the Prevention and Progression of Non-Alcoholic Fatty Liver Disease in Patients with Dyslipidemia Undergoing Statin Treatment: A Retrospective Cohort Study Using Dada from the Korean National Health Insu

Abstract Disclosure: J. Choi: None. S. Kim: None. D. Lim: None. K. Song: None. Background and Hypothesis: Non-alcoholic fatty liver disease (NAFLD), recognized as part of the metabolic syndrome, has become a significant public health issue. However, there has been no suitable pharmacological treatment beyond lifestyle management due to the lack of appropriate modalities for early diagnosis and treatment response assessment. Fibrates, potent drugs for treating hypertriglyceridemia, have been considered potential therapeutic candidates for hepatic steatosis due to their capacity to reduce liver lipid accumulation. However, they have failed to demonstrate histopathological improvement and lack large-scale randomized controlled trials showing radiological improvement. Purpose: We aimed to evaluate the effectiveness of fibrates in improving hepatic steatosis using the fatty liver index (FLI) and hepatic steatosis index (HSI). These are presented as predictive panels for hepatic steatosis by the Korean Association for the Study of the Liver, having been well validated in large-scale epidemiological studies for Koreans through radiological examinations. They are also independently valuable as they utilize different serological and clinical indicators. The analysis was feasible using claim data and health examination records from the Korean National Health Insurance Service. Research Method: This study was conducted on individuals with dyslipidemia receiving statin treatment, who had undergone consecutive health examinations provided by the KNHIS. Among these, patients newly starting fibrates treatment for moderate hypertriglyceridemia (triglyceride levels 150-500 mg/dl) were selected as the treatment group (n=10,616). A control group (n=10,616) was established using 1:1 propensity score matching. The odds ratios (ORs) for the hepatic steatosis were analyzed by the FLI and HSI between these two groups, respectively. Additionally, the fibrates treatment group was categorized based on medication possession ratio (MPR), and the ORs were evaluated accordingly. Results: The fibrate treatment group reduced hepatic steatosis by 10.8% according to the FLI and 17.6% according to the HSI, compared to the control group. Notably, in the subgroup with a high MPR of over 80%, there was a substantial decrease in hepatic steatosis, with a 69.8% reduction observed for FLI and a 66.3% reduction for HSI. Conclusion: Fibrate treatment in patients with hypertriglyceridemia who are already on statin therapy can significantly reduce the prevalence of hepatic steatosis. Presentation: 6/3/2024