Effect of Atorvastatin, Vitamin E and C on Nonalcoholic Fatty Liver Disease: Is the Combination Required?

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Nonalcoholic fatty liver disease is associated with the metabolic syndrome. The current standard of care, healthy diet and weight loss, has limited effect. The benefits of pharmacological treatments are unclear due to the difficulty of using liver histology as the main outcome in large randomized controlled trials (RCTs). In this issue, an RCT (1) with atorvastatin and antioxidants (vitamins E+C) vs. placebo shows improvement in liver steatosis based on computed tomography scans. The questions are (1) is this beneficial effect due to the combined treatment or the effect of an individual compound; (2) does this intervention improve nonalcoholic steatohepatitis.

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