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Nonalcoholic fatty liver disease (NAFLD) is associated with both dyslipidemia and increased risk for cardiovascular disease. Despite the indication to treat in patients affected by both dyslipidemia and NAFLD, an undertreatment in statin therapy due to the potential liver damage is frequently observed.We sought to evaluate retrospectively the impact of statin on the lipid profile and on the achievement of Low density Lipoprotein (LDL) cholesterol targets in relation to the Adult Treatment Panel III (ATP III) cardiovascular risk in dyslipidemic patients presenting with a clinical diagnosis of NAFLD and elevated liver enzymes before statin prescription. As a secondary endpoint we investigated whether statin could be associated with changes of liver enzymes.43 dyslipidemic NAFLD patients presenting with increased values of aspartate aminotransferase and/or alanine aminotransferase and/or γ-glutamyl-transferase at baseline were analyzed retrospectively as regard the lipid profile and liver enzymes (values reported before statin and during statin therapy).Total cholesterol, LDL and triglycerides were significantly reduced at follow-up (5.4 ± 5.4 months). The LDL target was achieved at the second visit in 30 patients (69.8%). The number of patients achieving the LDL target was significantly higher in low risk group as compared with moderate and high risk subjects. Liver enzyme levels showed no significant changes between baseline and follow-up.Statin treatment was effective (without changes in liver enzymes) in patients with dyslipidemia and NAFLD and therefore presenting a profound alteration in lipoprotein metabolism. The number of patients achieving LDL target was related to the ATPIII risk classification, being higher in the patients with lower risk.