Which lipid-lowering agent is known for its potential to lead to liver enzyme elevation?

Statins are lipid-lowering agents that are widely recognized for their role in reducing cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol. One of the notable side effects associated with the use of statins is the elevation of liver enzymes, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST). This phenomenon occurs in a subset of patients and is often monitored through routine liver function tests when patients are initiated on statin therapy.

The mechanism behind this elevation may relate to statins' effects on hepatic metabolism, as they serve to inhibit the enzyme HMG-CoA reductase, which plays a crucial role in cholesterol synthesis within the liver. In doing so, this leads to a compensatory increase in liver metabolism that can result in transient elevations in liver enzymes.

Because of this potential side effect, healthcare providers typically assess liver enzyme levels before starting statin therapy and may continue monitoring during treatment for any significant changes. If elevated liver enzymes persist, clinicians may consider dose adjustments or alternative therapies. Hence, statins stand out among lipid-lowering agents for their association with liver enzyme elevations.