Abstract
To increase our understanding of the effect of thiazolidinediones, a new class of
antidiabetic drugs, on liver function as well as glycemic control, we investigated
liver function before, during, and after treatment with troglitazone and pioglitazone.
A total of 32 patients with type 2 diabetes were studied. Glycemic control and liver
function were measured before, during, and after 4 to 12 weeks of treatment with troglitazone
or pioglitazone. Glycemic control was assessed by fasting levels of plasma glucose,
hemoglobin A1c, and serum insulin, and liver function was assessed by asparatate aminotransferase
(AST), alanine aminotransferase (ALT), and γ-glutamyl transpeptidase (γ-GTP). Homeostasis model assessment for insulin resistance was used as an index of
insulin resistance.
During treatment with troglitazone, fasting plasma glucose and hemoglobin A1c levels and homeostasis model assessment for insulin resistance were significantly
decreased. Serum AST, ALT, and γ-GTP levels were significantly decreased during treatment (AST, −17.4%; ALT, −27.2%;
γ-GTP, −47.9%) and returned to pretreatment levels after 4 weeks of withdrawal of the
drug. A similar tendency was observed during treatment with pioglitazone (AST, −4.7%;
ALT, −16.4%; γ-GTP, −30.8%).
These data suggest that, in contrast to the deterioration of liver function reported
in a small subset of patients treated with troglitazone, treatment with thiazolidinediones
was associated with a decrease in serum transaminases in most patients. The improvement
in liver function parameters known to be associated with fatty liver in the present
study, together with an improvement in fatty liver reported for another class of insulin
sensitizers, biguanides, suggests that thiazolidinediones may have a beneficial effect
on fatty liver.
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Article info
Publication history
Accepted:
November 23,
2004
Received in revised form:
October 25,
2004
Received:
May 29,
2004
Identification
Copyright
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
