Insulin resistance is a major factor influencing the progression of non-alcoholic fatty liver disease (NAFLD). Hence, insulin sensitisers such as thiazolidinediones (TZDs) are a potential treatment for NAFLD although their long-term benefits remain unknown.
Methods
We retrospectively studied 396 and 364 type 2 diabetes patients who received pioglitazone and rosiglitazone therapy respectively from diabetes clinics between May 2001 and November 2007.
Results
One hundred and seventy-seven pioglitazone-treated and 152 rosiglitazone-treated patients were included. After a year of treatment, significant improvement in glycated haemoglobin A1C (HbA1C), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) was observed in both groups despite weight gain. Changes in HbA1C and liver function test (LFT) were positively correlated in pioglitazone-treated (ALT p=0.01; GGT p<0.001; ALP p=0.006) and rosiglitazone-treated (GGT p= 0.01, ALP p=0.002) groups. Multiple regression showed no significant difference in the changes in ALT (p=0.43) and GGT (p=0.13) between the groups but a larger reduction in ALP (p=0.03) was noted in rosiglitazone-treated patients. Sixty patients remained on pioglitazone and 46 patients continued on rosiglitazone after four years. Sustained improvement in ALT, GGT and HbA 1C was observed in both groups despite weight gain over four years.
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