A Pilot Study of Pioglitazone for the Treatment of Non-Alcoholic Fatty Liver Disease

Insulin resistance appears to be a major factor involved in the pathogenesis of non-alcoholicfatty liver disease (nafld) and nonalcoholic steatohepatitis (nash). in this pilot study, we examined the effect ofpioglitazone, an insulin-sensitizing agent, on patients with nafld and nash.methods: the medical records of patients referred to our clinic over a 48-month period were reviewed, and individualswith a clinical diagnosis of nafld or nash, who were overweight (bmi|“|25) with chronic elevated liver enzymes wereincluded in this study. the patients were either treated with pioglitazone or advised to start a weight-reduction diet andexercise, in a non-blinded random method based on the treating physicians' discretion.results: thirty-four patients' charts were retrospectively analyzed. nineteen patients were treated with pioglitazoneand 15 patients were advised to start a weight reduction diet and exercise. there were significant improvements inmean alt and ast in the pioglitazone group at the end of treatment when compared to pretreatment values and to thediet/exercise group. there were no significant changes in the lipid profiles, body mass index or fasting glucose levelsbetween baseline and at the end of the therapy in either group. there were no adverse side effects, includinghypoglycemia, in patients treated with pioglitazone.conclusions: preliminary results using pioglitazone in patients with nafld or nash are promising. however, largerprospective studies are further needed to validate the results of our study and to examine histological response.