4. Discussion
NAFLD, occult blood, diarrhea, fatty liver, adverse cardiovascular events, angina pectoris, liver cirrhosis, ALD, NAFL, hypoglycemic, metabolic stress liver injury, hypertension
ADVERSE REACTIONS, ALCOHOLIC LIVER DISEASE, HYPERTENSION, ADVERSE EVENTS, NONALCOHOLIC STEATOHEPATITIS (NASH), DISEASE, NONALCOHOLIC FATTY LIVER, FATTY LIVER, LIVER CIRRHOSIS, INSULIN RESISTANCE, HEPATOCELLULAR CARCINOMA, NONALCOHOLIC FATTY LIVER DISEASE, ALD, TYPE 2 DIABETES
Nonalcoholic fatty liver disease is a metabolic stress liver injury closely related to insulin resistance and genetic susceptibility. Except that the patient has no history of excessive drinking, its pathological changes are similar to alcoholic liver disease (ALD). The disease spectrum includes nonalcoholic fatty liver (NAFL), nonalcoholic steatohepatitis (NASH), and related liver cirrhosis and hepatocellular carcinoma [In this double-blind, randomized, placebo-controlled trial, pioglitazone-metformin combined treatment met the predefined primary endpoint and can significantly reduce the liver fat content of newly diagnosed type 2 diabetes with moderate or severe fatty liver patients. In addition, after 24 weeks of treatment, the patient's No statistically significant changes were observed in patients with mild liver content; this is consistent with previous studies showing that insulin sensitizers can effectively improve NAFLD [In terms of safety, the addition of metformin did not significantly increase the risk of adverse events. The pioglitazone-metformin combination group had the same risk of adverse events as the metformin group, and they were well tolerated. Drug-related adverse reactions were mainly diarrhea, occult blood in the urine, and insufficient blood supply to the myocardium. These adverse events were, however, mainly transient and mild-to-moderate severity. A total of 2 serious adverse events occurred in the two groups, including hypertension and angina pectoris, with mild-to-moderate severity. Both cases were considered to be unrelated to the study drug. However, whether pioglitazone affects the cardiovascular system and the occurrence of adverse cardiovascular events remains to be confirmed by further increasing the number of studies. NAFLD is a recent research hotspot, and there is still no specific guideline for the treatment plan of NAFLD patients. Although many hypoglycemic drugs have been tested in NAFLD patients, there are currently no approved drugs for the treatment of NAFLD [