Efficacy and safety of pioglitazone metformin in the treatment of type 2 diabetes mellitus complicated by non-alcoholic fatty liver disease
WANG Haimin
TIAN Dezeng
LI Xiaoyan
Abstract：Objective To investigate the efficacy and safety of pioglitazone metformin in patients with type 2 diabetes mellitus(T2DM)complicated by non-alcoholic fatty liver disease(NAFLD).Methods A total of 140 patients with T2DM com-plicated by NAFLD treated at Anyang District Hospital in Puyang City from September 2023 to September 2024 were enrolled and randomly assigned into two groups using computer-generated random sequences,with 70 cases in each group.The observa-tion group received pioglitazone metformin tablets(containing 15 mg of pioglitazone hydrochloride and 500 mg of metformin hy-drochloride),with an initial dosage of 1 tablet once daily,taken orally before breakfast or dinner.After one week of treatment,the dosage was adjusted to 1 tablet twice daily,taken orally before breakfast and dinner.The control group received metformin hydro-chloride tablets,0.5 g once a day,taken orally before breakfast or dinner,and after one week of treatment,adjusted to 0.5 g twice a day,taken orally before breakfast and dinner.Both groups were treated for six months.The liver function indexes,body mass,waist circumference,levels of inflammation and glucose metabolism,and the incidence of adverse reactions of the two groups were compared before and after treatment.Results After treatment,alanine aminotransferase(ALT),aspartate aminotransfer-ase(AST),and γ-glutamyl transpeptidase levels decreased in both groups,and the indexes of the observation group((26.37±4.55)IU/L,(21.58±5.22)IU/L,(30.99±3.04)IU/L)were lower than those of the control group((32.63±5.02)IU/L,(23.66±5.90)IU/L,(40.55±3.43)IU/L)(t=7.730,2.209,17.451,all P<0.05).After treatment,body weight,waist circumference,the levels of ectodysplasin A,interleukin-1β and tumor necrosis factor α in both groups were lower than those before treatment,and the indexes of the observation group((67.58±11.58)kg,(86.58±5.22)cm,(92.80±12.50)ng/L,(6.09±0.81)pg/mL,(13.13±1.33)pg/mL)were lower than those of the control group((72.05±12.97)kg,(91.66±5.90)cm,(135.51±24.30)ng/L,(7.97±0.58)pg/mL,(19.58±1.87)pg/mL)(t=2.150,5.395,12.747,15.787,23.517,all P<0.05).After treatment,the levels of glycated hemoglobin,fasting plasma glucose,and insulin resistance indexes in both groups were improved compared with before treatment(P<0.05).The insulin resistance index of the observation group(2.60±0.49)was lower than that of the control group(2.89±0.52)(t=3.396,P<0.05),but there were no significant differences between the control group and the observation group in the levels of glycated hemoglobin and fasting blood glucose((6.35±0.58)%vs(6.50±0.86)%,(6.78±1.19)mmol/L vs(6.89±1.84)mmol/L)(t=1.210,0.420,both P>0.05).The incidence of adverse reactions in the observation group(7.14%,5/70)was lower than that in the control group(20.00%,14/70),and the difference was statistically significant(χ²=4.933,P<0.05).Conclusion Pioglitazone metformin treatment for 6 months can effectively improve the liver function,inflammatory indicators and glucose metabolism lev-els in patients with T2DM complicated by NAFLD,and reduce the incidence of adverse reactions.
Keywords：pioglitazonemetforminectodysplasin Ainterleukin-1 betatype 2 diabetes mellitusnon-alcoholic fatty liver disease
Publication Date：2025-10-25
Online Publishing Date：2025-11-03(First online date of this platform, not the publication date of the document)
Pages：5( 1187-1191 )