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- Title
Pioglitazone Treatment Increases Whole Body Fat But Not Total Body Water in Patients with Non-Alcoholic Steatohepatitis (NASH).
- Authors
Balas, Bogdan; Belfort, Renata; Harrison, Stephen A.; Darland, Celia; Finch, Joan; Gastaldelli, Amalia; Cusi, Kenneth
- Abstract
Non-Alcoholic Steatohepatitis (NASH) is a chronic liver disease frequently associated with insulin resistance and type 2 diabetes mellitus (T2DM), and characterized by steatosis and necroinflammation with or without perisinusoidal fibrosis. We have recently reported that 6 months treatment with pioglitazone (PIO) reverses the metabolic and histological abnormalities of patients with IGT or T2DM and NASH, but also leads to weight gain. We performed a careful evaluation to understand the nature of weight gain associated with PIO treatment in NASH, as it may be important to establish the safety of its use in this population. To this end we analyzed a subgroup of 35 patients who completed the tests for determination of whole body fat (WBF) and total body water (TBW): 21 patients received PIO (9 IGT/12 T2DM) and 14 placebo (6 IGT/8 T2DM), in a double-blind, randomized fashion for a period of 6 months. WBF and TBW were measured before and after treatment using dual energy X-ray absorptiometry (DXA, Hologic Inc, Waltham, MA), a water dilution technique using 3H20 and bioimpedance. Results: PIO increased body weight (from 93.6±19.2 to 96.1±20.8 kg, p<0.003) and WBF as measured by DXA (from 31.8±8.3 to 33.9±9.6 kg, p<0.003) while no changes were seen with placebo. Total body water measured with 3H20 was not altered significantly either after PIO (from 45.0±10.5 to 45.3±9.6) or placebo (from 44.5±9.9 to 44.6±12.5 1), p=NS. Muscle hydration [(assessed by the ratio of TBW (measured with 3H20) over fat-free mass (measured with DXA)] was unchanged both by PIO (from 0.72±0.07 to 0.73±0.07, p=NS) and placebo treatments (from 0.75±0.06 to 0.72±0.061/kg, p=NS). Extracellular water (measured with bioimpedance) was unchanged both in PIO (from 18.2±3.5 to 18.6±3.4) and in placebo (from 19.3±3.1 to 19.6±3.31), p=NS. Conclusion: Six months of PIO treatment in patients with IGT or T2DM and NASH is associated with mild to moderate weight gain that is attributable to an increase in adipose tissue mass and not to water retention.
- Subjects
LIVER diseases; INSULIN resistance; TYPE 2 diabetes; FATTY degeneration; WEIGHT gain; ADIPOSE tissues
- Publication
Diabetes, 2007, Vol 56, pA164
- ISSN
0012-1797
- Publication type
Article