Lobeglitazone, a Novel Thiazolidinedione, Improves Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: Its Efficacy and Predictive Factors Related to Responsiveness

Lee, Yong-ho; Kim, Jae Hyeon; Kim, So Ra; Jin, Heung Yong; Rhee, Eun-Jung; Cho, Young Min; Lee, Byung-Wan

In this study, we showed that 65% of NAFLD patients responded to lobeglitazone treatment, which is comparable to the 69% improvement in steatosis by pioglitazone treatment that was observed in PIVENS trial. Interestingly, a recent RCT meta-analysis showed that TZDs improve hepatic steatosis and inflammation, but not fibrosis (26) . Similarly, in this study, we demonstrated that lobeglitazone treatment in NAFLD patients improved hepatic steatosis, as assessed by CAP, and liver enzyme profiles, as assessed by aminotransferase and γGTP levels, but not liver fibrosis, based on measurements of liver stiffness. Because this was not a liver-biopsy proven study, we could not assess alterations in hepatic inflammation and hepatocellular ballooning following treatment. Regarding CAP, previous studies have analyzed the association of CAP values with liver histology, particularly in NAFLD patients with high-grade steatosis and elevated BMI, and have verified the utility of CAP as a non-invasive tool for diagnosing and monitoring NAFLD patients (27) (28) (29) (30) . However, despite its relatively high accuracy in detecting hepatic steatosis, the agreement between histologic analysis and CAP in hepatic fat quantification varies among individuals with mild steatosis (27) . Thus, for our study, we recruited T2D subjects with NAFLD using a higher cut-off CAP value (250 dB/m).