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Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes
BACKGROUND & AIMS: Studies have described prominent histologic improvement in patients with nonalcoholic steatohepatitis (NASH) using thiazolidinedione (TZD); however, these were all short term with moderate sample size, no liver‐related long‐term outcomes could be noted. METHODS: This retrospec...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317545/ https://www.ncbi.nlm.nih.gov/pubmed/31960563 http://dx.doi.org/10.1111/liv.14385 |
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author | Yen, Fu‐Shun Yang, Yu‐Cih Hwu, Chii‐Min Wei, James C.‐C. Huang, Yi‐Hsiang Hou, Ming‐Chih Hsu, Chih‐Cheng |
author_facet | Yen, Fu‐Shun Yang, Yu‐Cih Hwu, Chii‐Min Wei, James C.‐C. Huang, Yi‐Hsiang Hou, Ming‐Chih Hsu, Chih‐Cheng |
author_sort | Yen, Fu‐Shun |
collection | PubMed |
description | BACKGROUND & AIMS: Studies have described prominent histologic improvement in patients with nonalcoholic steatohepatitis (NASH) using thiazolidinedione (TZD); however, these were all short term with moderate sample size, no liver‐related long‐term outcomes could be noted. METHODS: This retrospective cohort study enrolled patients with newly diagnosed type 2 diabetes mellitus (T2DM) from Taiwan's National Health Insurance Research Database between 1 January 2000 and 31 December 2013. We matched TZD users and nonusers at a 1:1 ratio through propensity score matching. This study included 5095 paired TZD users and nonusers. Cox proportional hazard models were used to compare the risks of cirrhosis, hepatic decompensation, hepatic failure and all‐cause mortality between TZD users and nonusers. The Kaplan‐Meier method was used to compare the cumulative incidence of these main outcomes. RESULTS: The incidence rates of cirrhosis, hepatic decompensation, hepatic failure and all‐cause mortality during follow‐up were 0.77 vs 1.95, 1.43 vs 1.75, 0.36 vs 0.70, and 4.89 vs 3.78 per 1000 person‐years between TZD users and nonusers. The adjusted hazard ratios of cirrhosis, hepatic decompensation, hepatic failure and all‐cause mortality were 0.39 (95% confidence interval [CI]: 0.21‐0.72), 0.86 (95% CI: 0.52‐1.44), 0.46 (95% CI: 0.18‐1.17) and 1.18 (95% CI: 0.87‐1.61) respectively. CONCLUSIONS: Our study demonstrated that TZD use could significantly lower the risk of cirrhosis. In clinical settings, TZD use might be able to improve liver‐related long‐term outcomes. |
format | Online Article Text |
id | pubmed-7317545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-73175452020-06-29 Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes Yen, Fu‐Shun Yang, Yu‐Cih Hwu, Chii‐Min Wei, James C.‐C. Huang, Yi‐Hsiang Hou, Ming‐Chih Hsu, Chih‐Cheng Liver Int Metabolic & Toxic Liver Diseases BACKGROUND & AIMS: Studies have described prominent histologic improvement in patients with nonalcoholic steatohepatitis (NASH) using thiazolidinedione (TZD); however, these were all short term with moderate sample size, no liver‐related long‐term outcomes could be noted. METHODS: This retrospective cohort study enrolled patients with newly diagnosed type 2 diabetes mellitus (T2DM) from Taiwan's National Health Insurance Research Database between 1 January 2000 and 31 December 2013. We matched TZD users and nonusers at a 1:1 ratio through propensity score matching. This study included 5095 paired TZD users and nonusers. Cox proportional hazard models were used to compare the risks of cirrhosis, hepatic decompensation, hepatic failure and all‐cause mortality between TZD users and nonusers. The Kaplan‐Meier method was used to compare the cumulative incidence of these main outcomes. RESULTS: The incidence rates of cirrhosis, hepatic decompensation, hepatic failure and all‐cause mortality during follow‐up were 0.77 vs 1.95, 1.43 vs 1.75, 0.36 vs 0.70, and 4.89 vs 3.78 per 1000 person‐years between TZD users and nonusers. The adjusted hazard ratios of cirrhosis, hepatic decompensation, hepatic failure and all‐cause mortality were 0.39 (95% confidence interval [CI]: 0.21‐0.72), 0.86 (95% CI: 0.52‐1.44), 0.46 (95% CI: 0.18‐1.17) and 1.18 (95% CI: 0.87‐1.61) respectively. CONCLUSIONS: Our study demonstrated that TZD use could significantly lower the risk of cirrhosis. In clinical settings, TZD use might be able to improve liver‐related long‐term outcomes. John Wiley and Sons Inc. 2020-02-10 2020-05 /pmc/articles/PMC7317545/ /pubmed/31960563 http://dx.doi.org/10.1111/liv.14385 Text en © 2020 The Authors. Liver International published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Metabolic & Toxic Liver Diseases Yen, Fu‐Shun Yang, Yu‐Cih Hwu, Chii‐Min Wei, James C.‐C. Huang, Yi‐Hsiang Hou, Ming‐Chih Hsu, Chih‐Cheng Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
title | Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
title_full | Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
title_fullStr | Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
title_full_unstemmed | Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
title_short | Liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
title_sort | liver‐related long‐term outcomes of thiazolidinedione use in persons with type 2 diabetes |
topic | Metabolic & Toxic Liver Diseases |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317545/ https://www.ncbi.nlm.nih.gov/pubmed/31960563 http://dx.doi.org/10.1111/liv.14385 |
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