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2018 ; 9
(15
): 12389-12399
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Thiazolidinediones versus metformin on improving abnormal liver enzymes in
patients with type 2 diabetes mellitus: a meta-analysis
#MMPMID29552319
Xu C
; Zhao J
; Zhou X
; Zhang R
; Xie T
; Zou Z
; Liao L
; Dong J
Oncotarget
2018[Feb]; 9
(15
): 12389-12399
PMID29552319
show ga
BACKGROUND: Liver enzyme abnormalities are common in patients with type 2
diabetes. Currently, the inverse relationship between elevated liver enzymes and
antidiabetics intake may be explained by rigorous treatment and good control.
However, few studies have directly explored the influence of antidiabetics on
abnormal liver function, especially the comparison between two insulin
sensitizers-thiazolidinediones and metformin. MATERIALS AND METHODS: Databases,
including PubMed, Cochrane, CNKI, Wanfang and VIP were searched. Two reviewers
performed independently. Meta-analysis was used when studies were homogeneous
enough. RESULTS: Six studies, including 4726 patients with type 2 diabetes, were
involved in this systematic review. Compared with metformin, thiazolidinediones
significantly reduced the alanine transaminase, aspartate aminotransferase and
gamma-glutamyl transpeptidase. Further subgroup analysis suggested that
pioglitazone-treated participants showed vast improvement in decreasing alanine
transaminase (MD = -13.70; 95% CI = -16.91 to -10.52; P < 0.00001; I(2) = 1%),
aspartate aminotransferase (MD = -3.51; 95% CI = -5.74 to -1.28; P = 0.002; I(2)
= 0%) and gamma-glutamyl transpeptidase (MD = -5.41; 95% CI = -9.40 to -1.42; P =
0.008; I(2) = 0%), while rosiglitazone exhibited no difference in lowering
corresponding liver enzyme levels. Besides, thiazolidinediones similarly
decreased fasting plasma glucose. However, thiazolidinediones were inferior to
metformin in lowering HbA1C and alkaline phosphatase. Additionally, no
significant publication bias was seen. CONCLUSIONS: Thiazolidinediones may confer
modest biological improvement of liver function in people with type 2 diabetes
than metformin. But owing to the limited methodological quality, more clinical
researches are warranted in the future.