Effect and Safety of Pioglitazone-Metformin Tablets in the Treatment of Newly Diagnosed Type 2 Diabetes Patients with Nonalcoholic Fatty Liver Disease in Shaanxi Province: A Randomized, Double-Blinded, Double-Simulated Multicenter Study.

Objective: The aim of study was to evaluate the effect and safety of pioglitazone-metformin combined treatment in the newly diagnosed type 2 diabetes patients with nonalcoholic fatty liver disease. Methods: A total of 120 newly diagnosed type 2 diabetes patients with nonalcoholic fatty liver disease from 8 centers were randomly divided into the control group (metformin hydrochloride) and the test group (pioglitazone hydrochloride and metformin hydrochloride). Results: Compared to the control group, after treatment, the proportion of people with mild and moderate fatty liver increased, and the proportion of people with severe fatty liver decreased, and this change was more obvious in the population with moderate and severe fatty liver. The level of γ-GT decreased in both groups before and after treatment, which was statistically significant, and there was also a statistically significant difference in the level of γ-GT between the two groups after 24 weeks. There were no significant statistically differences in blood lipid, body weight, and waist circumference between the test group and the control group. Logistic regression analysis found that BMI is one of the risk factors for fatty liver. There was also no significant difference in the incidence of serious adverse events between the two groups (control group: 10.00% and test group: 6.67%, P = 0.74). Conclusion: Combined treatment with pioglitazone-metformin can effectively reduce liver fat content and gamma-GT level in newly diagnosed diabetic patients with nonalcoholic fatty liver disease, and adverse events do not increase compared with the control group, showing good safety and tolerance. This trial is registered with ClinicalTrials.gov NCT03796975.

Changes in myocardial enzymes in serum of patients with primary hypothyroidism / 西安交通大学学报(医学版)

Objective To investigate the changes in serum level of myocardial enzymes in patients with primary hypothyroidism and to evaluate the relationship between the level of those enzymes and clinical or experimental parameters.Methods We measured several myocardial enzymes in serum of 108 patients with primary hypothyroidism including 31 cases of Hashimoto's thyroiditis,28 cases of atrophic thyroiditis,24 cases of Graves' hyperthyroidism treated by 131I,and 25 cases of Graves' hyperthyroidism treated by antithyroid drugs,as well as 50 normal controls.Results All the myocardial enzymes,including creatine kinase(CK) and its isoenzyme CK-MB,aspartate aminotransferase(AST),lactate dehydrogenase(LDH) and its isoenzyme HBDH,especially CK,were elevated in serum of patients with hypothyroidism.In addition,significant negative correlations were found between CK and FT3,CK and FT4,CK-MB and FT3,CK-MB and FT4.No difference in enzyme level was found among different hypothyroidism groups.Conclusion Hypothyroidism may cause elevation of myocardial enzymes in serum of the patients.The degree of CK and CK-MB increase was associated with the severity of hypothyroidism,and thus can be regarded as indexes to determine the severity of hypothyroidism.