title: [Insulin sensitizer--anti-diabetic drugs, metformin and pioglitazone that can improve insulin resistance].
abstract: Nonalcoholic steatohepatitis (NASH), which is considered the hepatic manifestation of the metabolic syndrome is an increasingly cause of chronic liver disease in Japan. NASH is finally lead to liver cirrhosis and hepatocellular carcinoma as viral hepatitis, therefore, medical treatment should be considered, when NASH occurs. Treatment of patients with metabolic syndrome has been focused on the management of associated conditions such as obesity, hyperlipidemia, hypertension and hyperinsulinemia. Insulin resistance, that could accelerate liver inflammation and fibrosis by up-regulation of TNFa seems to be most important factor in many cases of NASH. The insulin-sensitizing drugs, which were biguanides (metformin) and thiazolidinediones (pioglitazone) have been shown to correct not only insulin resistance but also steatosis and inflammation in the liver. Metformin and pioglitazone might be useful drugs against NASH, however further investigations were needed.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Korenaga
authors.forename: Koutaro
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Korenaga
authors.forename: Kouichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Iso
authors.initials: I
authors.lastname: Sakaida
mesh_terms: D005234:Fatty Liver / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy; D008687:Metformin / Q000627:therapeutic use*; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D015854:Up-Regulation
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D014409:Tumor Necrosis Factor-alpha; D008687:Metformin; D000077205:Pioglitazone