About this trial
In this study the investigators will quantitate hepatic mitochondrial fluxes in T2D patients with NAFL and NASH before and after 16-weeks treatment with the insulin sensitizer pioglitazone
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Confirmed T2D based on OGTT (2 h glucose ≥200 mg/dl).
Treated with diet, metformin, and/or sulfonylurea and in good general health determined by medical history, physical exam, and routine blood chemistries;
age = 18-80 years;
BMI = 25-40 kg/m2;
Disqualifiers
Alcohol consumption >14 units/week for women and >21 units/week for men.
Cirrhosis (fibrosis stage 4).
Type 1 diabetes and/or GAD positive subjects.
Subjects not drug naive or have been on metformin more than 3 months.
Trial design
Parallel
Treatments tested in this trial
Pioglitazone
DrugAn insulin sensitizer and anti-diabetic agent. Participants will be started on 15 mg/day, increased to 30 mg/day at week 2 and then to 45 mg/day at week 4.
Placebo
Other interventionPlacebo for pioglitazone
Treatment groups
Trial outcomes
Primary outcomes
Effect of pioglitazone on hepatic mitochondrial TCA cycle fluxes
Quantitated using a combine stable isotope approach before and after treatment with pioglitazone
Secondary outcomes
Mean absolute change from baseline in liver fat content by magnetic resonance Imaging - Proton Density Fat Fraction (MRI-PDFF)
Mean absolute change from baseline in liver fat content by MRI-PDFF
Mean change from baseline in body weight
Mean change from baseline in body weight
Mean change from baseline in body composition
Mean change from baseline in lean and fat mass measured by DEXA
Quantitate the effect of pioglitazone on liver histology by improvement of fibrosis
Percentage of Participants with ≥1 Point Decrease in Fibrosis Stage with No Worsening of NASH on Liver Histology
Sponsors and contacts
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The University of Texas Health Science Center at San Antonio
Lead sponsor
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Collaborator