Tolman Keith G, Chandramouli Jane
Division of Gastroenterology, Department of Internal Medicine, University of Utah School of Medicine, 30 N 1900 E RM 4R118 SOM Salt Lake City, UT 84132, USA.
Clin Liver Dis. 2003 May;7(2):369-79, vi. doi: 10.1016/s1089-3261(03)00020-5.
Troglitazone, the first of the thiazolidinediones, caused severe hepatotoxicity including liver failure in several patients. It appears, however, that the thiazolidinediones as a class are not as hepatotoxic as troglitazone. Comparative data at comparable dates of usage indicate that pioglitazone and rosiglitazone are not significant hepatotoxins. This is further supported by experimental data that demonstrate that troglitazone, alone among the thiazolidinediones, is toxic in hepatocyte cell culture. All of the thiazolidinediones cause ALT elevations; however, ALT monitoring for hepatotoxicity does not appear to prevent serious liver disease nor reduce patient risk.
曲格列酮是噻唑烷二酮类药物中的首个药物，它在数名患者中引发了严重的肝毒性，包括肝衰竭。然而，噻唑烷二酮类药物作为一个类别，似乎不像曲格列酮那样具有肝毒性。在相同使用日期的对比数据表明，吡格列酮和罗格列酮并非显著的肝毒素。这一点得到了实验数据的进一步支持，这些数据表明，在噻唑烷二酮类药物中，只有曲格列酮在肝细胞培养中具有毒性。所有的噻唑烷二酮类药物都会导致谷丙转氨酶（ALT）升高；然而，监测ALT以检测肝毒性似乎并不能预防严重的肝脏疾病，也不能降低患者风险。
