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Perhaps inflammatory cytokines (the small hormones mentioned earlier) and the fat that produce the fatty liver and inflammation come from the body fat (adipose tissue), especially the remaining abdominal fat. There are little published data on the use of glucose lowering (hypoglycemic) agents jejunoileal bypass or lipid lowering agents in the treatment of NASH. Troglitazone (Rezulin) is a PPARg (peroxisome proliferator activating receptor gamma) compound that, as indicated above, enhances the effects of jejunoileal bypass insulin. The FDA, however, withdrew this drug from the market because it jejunoileal bypass caused cases of severe liver injury (hepatotoxicity). Before the drug was withdrawn, however, a small trial of troglitazone in patients with NASH was conducted for 6 months.
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