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This central action drastically decreases sympathetic outflow from the central nervous system to the heart, kidneys, and peripheral vasculature (Figure 1)(Patel and Saadabadi, 2025)

264 In summary, the beneficial effects of TZDs on the improvement and even the resolution of steatosis and histologic features of MASH were highly consistent, but the effects on liver fibrosis were inconsistent with several studies suggesting no significant improvement in fibrosis with TZDs, possibly because the intervention time was not long enough to produce significant improvement in fibrosis or because of the differences in baseline fibrosis stage between studies

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