吡格列酮对2型糖尿病合并非酒精性脂肪肝患者血浆同型半胱氨酸水平及胰岛素抵抗影响  

Effect of pioglitazone on plasma homocysteine and insulin resistance in patients with type 2 diabetes complicated by nonalcoholic fatty liver

作　　者：王芳[1] 雷崐[1] 

机构地区：[1]山西省人民医院,030012

出　　处：《山西医药杂志（上半月）》2012年第1期17-19,共3页Shanxi Medical Journal

摘　　要：目的观察吡格列酮对2型糖尿病合并非酒精性脂肪肝患者血浆同型半胱氨酸(Hcy)水平及胰岛素抵抗的影响。方法 75例2型糖尿病合并非酒精性脂肪肝患者随机分成3组:吡格列酮组:给予吡格列酮15mg,1次/d;二甲双胍组:给予二甲双胍缓释片1g,1次/d;对照组予以除二甲双胍及噻唑烷二酮类以外的其他降糖药物治疗,共24周。结果治疗后吡格列酮组肝脾CT比值、脂肪肝消失率最高,二甲双胍组次之,对照组最低。血浆Hcy水平吡格列酮组降低明显,而二甲双胍组与对照组虽有不同程度的降低,但与治疗前比较差异均无统计学意义。治疗后胰岛素抵抗指数(HOMA-IR)吡格列酮组最低,二甲双胍组次之,对照组无明显改善。结论吡格列酮能够治疗非酒精性脂肪肝,降低患者血浆Hcy水平,改善胰岛素抵抗,疗效优于二甲双胍,且对肝功能无明显损害。Objective To observe the effect of pioglitazone on plasma homocysteine（Hcy） and insulin resistance（IR） in patients with type 2 diabetes （T2DM） complicated by nonalcoholic fatty liver（NAFL）. Methods Seventy-five newly-diagnosed T2DM with NAFL displayed by CT scan were enrolled and divided into three groups randomly.. （1） pioglitazone group （R group） were treated for 24 weeks with pioglitazone, 15 mg once daily, （2）metformin group （M group）were treated with metformin, 1 g once daily, （3）control group were treated with other medicines except for thiazolidinedione and metformin. Results The CT value ratio of liver to spleen and disappearance rate of fatty liver were much higher in R group than those in M group, while those were much higher in M group than those in control group. The level of plasma Hcy and HOMA-IR was lowest in R group and highest in control group after the treatment. Conclusion Pioglitazone can treat NAFL, reduce the level of plasma Hcy and improve the insulin resistance in T2DM patients. The therapeutic effects of pioglitazone are better than metformin. Pioglitazone has no damage on liver function in our study.

关 键 词：糖尿病 2型 胰岛素抗药性 二甲双胍 非酒精性脂肪肝 吡格列酮 

分 类 号：R587.1[医药卫生—内分泌]