T_2DM伴NAFLD患者吡格列酮治疗前后血浆内脂素水平的变化  

Effect of pioglitazone on the plasma visfatin level among type 2 diabetic patients with non-alcoholic fatty liver disease

作　　者：王黎明[1] 励晶[1] 

机构地区：[1]宁波大学医学院附属医院,宁波315020

出　　处：《现代实用医学》2011年第12期1332-1336,共5页Modern Practical Medicine

基　　金：宁波市医学科技计划项目(2010B06)

摘　　要：目的探讨吡格列酮治疗前后2型糖尿病(T2DM)伴非酒精性脂肪肝(NAFLD)患者血浆内脂素(Vis-fatin)水平的变化及其与胰岛素抵抗、肝功能之间的关系。方法选取T2DM伴NAFLD者60例,随机分为两组,各30例。分别给予单纯胰岛素(A组)和胰岛素+吡格列酮(B组)治疗,另择单纯T2DM患者60例作为T2DM组,并正常体检者30例作为对照组,以观察三组人群Visfatin水平差异并T2DM伴NAFLD患者治疗前后Visfatin及胰岛素抵抗改善情况。结果单纯T2DM组的Visfatin水平、HOMA-IRI、腰围(WC)、TG均高于正常体检组,而均低于T2DM伴NAFLD组(均<0.05)。FBG、WC、ALT及GGT为影响血浆Visfatin的独立危险因素。A、B两组较治疗前胰岛素抵抗(IR)明显减轻,血浆Visfatin水平下降,胰岛功能(HOMA-BI)改善(均<0.05)。A与B组相比:治疗前IR、血浆Visfatin水平无明显差异,治疗后B组的IR及Visfatin水平显著低于A组(<0.05)。Visfatin与IR呈正相关。结论 Visfatin可能通过胰岛素抵抗机制与T2DM、腹型肥胖及NAFLD的进展有相关性。应用吡格列酮可能干预T2DM患者NAFLD的发生发展。Objective To investigate effect ofpioglitazone on plasma visfatin levels in type 2 diabetic（T2DM） patients with nonalcoholic fatty liver disease（NAFLD） and the relationship among visfatin, insulin resistance and liver function. Methods The fasting plasma visfatin levels were measured in 60 T2DM patients with NAFLD, who were then divided into two groups （A and B）randomly. Group A was given with insulin, and group B was given with insulin ＋ Pioglitazone. 60 T2DM patients without NAFLD and 30 healthy individuals were the control groups）. The effects of Pioglitazone on visfatin level and insulin resistance （IR） were observed. Results The plasma visfatin levels, HOMA-IRI, waist circumference（WC） and TG in diabetic patients without NAFLD were significantly higher than those in healthy individuals, but lower than those in diabetic patients with NAFLD（P 〈 0.05）. Multiple regression analysis showed FBG, WC, ALT and GGT were the risk factors of visfatin. After treatment, IR and plasma visfatin level significantly decreased in group A and B （P 〈 0.05）. There were no differences in IR and plasma visfatin before therapy between group A and B, but IR and plasma visfatin level were significant lower in group B after treatment （P 〈 0.05）. IR was positively correlated with visfatin. Conclusions Visfatin has correlation with T2DM, abdominal obesity and the progress of NAFLD probably by insulin resistance mechanism. Pioglitazone may interven the progress of NAFLD in T2DM.

关 键 词：VISFATIN 2型糖尿病 非酒精性脂肪肝 胰岛素抵抗 吡格列酮 

分 类 号：R58[医药卫生—内分泌]