吡格列酮、二甲双胍对2型糖尿病合并非酒精性脂肪肝患者血清视黄醇结合蛋白4、脂联素水平的影响比较  

Effect of Piglitazone and Metformin on Retinol-binding Protein-4 and Adiponcetin in Patients with Type 2 Diabetes Mellitus Complicated with Non-alcohol Fatty Acid Liver Diseases

作　　者：杨璐[1] 宋美情[1] 张秋玲[1] 寿岚[1] 臧淑妃[1] 杨燕丽[1] 

机构地区：[1]杭州师范大学附属医院内分泌科,杭州310015

出　　处：《中国医学科学院学报》2014年第3期309-312,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的比较吡格列酮和二甲双胍对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血清视黄醇结合蛋白-4(RBP-4)和脂联素(APN)水平的影响。方法将60例T2DM合并NAFLD患者随机分为吡格列酮组和二甲双胍组,在治疗前、后12周测定患者血生化指标、血清RBP-4和APN水平,并进行比较。结果治疗12周后,两组患者的体重指数、空腹血糖、胰岛素抵抗指数(HOMA-IR)、GHbA1C、空腹胰岛素(FIns)和三酰甘油水平均较治疗前显著降低(P均<0.05),APN水平较治疗前显著增高(P均<0.05)。吡格列酮组RBP-4水平较治疗前下降显著(P<0.05),二甲双胍组RBP-4水平与治疗前相比差异无统计学意义(P>0.05)。吡格列酮组的RBP-4、FIns和HOMA-IR水平明显低于二甲双胍组(P均<0.05),BMI水平明显高于二甲双胍组(P<0.05)。结论对于T2DM合并NAFLD的患者,吡格列酮在降低脂肪炎症因子RBP-4、改善胰岛素抵抗方面的效果优于二甲双胍。Objective To compare the effects of piglitazone and metformin on retinol-binding protein-4 （RBP-4） and adiponcetin （APN） in patients with type 2 diabetes mellitus （T2DM） complicated with Non alcohol fatty acid liver disease （NAFLD）.Methods Totally 60 T2DM patients complicated with NAFLD were equally and randomly divided into pioglitazone group and metform group.The levels of biochemical indicators including body mass index （BMI）,glucose hemoglobin A1c （GHbA1C）,insulin resistance （HOMA-IR）,fasting blood glucose （FBG）,fasting insulin （FIns）,and serum triglycerides （TG） as well as serum RBP-4 and APN level were measured pre-treatment and 12 weeks after treatments.Results After 12 weeks of treaments,BMI,FBG,HOMA-IR,GHbA1C,FIns,and TG decreased （all P ＜ 0.05） in both piglitazone group and metform group.APN increased （all P ＜0.05） in both groups.RBP-4 decreased （P ＜0.05） in piglitazone group.Compare with the metform group,the levels of RBP-4,FIns,and HOMA-IR decreased and BMI increased in piglitazone group （P ＜ 0.05）.Conclusion Piglitazone is superior to metoform in decreasing RBP-4 level and HOMA-IR in patients with T2DM complicated with NAFLD.

关 键 词：2型糖尿病 非酒精性脂肪肝 吡格列酮 二甲双胍 血清视黄醇结合蛋白-4 脂联素 

分 类 号：R587.1[医药卫生—内分泌]