艾塞那肽改善肥胖2型糖尿病合并非酒精性脂肪性肝病的疗效观察  

Observation of the effects of exenatide on hepatic biomarkers in obese type 2 diabetic patients with non-alcoholic fatty liver disease

作　　者：范慧[1] 潘清蓉[1] 刘佳[1] 王广[1] 徐援[1] 

机构地区：[1]首都医科大学附属朝阳医院内分泌科,北京100020

出　　处：《中国糖尿病杂志》2014年第9期820-823,共4页Chinese Journal of Diabetes

摘　　要：目的观察艾塞那肽对T2DM合并非酒精性脂肪性肝病(NAFLD)患者血糖、体重和肝酶学指标的治疗效果。方法 T2DM合并NAFLD患者117例,随机分为艾塞那肽组和二甲双胍组,治疗12周,观察体重、血糖、血脂、胰岛素抵抗指数(HOMA-IR)、肝酶学指标、脂联素(APN)及高敏C反应蛋白(hsC-RP)的变化。结果与二甲双胍组相比,艾塞那肽组体重[(76.09±9.85)vs(77.22±10.15)kg]、WHR[(0.94±0.05)vs(0.96±0.04)]、谷丙转氨酶[(39.82±14.05)vs(51.48±18.89)U/L]、谷草转氨酶[(25.61±7.87)vs(31.54±10.75)U/L]、谷氨酰转肽酶[(47.53±15.80)vs(53.44±15.00)U/L]和hsC-RP[(2.18±0.34)vs(2.69±0.53)mg/L]明显降低(P<0.05或P<0.01);APN水平[(10.44±3.29)vs(8.48±2.67)mg/L]明显升高。结论与二甲双胍相比,艾塞那肽用于T2DM合并NAFLD患者在有效控制血糖及降低体重的同时可更好地改善肝酶学指标。Objective To evaluate the curative effect of exenatide on the plasma glucose, body weight and liver enzymology in obese type 2 diabetic patients with non-alcoholic fatty liver disease （NAFLD）. Methods 117 cases of obese type 2 diabetic patients with NAFLD were randomly divided into two groups. Who were given exenatide and metformin treatment respectively for 12 weeks. The changes of body weight, blood glucose, lipids, insulin resistance index （HOMA-IR）, liver enzymes, adiponectin（APN） and high-sensitive C-reactive protein （hsC-RP） were measured and evaluated. Results After treatment with exenatide versus metformin for 12 weeks,weight [（76. 09±.85） vs （77.22±10. 15）kg] ,waist-hip ratio [（0. 94±0. 05） vs （0. 96±0. 04）] ,alanine transaminase [（39. 82±14.05） vs （51.48±18.89） U/L], aspartate aminotransferase[（25.61 ± 7.87） vs （31.54± 10. 75）U/L], glutamyl transpeptidase [（47.53±15.80） vs （53.44±15.00）U/L]and hsC-RP [（2. 18±0. 34） vs （2.69±0. 53） mg/L] were significantly lower in exenatide group than in metformin group（all P〈0.05 or P〈0. 01） ,and plasma adiponectin level was obviously higher in exenatide group than in metformin group[（10. 44±3.29） vs（8. 47±2.67）]（P〈0.05 or P〈0.01）. There were no significant difference in HbA1 c, HOMA-IR, and lipid metabolism marker between two groups. Conclusion Compared with metformin, exenatide can control plasma glucose and lower body weight effectively, and improve liver enzymolog of type 2 diabetic patients with NAFLD significantly.

关 键 词：糖尿病 2型 非酒精性脂肪性肝病 艾塞那肽 二甲双胍 

分 类 号：R587.1[医药卫生—内分泌] R575.5[医药卫生—内科学]