二肽基肽酶Ⅳ抑制剂对2型糖尿病合并非酒精性脂肪肝患者的治疗作用  

Therapeutic effect of dipeptidyl peptidase-4 inhibitor on patients with type 2 diabetes mellitus with nonalcoholic fatty liver disease

作　　者：张叶丽 陆雷群 马晓英 沈莹 高平 顾玺 杜晓岚 陈玲 

机构地区：[1]瑞金医院卢湾分院内分泌科,上海市200020

出　　处：《实用医学杂志》2017年第13期2160-2164,共5页The Journal of Practical Medicine

基　　金：上海市黄浦区卫生局科委课题(编号:HKW201446)

摘　　要：目的探讨二肽基肽酶Ⅳ(DPP-4)抑制剂对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)的治疗作用。方法选取2014年10月至2016年3月我院收治的T2DM合并NAFLD患者120例,将其平均且随机分为观察组和对照组,其中对照组给予T2DM常规治疗,观察组在常规治疗基础上给予DPP-4抑制剂治疗,分别测量两组患者的身高、体重、腰围、臀围:检测脂代谢指标、肝功能指标、空腹血糖(FPG)、餐后2 h血糖(2hPG)及糖化血红蛋白(HbA1c)、胰岛素(Ins)、C肽,计算其稳态模型评估-胰岛素抵抗指数(HOMA-IR)。结果观察组患者临床治疗脂肪肝总有效率(88.3%)高于对照组总有效率(78.3%),差异有统计学意义;治疗组糖尿病患者FPG、2hPG及HbA1c水平、HOMA-IR、脂代谢指标低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)及甘油三酯(TG)、肝功能指标天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(γ-GT)水平均低于对照组,差异有统计学意义。结论 DPP-4治疗T2DM合并NAFLD患者疗效显著,能够显著降低血糖同时改善胰岛素抵抗,对患者血糖控制及脂代谢调节具有较佳效果。Objective To explore therapeutic effect of dipeptidyl peptidase IV inhibitor on type 2 diabetes mellitus with nonalcoholic fatty liver disease. Methods 120 patients suffering type 2 diabetes mellitus with nonalcoholic fatty liver disease from October 2014 to March 2016 in our hospital were randomly divided into two groups ： treatment group and control group. Both groups were given type 2 diabetes conventional treatment, and the treatment group was given dipeptidyl peptidase IV inhibitor in addition. Height, weight, waist circumference, hip circumference were measured. Lipid metabolism and, function index, FPG, 2 h PG, HbAlc, Ins, C peptide were detected. HOMA-IR was calculated. Results The total effective rate of clinical treatment of fatty liver in the treatment group （ 88.3% ） was higher than the control group （78.3%）. The difference was statistically significant. FPG, 2hPG, HbAle, HOMA-IR, LDL-C, TC, TG, AST, ALT and γ-GT in the treatment group were lower than the control group. The difference was also statistically significant. Conclusion The efficacy of sitagliptin in the treatment of type 2 diabetes with nonalcoholic fatty liver was significant. It can also significantly reduce blood glucose and insulin resistance. Furthermore, it has a better effect on the patients with blood glucose control and lipid metabolism regulation.

关 键 词：2型糖尿病 非酒精性脂肪肝 二肽基肽酶IV抑制剂 

分 类 号：R575.5[医药卫生—消化系统] R587.1[医药卫生—内科学]