利拉鲁肽对2型糖尿病合并非酒精性脂肪性肝病患者糖脂代谢及胰岛素抵抗的影响  

Effects of liraglutide on glucose and lipid metabolism and insulin resistance in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease

作　　者：谢晶 杨淼 邢英[2] Xie Jing;Yang Miao;Xing Ying(Department of Pharmacy,the Seventh Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;Department of Comprehensive Internal Four,Xinjiang Medical University First Affiliated Hospital,Urumqi 830000,China)

机构地区：[1]新疆医科大学第七附属医院药学部,乌鲁木齐830000 [2]新疆医科大学第一附属医院综合内四科,乌鲁木齐830000

出　　处：《中国肝脏病杂志（电子版）》2021年第4期46-53,共8页Chinese Journal of Liver Diseases：Electronic Version

基　　金：新疆维吾尔自治区自然科学基金(2017D01C343)。

摘　　要：目的探讨利拉鲁肽对2型糖尿病合并非酒精性脂肪性肝病(non-alcoholic fatty liverdisease,NAFLD)患者糖脂代谢及胰岛素抵抗的影响。方法回顾性分析2018年1月至2020年1月于新疆医科大学第七附属医院就诊的84例2型糖尿病合并NAFLD患者的临床资料,根据用药不同分为观察组(43例)和对照组(41例),对照组患者采用二甲双胍治疗,观察组患者采用二甲双胍联合利拉鲁肽治疗,疗程3个月。检测两组患者治疗前后血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血脂(甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白)、胰岛素抵抗指数、胰岛β-细胞功能指数、脂肪肝严重程度、体重指数(body mass index,BMI)、肝功能[丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartateaminotransferase,AST)],记录患者不良反应。结果(1)治疗后,两组患者空腹血糖[观察组:(5.42±0.63)mmol/L vs(8.87±0.65)mmol/L;对照组:(6.49±0.55)mmol/L vs(8.92±0.71)mmol/L]、餐后2 h血糖[观察组:(8.27±0.95)mmol/L vs(13.84±1.25)mmol/L;对照组:(11.19±1.04)mmol/L vs(13.69±1.18)mmol/L]和糖化血红蛋白[观察组:(5.62±0.64)%vs(7.37±0.87)%;对照组:(6.34±0.71)%vs(7.44±0.75)%]水平均较治疗前显著降低,且观察组显著低于对照组(P均<0.05)。(2)治疗后,两组患者甘油三酯[观察组:(1.80±0.27)mmol/L vs(3.12±0.37)mmol/L;对照组:(2.51±0.32)mmol/L vs(3.05±0.41)mmol/L]、总胆固醇[观察组:(5.31±0.59)mmol/L vs(6.70±0.67)mmol/L;对照组:(5.94±0.65)mmol/L vs(6.64±0.73)mmol/L]和低密度脂蛋白[观察组:(2.42±0.27)mmol/L vs(3.59±0.39)mmol/L;对照组:(2.93±0.31)mmol/L vs(3.65±0.34)mmol/L]水平均显著低于治疗前,高密度脂蛋白水平显著高于治疗前[观察组:(1.63±0.53)mmol/L vs(1.21±0.40)mmol/L;对照组:(1.33±0.41)mmol/L vs(1.16±0.37)mmol/L],差异有统计学意义(P均<0.05)。治疗后,观察组甘油三酯、总胆固醇和低密度脂蛋白水平均显著低�Objective To investigate the effects of liraglutide on glucose and lipid metabolism and insulin resistance in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease(NAFLD).Methods The clinical data of 84 patients with type 2 diabetes mellitus complicated with NAFLD in the Seventh Affiliated Hospital of Xinjiang Medical University from January 2018 to January 2020 were retrospectively analyzed.The patients were divided into observation group(43 cases)and control group(41 cases)according to the different treatment.Patients in control group were treated with metformin and patients in observation group were treated with metformin combined with liraglutide for 3 months.Glucose indexes(fasting plasma glucose,2 h postprandial blood glucose,glycosylated hemoglobin),lipid metabolism indexes(triglyceride,total cholesterol,low density lipoprotein,high density lipoprotein),insulin resistance index,isletβcell function index,severity of fatty liver,body mass index(BMI),liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]and adverse reactions were observed before and after treatment.Results(1)After treatment,the fasting blood glucose[observation group:(5.42±0.63)mmol/L vs(8.87±0.65)mmol/L;control group:(6.49±0.55)mmol/L vs(8.92±0.71)mmol/L],2 h postprandial blood glucose[observation group:(8.27±0.95)mmol/L vs(13.84±1.25)mmol/L;control group:(11.19±1.04)mmol/L vs(13.69±1.18)mmol/L]and glycosylated hemoglobin[observation group:(5.62±0.64)%vs(7.37±0.87)%;control group:(6.34±0.71)%vs(7.44±0.75)%]levels of patients in two groups were significantly lower than those before treatment,and the above indexes of patients in observation group were significantly lower than those of control group(all P<0.05).(2)After treatment,the triglyceride[observation group:(1.80±0.27)mmol/L vs(3.12±0.37)mmol/L;control group:(2.51±0.32)mmol/L vs(3.05±0.41)mmol/L],total cholesterol[observation group:(5.31±0.59)mmol/L vs(6.70±0.67)mmol/L;control group:(5.94±0.65)mmol/L vs(6.64±0.73)mmol/L]and l

关 键 词：利拉鲁肽 2型糖尿病 脂肪性肝病 非酒精性 血糖 血脂 胰岛素抵抗 

分 类 号：R587.2[医药卫生—内分泌] R575.5[医药卫生—内科学]