肠促胰岛素治疗不同体质指数2型糖尿病合并非酒精性脂肪性肝病患者差异性分析  

Analysis of incretin on patients with different BMI of T2DM complicated with NAFLD

作　　者：王琛 陈婷婷 王滋滋 王怡文 杜进娟 刘新明 Wang Chen;Chen Tingting;Wang Zizi;Wang Yiwven;Du Jinjuan;Liu Xinming(Department of Endocrinology,PKU Care Zibo Hospital,Shandong 255000,China)

机构地区：[1]北大医疗淄博医院内分泌科,255000

出　　处：《山西医药杂志》2023年第15期1132-1135,共4页Shanxi Medical Journal

摘　　要：目的探索肠促胰岛素对于不同体质指数(BMI)的2型糖尿病患者合并非酒精性脂肪性肝病(NAFLD)的临床效果,分析2型糖尿病合并非酒精性脂肪性肝病患者NAFLD改善情况与BMI的相关性。方法从2020年6月至2021年6月纳入北大医疗淄博医院内分泌科收治的2型糖尿病合并NAFLD病患者120例,并根据不同BMI值分为3组。3组患者在维持原来的用药基础和饮食习惯上,每组均给予肠促胰素皮下注射,连续治疗24周后,观察并比较3组患者BMI、丙氨酸转氨酶(ALT)、甘油三酯(TG)、糖化血红蛋白(HbA_(1)c)、空腹血糖(FBG)、空腹胰岛素(FINS)、肝脏超声积分、胰岛素抵抗指数(HOMA-IR)变化情况。结果3组患者通过24周的肠促胰岛素治疗,各组BMI、ALT、TG、HbA_(1)c、FBG、肝脏超声积分评分均较治疗前明显下降,差异有统计学意义(P<0.05)。3组HOMA-IR较治疗前下降,差异有统计学意义;NAFLD改善情况与治疗前BMI呈正相关(r=0.37,P<0.05)。结论肠促胰岛素可以明显降低患者BMI,改善患者非酒精性脂肪性肝病状况,NAFLD改善情况与治疗前BMI呈正相关,对于2型糖尿病合并NAFLD病患者应用肠促胰岛素能够改善糖脂代谢,减轻胰岛素抵抗,逆转NAFLD及其不良结局。Objective To explore the clinical effect of incretin on non-alcoholic fatty liver disease(NAFLD)in type 2 diabetic patients with different body mass index(BMI),and to analyze the correlation between the improvement of NAFLD and BMI.Methods From June 2020 to June 2021,120 patients with type 2 diabetes mellitus complicated with NAFLD admitted to the Department of Endocrinology,Zibo Hospital of Peking University Medical College were enrolled and divided into 3 groups according to different BMI values.Patients in the three groups maintained the original medication basis and diet habits,each group was given incretin subcutaneously,after 24 weeks of continuous treatment.The BMI,alanine aminotransferase(ALT),triglyceride(TG),glycosylated hemoglobin(HbA_(1)c),fasting blood glucose(FBG),liver ultrasound score and insulin resistance index(HOMA-IR)were observed and compared among the three groups,and the changes were analyzed.Results After 24 weeks of incretin treatment,BMI,ALT,TG,HbAlc,FBG,and liver ultrasound scores of the three groups were significantly decreased compared with those before treatment(P<0.05),and the difference was statistically significant.Compared with before treatment,the HOMA-IR of group A,B and C decreased significantly after treatment(P<0.05).The improvement of NAFLD was positively correlated with pre-treatment BMI(r=0.37,P<0.05).Conclusion Incretin can significantly reduce BMI and improve the condition of NAFLD patients,and the improvement of NAFLD is significantly positively correlated with pre-treatment BMI.For patients with type 2 diabetes mellitus combined with NAFLD,incretin can improve glucose and lipid metabolism,reduce insulin resistance,and reverse NAFLD and its adverse outcomes.

关 键 词：糖尿病 2型 脂肪肝 非酒精性 肠促胰岛素类 利拉鲁肽 体质指数 

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