司美格鲁肽联合二甲双胍对初诊2型糖尿病合并非酒精性脂肪性肝病患者血糖与胰岛β细胞功能和肝功能的影响  

Effects of semaglutide combined with metformin on blood glucose,islet β cell function and liver function in patients with newly diagnosed type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease

作　　者：袁娇 陈志雄[1] 吴明斌[1] YUAN Jiao;CHEN Zhixiong;WU Mingbin(Department of Endocrinology and Metabolism,Jiangxi Provincial People's Hospital,Nanchang,Jiangxi,330006,China)

机构地区：[1]江西省人民医院内分泌代谢科,江西南昌330006

出　　处：《当代医学》2024年第23期66-70,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(202210191)。

摘　　要：目的探讨司美格鲁肽联合二甲双胍对初诊2型糖尿病(type 2 diabetes mellitus,T2DM)合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者血糖、胰岛β细胞功能和肝功能的影响。方法选取2021年7月至2022年12月于江西省人民医院就诊的60例T2DM合并NAFLD患者作为研究对象,按照不同治疗方法分为观察组与对照组,每组30例。观察组采用司美格鲁肽联合二甲双胍治疗,对照组采用二甲双胍治疗。比较两组血糖指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(postprandial 2 h blood glucose,2 h PBG)、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbA1c)]、胰岛β细胞功能[稳态模型评估的胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、稳态模型评估的胰岛素β细胞功能(homeostasis model assessmentβ-cell function,HOMA-β)]、炎症因子[超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、可溶性白细胞介素-2受体(soluble interleukin-2 receptor,SIL-2R)]水平、肝功能指标[丙氨酸转氨酶(alanine aminotransferase,ALT)/天冬氨酸转氨酶(aspartate transaminase,AST)、γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,GGT)]和不良反应发生率。结果治疗后,两组FBG、2 h PBG、HbA1c、HOMA-IR水平均低于治疗前,HOMA-β水平高于治疗前,且观察组HbA1c、HOMA-IR水平均低于对照组,差异有统计学意义(P<0.05),两组间FBG、2 h PBG、HOMA-β水平比较差异均无统计学意义。治疗后,两组血清hs-CRP、SIL-2R水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清ALT、AST、GGT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组治疗期间均未出现任何严重不良反应,观察组不良反应发生率为3.33%,低于对照组的20.00%,但组间比较差异无统计学意义。结论司美格鲁肽联合二甲双胍治疗T2DM合并NAFLD疗效显著,能有效降低患者机�Objective To explore the effect of semaglutide combined with metformin on blood glucose,isletβcell function and liver function in patients with newly diagnosed type 2 diabetes mellitus(T2DM)complicated with non-alcoholic fatty liver disease(NAFLD).Methods 60 patients with T2DM complicated with NAFLD in Jiangxi Provincial People's Hospital from July 2021 to December 2022 were selected as the study subjects,and they were divided into the observation group and the control group,with 30 cases in each group.The observation group was treated with semiglutide combined with metformin,the control group was treated with metformin.Blood glucose index(fasting blood glucose[FBG],postprandial 2 h blood glucose[2 h PBG],glycosylated hemoglobin A1c[HbA1c]),isletβcell function(homeostasis model assessment of insulin resistance[HOMA-IR],homeostasis model assessmentβ-cell function[HOMA-β]),inflammatory factors(serum hypersensitive C-reactive protein[hs-CRP],soluble interleukin-2 receptor[SIL-2R]),liver function indicators(alanine aminotransferase[ALT]/aspartate transaminase[AST],γ-glutamyl transpeptidase[GGT])and the incidence of adverse reactions were compared between the two groups.Results After treatment,the levels of FBG,2 h PBG,HbA1c and HOMA-IR of the two groups were lower than before treatment,and the level of HOMA-βwere higher than before treatment,and the levels of HbA1c and HOMA-IR in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05),and there was no statistically significant difference in the levels of FBG,2 h PBG,HOMA-βbetween the two groups.After treatment,the levels of serum hs-CRP and SIL-2R of the two groups were lower than before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of serum ALT,AST and GGT levels of the two groups were lower than before treatment,and the observation group was lower than the control group,the difference

关 键 词：2型糖尿病 非酒精性脂肪性肝病 司美格鲁肽 二甲双胍 胰岛Β细胞 

分 类 号：R58[医药卫生—内分泌]