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罗格列酮治疗中国 2 型糖尿病患者异常肝酶的改善。

Improvement of abnormal liver enzymes after rosiglitazone treatment in Chinese type 2 diabetes.

机构信息

Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Catholic Fu-Jen University, Taipei, Taiwan, ROC.

出版信息

Indian J Pharmacol. 2012 May;44(3):372-6. doi: 10.4103/0253-7613.96340.

Abstract

OBJECTIVES

Insulin resistance is one of the important underlying abnormalities of type 2 diabetes. The effect of thiazolidinedione on liver functions has been controversial in different studies. In this study, we evaluated the effect of rosiglitazone on liver enzymes in subjects with type 2 diabetes with and without abnormal liver function.

MATERIALS AND METHODS

Seventy-three patients with type 2 diabetes taking rosiglitazone 4 mg daily were enrolled in this 3-month study. Forty-two of them had normal liver function (NLF), and 31 had abnormal liver function (ABLF). Blood biochemistries were collected monthly during the treatment period.

RESULTS

At baseline, other than age and liver enzymes, there were no differences in body mass index, fasting plasma glucose, hemoglobin A1c (HbA1c), and lipid profiles between the NLF and ABLF groups. At the end of the treatment, HbA1c was lowered in both groups, but only significantly in the ABLF group (P = 0.027). More importantly, serum concentrations of both aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the ABLF group decreased significantly (AST: 57.8 ± 26.5 to 47.5 ± 20.2 U/L, P = 0.006; ALT 66.6 ± 35.0 to 51.9 ± 23.5 UL, P = 0.004), while in the NLF group, a similar change was not found.

CONCLUSION

After 3-month rosiglitazone treatment in subjects with type 2 diabetes with mildly elevated liver enzymes, significant improvement in AST and ALT were observed. Our study provides some hints that rosiglitazone might not be contraindicated in subjects with diabetes with abnormal liver function as previously thought, but further well-designed studies are necessary to clarify this issue.

摘要

目的

胰岛素抵抗是 2 型糖尿病的重要潜在异常之一。不同研究中噻唑烷二酮类药物对肝功能的影响存在争议。在本研究中,我们评估了罗格列酮对肝功能异常和正常的 2 型糖尿病患者的肝酶的影响。

材料和方法

本 3 个月研究纳入了 73 名每天服用罗格列酮 4mg 的 2 型糖尿病患者。其中 42 名患者肝功能正常(NLF),31 名患者肝功能异常(ABLF)。治疗期间每月采集血液生化指标。

结果

基线时,除年龄和肝酶外,NLF 和 ABLF 两组之间的体重指数、空腹血糖、糖化血红蛋白(HbA1c)和血脂谱均无差异。治疗结束时,两组的 HbA1c 均降低,但仅 ABLF 组有统计学意义(P=0.027)。更重要的是,ABLF 组的天冬氨酸氨基转移酶(AST)和丙氨酸氨基转移酶(ALT)血清浓度显著降低(AST:57.8±26.5 至 47.5±20.2U/L,P=0.006;ALT:66.6±35.0 至 51.9±23.5U/L,P=0.004),而 NLF 组则没有发现类似的变化。

结论

在轻度升高肝酶的 2 型糖尿病患者中,使用罗格列酮治疗 3 个月后,AST 和 ALT 显著改善。我们的研究提示,罗格列酮可能不像之前认为的那样在肝功能异常的糖尿病患者中是禁忌的,但需要进一步的精心设计的研究来阐明这个问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd76/3371462/5f005a085e4d/IJPharm-44-372-g003.jpg

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