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利拉鲁肽治疗 2 型糖尿病合并非酒精性脂肪肝的疗效。

Efficacy of liraglutide in treating type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease.

机构信息

Department of Endocrinology and Metabolism, Shenzhen Guangming New District People's Hospital, Shenzhen 518000, China.

Department of Internal Medicine, Shenzhen Yantian District People's Hospital, Shenzhen 518000, China.

出版信息

Biosci Rep. 2018 Dec 21;38(6). doi: 10.1042/BSR20181304.

Abstract

Type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) is difficult to treat. The present study explored the efficacy of (liraglutide) Lira in treating T2DM complicated with NAFLD. A total of 127 patients suffering from T2DM complicated with NAFLD were enrolled in the present study, and randomly assigned to a Lira group (liraglutide injection: 0.6-1.2 mg/day, 12 weeks, =52) or a Metformin (Met) group (oral metformin: 1000-1500 mg/day, 12 weeks, =75). During the treatment phase, the values for fasting plasma glucose (FPG), 2 h plasma glucose (2hPG), glycated hemoglobin (HbA1c), aspartate aminotransferase (AST)/alanine aminotransferase (ALT), and adiponectin (APN) decreased in both the Lira and Met groups, and the levels of Δ2hPG, ΔAST/ALT, and ΔAPN in the Lira group were significantly lower than those in the Met group. The values for total cholesterol (TC), triglycerides (TG), low-and high-density lipoproteins (LDL and HDL), ALT, AST, weight, body mass index (BMI), waist to hip ratio (WHR), and C-reactive protein were markedly increased in both groups, and levels of ΔAST, ΔALT, Δweight, ΔBMI, ΔWHR, and ΔCRP (C-reactive protein) in the Lira group were significantly higher than those in the Met group. An analysis of treatment efficacy showed that liraglutide was better than metformin in its ability to significantly decrease the ALT levels in patients with combined T2DM and NAFLD. Furthermore, liraglutide was more effective than metformin at ameliorating the severity of T2DM complicated with NAFLD, and produced its effects by alleviating liver inflammation and improving liver function.

摘要

2 型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)难以治疗。本研究探讨了利拉鲁肽(liraglutide)治疗 T2DM 合并 NAFLD 的疗效。本研究共纳入 127 例 T2DM 合并 NAFLD 患者,随机分为利拉鲁肽组(liraglutide 注射:0.6-1.2 mg/天,12 周,=52)和二甲双胍组(metformin,口服二甲双胍:1000-1500 mg/天,12 周,=75)。在治疗期间,利拉鲁肽组和二甲双胍组的空腹血糖(FPG)、2 小时血糖(2hPG)、糖化血红蛋白(HbA1c)、天冬氨酸氨基转移酶(AST)/丙氨酸氨基转移酶(ALT)和脂联素(APN)值降低,利拉鲁肽组的Δ2hPG、ΔAST/ALT 和 ΔAPN 水平明显低于二甲双胍组。两组的总胆固醇(TC)、甘油三酯(TG)、低和高密度脂蛋白(LDL 和 HDL)、ALT、AST、体重、体重指数(BMI)、腰臀比(WHR)和 C 反应蛋白(CRP)明显升高,利拉鲁肽组的ΔAST、ΔALT、Δ体重、ΔBMI、ΔWHR 和ΔCRP(C 反应蛋白)水平明显高于二甲双胍组。治疗效果分析表明,利拉鲁肽在降低 T2DM 合并 NAFLD 患者 ALT 水平方面优于二甲双胍。此外,利拉鲁肽在改善 T2DM 合并 NAFLD 的严重程度方面优于二甲双胍,其作用机制可能是通过减轻肝脏炎症和改善肝功能。

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