Medicare Cardiac and General Hospital, Sohail University, Karachi, Pakistan.
Department of Pharmacology, Jinnah Medical and Dental College, Sohail University, Karachi, Pakistan.
J Pak Med Assoc. 2024 Sep;74(9):1654-1658. doi: 10.47391/JPMA.11151.
To determine the prevalence of non-alcoholic fatty liver disease, and the effect of oral hypoglycaemic drugs and lifestyle modifications in reducing fatty liver changes and liver enzymes in these patients.
The comparative, observational study was conducted at the Department of Pharmacology, Sohail University, Karachi, from October 2022 to October 2023, and comprised patients of either gender having elevated liver enzymes and ultrasound finding of fatty liver changes along with raised glycated haemoglobin, transaminases, total cholesterol and triglycerides. The participants were prescribed oral hypoglycaemic agents by endocrinologists. Those given empaglifazolin + metformin were in group A, empaglifazolin + linglaptin in group B, sitaglaptin + metformin in group C, metformin alone in group D and sitaglaptin alone in group E. Lifestyle modifications were advised in all the treatment groups, while control group F was only advised lifestyle modifications. The intervention lasted 3 months. Investigations included B-mode ultrasound liver, liver enzymes and glycated haemoglobin, which were done at baseline and after the intervention. Data was analysed using SPSS 25.
Of 200 patients, 40 were males and 160 were females in ratio of 1:4. The overall mean age was 48±16 years. There were 154(77%) patients who had non-alcoholic fatty liver disease with type 2 diabetes mellitus, while 46(23%) had only fatty liver changes. There were 50(25%) patients in group A, 30(15%) in group B, 30(15%) in group C, 40(20%) in group D, 10(5%) in group E and 40(20%) in group F. Post-intervention improvement was noted in 48(24%) patients, with 20(41.7%) of them being in group A.
The prevalence of non-alcoholic fatty liver disease with type 2 diabetes was high. Combination of empagliflozin + metformin along with lifestyle modifications was highly effective in reducing fatty changes and the level of liver enzymes.
确定非酒精性脂肪性肝病的患病率，以及口服降糖药物和生活方式改变在减少这些患者的脂肪肝变化和肝酶方面的效果。
本对比观察性研究于 2022 年 10 月至 2023 年 10 月在卡拉奇苏海尔大学药理学系进行，纳入了肝酶升高且超声检查发现脂肪肝改变以及糖化血红蛋白升高、转氨基酶、总胆固醇和甘油三酯升高的男女患者。内分泌学家为这些患者开了口服降糖药。接受恩格列净+二甲双胍治疗的患者归入 A 组，接受恩格列净+利格列汀治疗的归入 B 组，接受西格列汀+二甲双胍治疗的归入 C 组，单独接受二甲双胍治疗的归入 D 组，单独接受西格列汀治疗的归入 E 组。所有治疗组均接受生活方式改变建议，而仅给予生活方式改变建议的对照组归入 F 组。干预持续 3 个月。基线和干预后进行 B 型超声肝、肝酶和糖化血红蛋白检查。使用 SPSS 25 进行数据分析。
200 名患者中，男性 40 名，女性 160 名，男女比例为 1:4。总体平均年龄为 48±16 岁。154 名（77%）患者患有 2 型糖尿病合并非酒精性脂肪性肝病，46 名（23%）仅患有脂肪肝改变。A 组 50 名（25%）、B 组 30 名（15%）、C 组 30 名（15%）、D 组 40 名（20%）、E 组 10 名（5%）和 F 组 40 名（20%）。干预后，有 48 名（24%）患者病情改善，其中 A 组有 20 名（41.7%）。
2 型糖尿病合并非酒精性脂肪性肝病的患病率较高。恩格列净+二甲双胍联合生活方式改变在减少脂肪肝变化和肝酶水平方面非常有效。
