二甲双胍对非酒精性脂肪性肝病氧化应激的影响

Effect of metformin on oxidative stress of non-alcholic liver disease

目的探讨二甲双胍对非酒精性脂肪肝病氧化应激的影响。方法非酒精性肝病患者65例,随机分为治疗组32例和对照组33例。2组均给予饮食、运动治疗,治疗组加用二甲双胍0.5g,每日2次,疗程6个月。观察2组治疗前后体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)、丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、超氧化物歧化酶(SOD)、丙二醛(MDA),并计算胰岛素抵抗指数(HOMA-IR),肝脏B超或CT。结果治疗组在降低LDL-C、TG、TC、FINS、ALT、AST、HOMA-IR、肝脾CT比值以及MDA方面,明显优于对照组(P<0.05),SOD显著升高(P<0.01)。结论二甲双胍能改善胰岛素抵抗,提高抗氧化应激的能力,从而发挥对非酒精性脂肪肝病的治疗作用。

Objective To observe the effect of metformin on oxidative stress of non-alcoholic fatty liver disease（NAFLD）.Methods The subjects were divided into two groups：the metformin group with 32 patients and the control group with 33.Except lifestyle intervention,metformin was also used in the treatment group for 6 months.Before and after treatment,body mass index（BMI）,low density lipoprotein cholesterol（LDL-C）,triglyceride（TG）,total cholesterol（TC）,high density lipoprotein cholesterol（HDL-C）,fasting serum insulin（FINS）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,superoxide dismutase（SOD）,malondialdehyde（MDA）,and the insulin resistance index（HOMA-IR）were measured,and the liver B ultrasound or CT examination in the evaluation of hepatic steatosis degree was also used.Results Life-style intervention could improve ALT,AST,but metformin group in reducing LDL-C,TG,TC,FINS,ALT,AST,HOMA-IR,CT ratio and MDA were obviously better than the control group（P〈0.05）,SOD in the metformin group increased significantly（P〈0.01）.Conclusion Metformin can improve insulin resistance and oxidative stress in the treatment of NAFLD.