二甲双胍联合吡格列酮对初发2型糖尿病并发非酒精性脂肪肝的疗效及对血清Vaspin水平的影响

Effect of metformin and pioglitazone on first-onset diabetic patients with fatty liver and serum Vaspin level

目的观察二甲双胍联合吡格列酮对初发2型糖尿病(type 2diabetes mellitus,T2DM)并发非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)的疗效及对血浆Vaspin水平的影响。方法初发T2DM并发NAFLD患者44例应用二甲双胍和吡格列酮治疗半年,观察治疗后血糖、胰岛素抵抗指数、肝功能及血清Vaspin水平的变化。结果初发T2DM并发NAFLD患者血清Vaspin水平高于初发T2DM未并发NAFLD及正常对照组(P<0.01),T2DM并发NAFLD组应用二甲双胍和吡格列酮治疗后血清空腹血糖、糖化血红蛋白、胰岛素抵抗指数、天冬氨酸转氨酶、丙氨酸转氨酶、γ-谷氨酰转移酶及Vaspin水平与治疗前比较均显著降低(P<0.05或<0.01)。结论二甲双胍吡格列酮联合对初发T2DM并发NAFLD患者治疗有效,并可以显著降低其血清Vaspin水平,血Vaspin水平可作为T2DM发生NAFLD的风险因子。

Objective To investigate the effect of metformin and pioglitazone treatment on nonalcoholic fatty liver disease （NAFLD） patients with first-onset type 2 diabetes mellitus （T2DM） and serum Vaspin levels of these patients. Methods Forty-four first-onset T2DM patients with NAFLD were treated with metformin and pioglitazone combination for six months. Blood glucose,liver function and Vaspin levels after treatment were detected.Results The serum Vaspin levels in T2DM with NAFLD were significantly higher than those in T2DM without NAFLD and normal control group （both P〈 0.01）. After the treatment with metformin and pioglitazone for six months, the fasting blood glucose, glycosylated hemoglobin, HOMA-insulin resistance index,aspartate transferase, alanine transferase, gama glutamyl transferase and Vaspin levels were also significantly decreased （P〈0.05 or 〈 0.01）. Conclusion Metformin and pioglitazone therapy is effect in first-onset T2DM with NAFLD. Elevated plasma Vaspin levels significantly decreased after treatment.The level of serum Vaspin could be used to predict the risk of NAFLD in T2DM.