艾塞那肽对2型糖尿病合并非酒精性脂肪性肝病的肝脏病变治疗评估

The effective assessment of diabetes mellitus and nonalcoholic fatty liver disease treated by Exenatide

目的通过脂肪肝指数(FLI)的变化来评价艾塞那肽对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者的脂肪肝治疗效果。方法选择经确诊的T2DM合并NAFLD患者102例,分为艾塞那肽单独治疗的艾塞那肽组和口服降糖药组,对治疗前及治疗24周后BMI、血脂、HbA1c、肝功能、FLI等指标变化进行分析,评估艾塞那肽对T2DM合并NAFLD患者肝脏病变的治疗效果。结果艾塞那肽组接受艾塞那肽治疗24周后,反应代谢的各项指标BMI、腰围、血脂及HbA1c等、反应肝脏病变程度的指标血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰胺转肽酶(GGT)及脂肪肝指数(FLI)等均有显著性改善(P<0.05)。而口服降糖药组治疗24周后仅BMI于治疗前比较差异有统计学意义(P<0.05),其余各指标差异均无统计学意义(P>0.05)。结论 T2DM患者中使用艾塞那肽对NAFLD产生积极的治疗效应,尤其是对肝脏内脂肪蓄积的情况有着明显的改善。

Objective To assess the effectiveness of Exenatide on non-alcoholic fatty liver disease（NAFLD） with diabetes mellitus by evaluating fatty liver index（FLI） variation. Methods One hundred and two NAFLD patients with type 2 diabetes melli tus were enrolled and divided into two groups. One group were treated with Exenatide and another with Oral antidiabetic agents. The data of BMI,blood fat,HbAlc,ALT,AST,GGT, FLI and so on were collected at enrollment and the end point of 24 weeks treatment. The effectiveness of Exenatide were analysed by Kolmogorov-Smirnov and Pearson correlation coefficient （r） analysis. Results The indicators of metabolic disorder,the parameters of liver biochemistry and fatty liver disease （FLI） were significantly improved （P〈0.05） after 24 weeks treatment by Exenatide. While only BMI showed significant decrease after 24 weeks treatment with Oral antidiabetic agents（P〈0.05）. The rest of the parameters in oral antidiabetic agants group showed no significant difference （P〉0.05）. Conclusion Exenatide has a positive effect on non-alcoholic fatty liver disease treatment who with type 2 diabetes mellitus,especially for liver fat accumulation.