利拉鲁肽应用于2型糖尿病合并非酒精性脂肪肝患者的疗效及安全性分析

Efficacy and Safety of Liraglutidein Treatment on Type 2 Diabetes Mellitus with Non-alcoholic Fatty Liver

目的观察利拉鲁肽治疗2型糖尿病合并非酒精性脂肪肝患者的疗效和安全性。方法随机选择40例符合诊断标准的2型糖尿病合并NAFLD患者,口服二甲双胍,每天2次,每次1g,疗程12周,同时给予利拉鲁肽,初始剂量0.6mg,1次/d,睡前皮下注射,疗程12周。第2周调整剂量为1.2 mg/d,第3周调整为1.8 mg/d,若不能耐受则维持0.6 mg/d,症状缓解再按上述原则加量。若为非初诊治疗的患者,在纳入前停服其他药物(二甲双胍除外)。比较治疗前后体重、体质指数(BMI)、空腹血糖(FPG)、餐后2h血糖(2h PG)、糖化血红蛋白(Hb A1c),以及肝功指标:谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT),脂代谢及其他指标:总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),血尿酸(UA),同时观察用药期间有无不良反应。结果患者体重、BMI、FPG、2h PG、Hb A1c均较治疗前下降(P<0.05);ALT、AST、GGT及SUA均较治疗前下降(P<0.05);治疗后血脂水平(低密度脂蛋白、甘油三酯、总胆固醇)较治疗前降低,差异有统计学意义(P<0.05)。治疗过程中无低血糖及其他严重的不良反应。结论利拉鲁肽治疗2型糖尿病合并NAFLD患者,可有效安全降糖,改善肝功能,同时调脂并降低体重。

Objective To observe the efficacy and safety of liraglutidein treatmenton type 2 diabetes patients with non-alcoholic fatty liver（NAFLD）.Methods We randomly selected 40 patients who met the diagnostic criteria of type 2 diabetes with NAFLD patients.Subjects were given metformin and liraglutide for 12 weeks.The body weight,body mass index（BMI）,fasting plasma glucose（FPG）,postprandial 2H plasma glucose（2h PG）,glycosylated hemoglobin（Hb A1c）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,valley ammonia acyl turn peptidase（GGT）,blood uric acid（SUA）,total cholesterol（TC）,triglyceride（TG）,lowdensity lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C） were all compared before and after the treatment and between groups.Results The body weight,BMI,FPG,2h PG,Hb A1 cdecreased compared to before treatment（P〈0.05）.ALT 、AST 、GGT and SUA all decreased significantly compared tobefore treatment（P〈0.05）.The serum lipid levels（lowdensity lipoprotein,triglyceride,total cholesterol（TC） decreased,the difference is statistically significant（P〈0.05）after treatment.No hypoglycemia and other severe adverse reactions during treatment.Conclusion Liraglutidetreatment type 2 diabetic patients with NAFLD issafe and effective.It can lower blood sugar,improve liver function,regulateblood lipids and reducebody weight.