甘草酸二铵脂质配位体对非酒精性脂肪性肝病糖脂代谢的影响

Effects of diammonium glycyrrhizinate lipid ligand on glucolipid metabolism in nonalcoholic fatty liver disease

目的观察甘草酸二铵脂质配位体(DGLL)对非酒精性脂肪性肝病(NAFLD)的治疗作用以及糖脂代谢的影响。方法选取NAFLD患者66例,随机分为DGLL组35例和PPC组31例,分别给予甘草酸二铵肠溶胶囊(DGLL)和多烯磷脂酰胆碱胶囊(PPC)。观察治疗1月、3月两组转氨酶、血脂、空腹胰岛素(FINS)、HOME-IR等血清学指标及治疗3月肝脏脂肪变性程度的变化。结果治疗1月DGLL组和PPC组转氨酶均较治疗前水平下降(P<0.05);治疗3月两组转氨酶、血脂均较治疗前水平下降(P<0.05),治疗3月较1月两组转氨酶下降更明显(P<0.05),且DGLL组转氨酶及血脂的下降较PPC组明显(P<0.05)。治疗3月DGLL组FINS、HOME-IR较治疗前水平降低(P<0.05),两组瘦素较治疗前水平降低,脂联素较治疗前水平升高(P<0.05),但两组间瘦素和脂联素水平差异无统计学意义(P>0.05)。治疗3月DGLL组肝脏脂肪变性程度较治疗前明显改善(P<0.05)。结论 DGLL、PPC能显著降低NAFLD患者转氨酶、血脂水平,治疗3月效果更显著;且在降低转氨酶及血脂方面,DGLL优于PPC。长期应用DGLL能通过降低瘦素、升高脂联素水平、改善胰岛素抵抗以及改善肝脏脂肪变性程度来影响NAFLD的糖脂代谢。

Objective To explore the therapeutic effect of diammonium glycyrrhizinate lipid ligand（DGLL） on nonalcoholic fatty liver disease（NAFLD） and glucolipid metabolism. Methods Sixty-six NAFLD patients were randomly divided into DGLL group（ diammonium glycyrrhizinate enteric-coated capsule） and PPC group（ polyene phosphatidyl choline capsule）. The changes of serological indicators such as transaminase,blood lipid,fasting insulin（ FINS） and HOME-IR were observed after treatment for 1 and 3 months,and the degree of liver steatosis was observed after treatment for 3 months. Results The level of transaminase reduced after treatment for 1month in DGLL group and PPC group（ P〈0. 05）; both transaminase and blood lipid reduced after treatment for 3 months in the two groups（ P〈0. 05）,the levels of transaminase in the two groups at 3 month after treatment were lower than that at 1 month. The levels of transaminase and blood lipid were significantly lower in DGLL group than in PPC group. Both FINS and HOME-IR reduced after treatment for 3 month in DGLL group（ P〈0. 05）. The level of leptin reduced and the level of adiponectin elevated after 3-month treatment in the two groups（ P〈0. 05）,however,there was no statistical significance between the two groups（ P〈0. 05）. The degree of liver steatosis in DGLL group was obviously improved after treatment for 3 months（ P〈0. 05）. Conclusion DGLL and PPC could significantly reduce the levels of transaminase and lipid in NAFLD patients,and the effect is better after treatment for 3 months. Moreover,DGLL is better than PPC in lowering transaminase and blood lipid. Long term use of DGLL could affect the lipid metabolism of NAFLD patients by reducing leptin,elevating lipid levels,and improving insulin resistance and liver fat variability.