利拉鲁肽联合二甲双胍治疗初诊2型糖尿病合并非酒精性脂肪肝的疗效观察

Clinical observation on the efficacy of liraglutide combined with metformin in the treatment of type2diabetes mellitus with non-alcoholic fatty liver

目的观察利拉鲁肽联合二甲双胍对初诊2型糖尿病合并非酒精性脂肪肝(NAFLD)的疗效。方法选取40例新诊断2型糖尿病合并脂肪肝患者,随机分为对照组和观察组,在生活方式干预治疗基础上,观察组给予二甲双胍500 mg口服,3次/d,利拉鲁肽注射液1.8 mg皮下注射,1次/d,对照组仅给予二甲双胍500 mg口服,3次/d,治疗12周后,对两组患者的腰围、BMI、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、总胆固醇(TC)、甘油三酯(TG)、转化生长因子β(TGF-β)及脂肪肝改善程度进行比较,判断两组患者的疗效,记录不良事件。结果与对照组比较,观察组腰围、BMI、FPG、2hPG、HbA1c、TG、TGF-β及脂肪肝程度均明显改善(P <0. 05),两组不良反应的差异无统计学意义(P>0.05)。结论利拉鲁肽联合二甲双胍对初诊2型糖尿病合并脂肪肝的患者有显著疗效。

Objective To observe the clinical efficacy of liraglutide combined with metformin in the treatment of newly diagnosed type2 diabetes mellitus （T2DM） accompanying non-alcoholic fatty liver disease （NAFLD）. Methods 40 newly diagnosed patients with type 2 diabetes combined with fatty liver were randomly divided into observation group and control group. On the basis of lifestyle intervention, the observation group was given metformin 500 mg, oral, 3 times/d, Liraglutide Injection 1.8 mg, subcutane- ous injection, 1 times/d, and the control group was given metformin 500 mg, orally,3 times/d. The treat- ment process lasted for 12 weeks. Waist circumference, body mass index （BMI） , fasting plasma glucose （FPG） ,2 hour postprandial glucose （2 h PG）, glycosylated hemoglobin A lc （HbAlc）, alanine amin- otransferase （ALT）, aspartate transaminase （AST）, glutamyl transpeptidase （GGT）, total cholesterol （TC）, triglyceride （TG）, Transforming growth factor beta （TGF-β） and the degree of fatty liver were com- pared before and after treatment, and the adverse events were recorded. Results Compared with the con- trol group, the degree of WC, BMI, FPG, 2 h PG, HbAlc, TG, TGF-beta and fatty liver were significantly improved in the observation group （ P 〈 0. 05 ）. There was no significant difference in adverse reactions be- tween the two groups （P 〉 0. 05 ）. Conclusions Liraglutide combined with metformin is a new kind of safe and effective treatment for T2DM accompanying NAFLD.