二甲双胍对2型糖尿病合并非酒精性脂肪肝患者血清FGF-21和血浆hs-CRP水平的影响

Effects of metformin on serum FGF21 and plasma hs-CRP levels in patients with type 2 diabetes mellitus with non-alcoholic fatty liver

目的探讨二甲双胍对2型糖尿病合并非酒精性脂肪肝患者血清成纤维细胞生长因子21(FGF-21)和血浆超敏-C反应蛋白(hs-CRP)水平的影响。方法抽取大同市第三人民医院2018年2月至2019年10月收治的2型糖尿病合并非酒精性脂肪肝患者84例,采用随机数表法分为对照组42例和观察组42例,对照组采用胰岛素皮下注射,观察组采用胰岛素皮下注射联合二甲双胍口服治疗,对两组患者治疗前后hs-CRP、FGF-21水平变化进行分析。结果两组患者治疗后血糖水平得到有效控制,观察组治疗后空腹血糖(FPG)、餐后2 h血糖(2hPG)、胰岛素抵抗指数(HOMA-IR)水平低于对照组,差异有统计学意义(P<0.05);对照组治疗后hs-CRP、FGF-21与肝脏脂肪含量下降,但差异未见统计学意义(P>0.05);观察组治疗后hs-CRP、FGF-21、肝脏脂肪含量低于治疗前,差异有统计学意义(P<0.05)。结论在常规方案的基础上联合二甲双胍治疗2型糖尿病合并非酒精性脂肪肝,可有效控制患者血糖水平,降低其胰岛素抵抗,并有助于减少肝脏脂肪含量,促进hs-CRP、FGF-21水平下降,对于控制患者肝脏病变进展、改善其肝功能具有积极作用。

Objective To investigate the effect of metformin on plasma high-sensitivity-C reactive protein(hs-CRP)and serum fibroblast growth factor 21(FGF-21)levels in patients with type 2 diabetes mellitus with non-alcoholic fatty liver.Methods Eighty-four patients with type 2 diabetes and non-alcoholic fatty liver admitted to the Third People’s Hospital of Datong from February 2018 to October 2019 were selected and divided into control group(42 cases)and observation group(42 cases)according to random number table method,and the control group were treated with insulin subcutaneous injection,and the observation group was treated with insulin subcutaneous injection combined with metformin.The changes of hs-CRP and FGF-21 levels before and after treatment were detected and analyzed in the two groups.Results The blood glucose levels of the two groups of patients were effectively controlled after treatment.The fasting plasma glucose(FPG),and 2-hour plasma glucose(2hPG),and homeostatic model assessment of insulin resistance(HOMA-IR)levels of the observation group were lower than those of the control group after treatment(P<0.05);hs-CRP,FGF-21,and liver fat content of the control group patients decreased,but the difference was not statistically significant(P>0.05).The contents of hs-CRP,FGF-21,and liver fat in observation group after treatment before treatment,the difference was statistically significant(P<0.05).Conclusions Combined metformin in the treatment of type 2 diabetes with non-alcoholic fatty liver on the basis of conventional regimen can effectively control blood glucose levels of patients,reduce their insulin resistance,and help reduce liver fat content,promote the decline of hs-CRP,FGF-21 levels,and have a positive effect on controlling the progress of liver disease and improving liver function.