胰高血糖素样肽-1受体激动剂对改善2型糖尿病伴代谢相关脂肪性肝病患者糖脂水平及肝脏脂肪含量的影响

Clinical study of glucagon-like peptide-1 receptor agonist on improving glucose and lipid levels and liver fat content in patients with type 2 diabetes mellitus complicated with metabolic-related fatty liver disease

目的研究探讨胰高血糖素样肽-1(GLP-1)受体激动剂对改善2型糖尿病(T2DM)伴代谢相关脂肪性肝病(MAFLD)患者糖脂水平及肝脏脂肪含量的影响,为后续的治疗总结临床经验。方法选取广州医科大学附属第四医院及广州中医药大学深圳医院(福田)2019年1月至2020年1月收治的90例T2DM伴MAFLD患者为研究对象,随机分为研究组(n=45)与对照组(n=45)。其中对照组患者服用盐酸二甲双胍片,研究组使用利拉鲁肽注射液,疗程90 d。观察比较两组患者的临床疗效、糖脂水平及肝脏脂肪含量变化。结果研究组及对照组治疗总有效率分别为93.33%、77.78%,研究组更高,差异有统计学意义(P<0.05);治疗前,两组患者的空腹血糖(FPG)、餐后2 h血糖(2 h PBG)以及糖化血红蛋白(HbA1C)比较,差异无统计学意义(P>0.05);治疗后,两组FPG、2 h PBG及HbA1C水平较治疗前均降低,研究组低于对照组,但差异无统计学意义(P>0.05);治疗前,两组患者的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P>0.05);治疗后,两组TG、TC、LDL-C均显著降低,研究组的TG、TC、LDL-C低于对照组,差异有统计学意义(P<0.05);治疗后,两组HDL-C升高,且研究组高于对照组,差异有统计学意义(P<0.05);治疗前,两组患者肝脏脂肪含量比较,差异无统计学意义(P>0.05);治疗后均降低,研究组的肝脏脂肪含量低于对照组,差异有统计学意义(P<0.05)。结论使用GLP-1受体激动剂可以有效改善T2DM伴MAFLD患者的糖脂水平及肝脏脂肪含量,有较好的临床应用价值。

Objective To study the effect of glucagon-like peptide-1(GLP-1)receptor agonist on improving glucose and lipid levels and liver fat content in patients with type 2 diabetes mellitus(T2DM)complicated with metabolicrelated fatty liver disease(MAFLD),and to summarize clinical experience for subsequent treatment.Methods A total of 90 patients with T2DM and MAFLD treated in the Fourth Affiliated Hospital of Guangzhou Medical University and Shenzhen Hospital of Guangzhou University of Chinese Medicine(Futian)from January 2019 to January 2020 were selected as research objects,and they were randomly divided into the study group(n=45)and the control group(n=45).Patients in the control group were treated with metformin hydrochloride tablets,while patients in the study group were treated with liraglutide injection.The course of treatment was 90 days.The changes of glucose and lipid levels and liver fat content were compared between the two groups.Results The total effective rate of treatment in the study group and the control group was 93.33%and 77.78%,which was significantly higher than that of the control group(P<0.05);there were no significant differences in FPG,2 h PBG and HbA1C between the two groups before treatment(P>0.05).After treatment,the levels of FPG,2 h PBG and HbA1C in both groups were lower than those before treatment,and the FPG,2 h PBG and HbA1C in the study group were lower than those in the control group,with no statistically significant differences(P>0.05).There were no significant differences in TG,TC,LDL-C and HDL-C between the two groups before treatment(P>0.05).TG,TC,LDL-C in the two groups decreased significantly after treatment,and TG,TC,LDL-C in the study group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,HDL-C increased,and the HDL-C in the study group was higher than that in the control group,with statistically significant difference(P<0.05).There was no significant difference in liver fat content between the two groups before treatment(P>0.05),they all decreased after treatment,and the liver fat content in the study group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion GLP-1 receptor agonist can effectively improve the glucose and lipid levels and liver fat content in T2DM patients with MAFLD.