利拉鲁肽对新诊断的T2DM合并NALFD患者生化指标、肝脏及腹部脂肪的影响

Effects of Liraglutide on Biochemical Indexes,Liver and Abdominal Fat in Patients with Newly Diagnosed T2DM Complicated with NALFD

目的:研究利拉鲁肽对新诊断的T2DM合并NALFD患者生化指标、肝脏及腹部脂肪的影响。方法:选择2019年6月-2021年3月间某院收治的76例新诊断T2DM合并NAFLD患者,随机分为对照组和利拉鲁肽组各38例,对照组采用二甲双胍单药治疗的对照组,利拉鲁肽组采用利拉鲁肽联合二甲双胍治疗,治疗前及治疗后6个月时,检测空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹血胰岛素(F-Ins)、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)、门冬氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、内脏脂肪组织来源的丝氨酸蛋白酶抑制剂(vaspin)、脂联素(ADP)、白介素-6(IL-6)、皮下脂肪面积(SAA)、内脏脂肪面积(VAA)、总脂肪面积(TAA)、肝脏脂肪含量(LFC),计算胰岛素抵抗指数HOMA-IR。结果:治疗后6个月时,两组患者的FBG、HbA1c、F-Ins、HOMA-IR、TC、TG、LDL-C、ALT、AST、γ-GT、vaspin、ADP、IL-6水平均较治疗前降低,HDL-C水平较治疗前升高(P<0.05),利拉鲁肽组的SAA、VAA、TAA、LFC较治疗前降低(P<0.05),对照组的SAA、VAA、TAA、LFC与治疗前比较无差异(P>0.05),且利拉鲁肽组组的FBG、HbA1c水平与对照组比较无差异(P>0.05),F-Ins、HOMA-IR、TC、TG、LDL-C、ALT、AST、γ-GT、vaspin、ADP、IL-6、SAA、VAA、TAA、LFC水平均低于对照组,HDL-C水平高于对照组(P<0.05)。结论:利拉鲁肽用于新诊断T2DM合并NAFLD的治疗能够改善糖脂代谢及肝功能,降低肝脏及腹部脂肪含量。

Objective:To study the effects of liraglutide on biochemical indexes,liver and abdominal fat in newly diagnosed T2DM patients complicated with NALFD.Methods:76 patients with newly diagnosed T2DM complicated with NAFLD treated in a hospital from June 2019 to March 2021 were selected and randomly divided into control group treated with metformin alone(n=38)and liraglutide group treated with liraglutide combined with metformin(n=38).Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),fasting blood insulin(f-Ins),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),aspartate aminotransferase(ALT),aspartate aminotransferase(AST)andγ-glutamyl transpeptidase(γ-GT),vaspin,adiponectin(ADP),interleukin-6(IL-6),subcutaneous adipose area(SAA),visceral adipose area(VAA),total adipose area(TAA),liver fat content(LFC)were detected,and insulin resistance index HOMA-IR before and at 6 months after treatment were tested.Results:6 months after treatment,the levels of FBG,HbA1c,F-Ins,HOMA-IR,TC,TG,LDL-C,ALT,AST,γ-GT,vaspin,ADP,and IL-6 in the two groups were decreased compared with those before treatment,and the HDL-C was increased compared with that before treatment(P<0.05).The SAA,VAA,TAA and LFC in the lilarlutide group were lower than those before treatment(P<0.05).There was no difference in SAA,VAA,TAA,and LFC after treatment in the control gorup compared with before treatment(P>0.05).There was no difference in levels of FBG and HbA1c between the two groups(P>0.05),the levels of F-Ins,HOMA-IR,TC,TG,LDL-C,ALT,AST,γ-GT,vaspin,ADP,IL-6,SAA,VAA,TAA and LFC in the lilarlutide group were lower than those in the control group,and the level of HDL-C was higher than that in the control group(P<0.05).Conclusion:Liraglutide in the treatment of newly diagnosed T2DM complicated with NAFLD can improve glucose and lipid metabolism and liver function,and reduce the content of liver and abdominal fat.