二甲双胍对2型糖尿病合并非酒精性脂肪肝患者血清FGF21、Hs-CRP的影响

Effect of metformin on serum FGF21 and Hs-CRP in patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

目的:通过观察T2DM合并NAFLD患者二甲双胍治疗前后FGF21、Hs-CRP的变化,探讨二甲双胍对T2DM合并NAFLD患者血清FGF21、Hs-CRP的影响.方法:选取2018年1月~2019年12月期间在我院体检中心、内分泌科门诊和住院的NAFLD、T2DM、T2DM合并NAFLD患者共103例为研究组,同期年龄、性别匹配的健康人群30例为对照组,检测血糖、血脂、糖化血红蛋白、肝功能、FGF21、Hs-CRP等指标,分析FGF21、Hs-CRP与血糖、血脂、HOMA-IR等相关性,比较三个治疗组二甲双胍治疗前后FGF21、Hs-CRP变化.结果:与对照组比较,其他三组FGF21、Hs-CRP均增高,且T2DM合并NAFLD组>T2DM组>NAFLD组;FGF21、Hs-CRP与FPG、2hPG、FINS、TG、TC、LDL-C、HOMA-IR均呈正相关;以FGF21、Hs-CRP为检验变量,T2DM合并NAFLD为状态变量作ROC曲线,其曲线下面积分别为0.905,0.747;三个治疗组二甲双胍治疗后FGF21、Hs-CRP均降低,且降低幅度为T2DM合并NAFLD组>T2DM组>NAFLD组.结论:二甲双胍可改善T2DM合并NAFLD患者糖脂代谢紊乱,使FGF21、Hs-CRP下降.而FGF21、Hs-CRP可以作为T2DM、NAFLD尤其是T2DM合并NAFLD的预测因子,FGF21的预测性更好,以便进行早期干预.

Objective To observe the changes of serum fibroblast growth factor 21(FGF21)and hypersensitive C-reactive pro-tein(Hs-CRP)in patients of T2DM complicated with NAFLD that treaded by metformin,and investigate the effect of metformin on FGF21 and Hs-CRP in patients of T2DM complicated with NAFLD.Methods 103 patients with T2DM or NAFLD or T2DM complicated with NAFLD in the physical examination center,endocrinology clinic or hospitalization from January 2018 to December 2019 were enrolled as the study group,and in the same period 30 healthy people with age and gender matched were selected as the control group in the study.The blood glucose,blood lipid,glycosylated hemoglobin,liver function,FGF21,Hs-CRP and other indicators were detected in patients of the four groups.The coiTelation between FGF21,Hs-CRP and blood glucose,blood lipids,HOMA-IR and other parameters were analysed.We compared the changes of FGF21,Hs-CRP,blood glucose,blood lipids,HO-MA_IR and other indicators before and after treatment in each group.Results Compared with the control group,the serum levels of FGF21 and Hs-CRP in the study group were increased,and all of them were the T2DM complicated with NAFLD group>T2DM group>NAFLD group.FGF21 and Hs-CRP were positively correlated with FPG,FINS,2KPG,TG,TC,LDL-C and HOMA-IR.Using FGF21 and Hs-CRP as test variables,T2DM complicated with NAFLD as state variables for ROC curve analysis showed that the area of under the curve were 0.905,0.747 respectively.FGF21 and Hs-CRP were decreased in the study group after treatment with metformin,and the reduction was the T2DM complicated with NAFLD group>T2DM group>NAFLD group.Conclusion Metformin can improve the disorder of glucose and lipid metabolism in patients with T2DM complicated with NAFLD,and decrease FGF21 and Hs-CRP.FGF21 and Hs-CRP can be used as predictors of T2DM,NAFLD,especially T2DM complicated with NAFLD,and FGF21 is more predictive.So that we can go to intervene early.