利拉鲁肽治疗2型糖尿病合并非酒精性脂肪性肝病的临床效果

Clinical effect of Liraglutide in the treatment of type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease

目的探讨利拉鲁肽治疗2型糖尿病并非酒精性脂肪性肝病(NAFLD)的效果。方法选取2021年9月至2022年9月赣南医学院附属兴国医院收治的60例2型糖尿病合并NAFLD患者作为研究对象,以计算机随机分组法将其分为观察组(30例)和对照组(30例)。对照组患者采用常规用药治疗,观察组患者采用常规用药联合利拉鲁肽治疗,比较两组治疗前后血糖水平、胰岛β细胞功能、肝功能、血脂情况等变化。结果治疗后,观察组患者空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)及空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)均低于对照组,差异有统计学意义(P<0.05);肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均低于对照组,差异有统计学意义(P<0.05);脂联素(APN)及高密度脂蛋白胆固醇(HDL-C)水平高于对照组,差异有统计学意义(P<0.05);谷丙转氨酶(ALT)、谷草转氨酶(AST)及肝脏脂肪衰减值(CAP)均低于对照组,差异有统计学意义(P<0.05)。两组的低血糖发生率比较,差异无统计学意义(P>0.05)。结论2型糖尿病合并NAFLD患者应用利拉鲁肽治疗是可行的,能有效降低血糖水平,降低机体血脂水平并控制炎症因子浓度、改善肝内脂质沉积,进而改善肝功能。

Objective To investigate the effect of Liraglutide in the treatment of type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease(NAFLD).Methods A total of 60 patients with type 2 diabetes mellitus and NAFLD admitted to Xingguo Hospital Affiliated to Gannan Medical University from September 2021 to September 2022 were selected as the research objects.They were divided into observation group(30 cases)and control group(30 cases)by computer randomization method.Patients in the control group were treated with conventional medication,and patients in the observation group were treated with conventional medication combined with Liraglutide.The changes of blood glucose level,isletβcell function,liver function and blood lipid before and after treatment were compared between the two groups.Results After treatment,fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),and insulin resistance index(HOMA-IR)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of adiponectin(APN)and high-density lipoprotein cholesterol(HDL-C)in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and liver fat attenuation value(CAP)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of hypoglycemia between the two groups(P>0.05).Conclusion It is feasible to use Liraglutide in patients with type 2 diabetes mellitus complicated with NAFLD,which can effectively reduce blood glucose level,reduce blood lipid level,control the concentration of inflammatory factors,improve intrahepatic lipid deposition,and improve liver function.