2型糖尿病合并非酒精性脂肪肝患者经吡格列酮治疗后核苷酸结合寡聚化结构域样受体蛋白3的变化

Changes in livels of NLR family pyrin domain containing 3 after pioglitazone treatment in patients with type 2diabetes combined with nonalcoholic fatty liver disease

目的探讨吡格列酮治疗2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)水平的改变。方法收集上海健康医学院附属周浦医院内分泌科2021年1月到2022年10月就诊的T2DM合并NAFLD患者80例,随机分为对照组及吡格列酮治疗组,随访4周。分析两组研究对象基线及随访时血糖、血脂、肌酐、谷丙转氨酶等生化指标;运用ELISA双抗体夹心法检测外周血NLRP3水平。结果最终吡格列酮组35例、对照组36例完成全部试验。吡格列酮组基线血清NLRP3为(5.4±1.1)μg/L,随访时为(4.8±0.8)μg/L,有明显下降;而对照组基线血清NLRP3为(5.2±1.0)μg/L,随访时为(5.2±0.8)μg/L,无明显改变,并且随访时吡格列酮组血清NLRP3水平低于对照组。除随访时吡格列酮组TC水平高于对照组外,两组间血糖、血脂、肝肾功能均无明显差异。结论T2DM合并NAFLD患者使用吡格列酮治疗后在改善糖脂代谢的同时,也可以降低血清NLRP3水平。

Objective To investigate the changes in the levels of serum NLR family pyrin domain containing 3(NLRP3)in patients with type 2 diabetes mellitus(T2DM)combined with nonalcoholic fatty liver disease(NAFLD)treated with pioglitazone.Methods A total of 80 patients with T2DM complicated with NAFLD treated in Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital from January 2021 to October 2022 were randomly divided into control group and pioglitazone treatment group.The follow-up was made after 4 weeks.The biochemical indexes such as blood glucose,blood lipid,creatinine and glutamic pyruvic transaminase were analyzed at baseline and during fllow-up,and the level of serum NLRP3 was analyzed by ELISA double antibody sandwich method.Results Finally 35 people in the pioglitazone group and 36 people in the control group completed the whole trial.The baseline serum NLRP3 level was(5.4±1.1)μg/L in the pioglitazone group and(4.8±0.8)μg/L at follow-up,with a significant decrease,whereas the baseline serum NLRP3 was(5.2±1.0)μg/L in the control group and(5.2±0.8)μg/L at follow-up,with no significant change,and the serum NLRP3 level in the pioglitazone group at follow-up was lower than that of the control group.There were no significant differences in blood glucose,lipids,or liver and kidney function between the two groups,except that the TC level in the pioglitazone group was higher than that in the control group at the time of follow-up.Conclusion Treatment with pioglitazone in patients with T2DM combined with NAFLD improves glucose and lipid metabolism while reducing serum NLRP3 levels.