利拉鲁肽联合阿托伐他汀钙治疗伴有糖脂代谢异常的非酒精性脂肪性肝病患者疗效研究

Efficacy of liraglutide and atorvastatin calcium combination in treating patients with nonalcoholic fatty liver diseases complicated with abnormal glucolipid metabolism

目的观察应用利拉鲁肽联合阿托伐他汀钙治疗伴有糖脂代谢异常的非酒精性脂肪性肝病(NAFLD)患者的效果。方法2020年1月~2022年12月我院收治的伴糖脂代谢异常的NAFLD患者86例,被随机分为对照组43例和观察组43例,分别给予利拉鲁肽治疗或利拉鲁肽联合阿托伐他汀钙治疗,连续观察12 w。常规检测血生化指标、肝脏硬度检测(LSM)和受控衰减参数(CAP),计算中国人内脏脂肪指数(VAI)和脂质蓄积指数(LAP)。结果在治疗12 w末,观察组丙氨酸氨基转移酶、谷氨酰基转肽酶、LSM和CAP分别为(32.8±4.9)U/L、(32.7±5.4)U/L、(5.0±0.9)kPa和(245.7±18.2)dB/m,均显著低于对照组【分别为(36.4±4.2)U/L、(39.0±5.1)U/L、(6.0±0.8)kPa和(268.9±19.1)dB/m,P<0.05】;观察组VAI和LAP分别为(102.2±9.1)和(55.7±7.0),均显著低于对照组【分别为(118.3±10.5)和(62.0±6.7),P<0.05】;观察组血清总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平分别为(4.8±0.8)mmol/L、(1.6±0.3)mmol/L和(2.7±0.4)mmol/L,均显著低于对照组【分别为(5.5±0.9)mmol/L、(2.8±0.3)mmol/L和(4.1±0.6)mmol/L,P<0.05】,而血清高密度脂蛋白胆固醇水平为(1.3±0.3)mmol/L,显著高于对照组【(1.1±0.2)mmol/L,P<0.05】。结论应用利拉鲁肽联合阿托伐他汀钙治疗伴有糖脂代谢异常的NAFLD患者可改善糖脂代谢紊乱,有利于减轻肝内脂质蓄积,降低内脏脂肪含量,其长期疗效还需进一步观察。

Objective The aim of this study was to observe the efficacy of liraglutide and atorvastatin calcium combination in the treatment of patients with nonalcoholic fatty liver diseases(NAFLD)with abnormal glucolipid metabolism.Methods 86 patients with NAFLD and abnormal glucolipid metabolism were enrolled in our hospital between January 2020 and December 2022,and were randomly divided into control(n=43)and observation group(n=43).The patients in both groups were given liraglutide treatment and those in the observation were treated by liraglutide and atorvastatin calcium combination for 12 weeks.The blood biochemical indicators,the liver stiffness measurement(LSM)and controlled attenuation parameter(CAP)of liber were routinely detected.The visceral adiposity index(VAI)and the lipid accumulation product index(LAP)were calculated.Results At the end of 12 week of treatment,serum alanine aminotransferase,gamma-glutamyltransferase,LSM and CAP in the observation group were(32.8±4.9)U/L,(32.7±5.4)U/L,(5.0±0.9)kPa and(245.7±18.2)dB/m,all significantly lower than[(36.4±4.2)U/L,(39.0±5.1)U/L,(6.0±0.8)kPa and(268.9±19.1)dB/m,respectively,P<0.05]in the control;the VAI and LAP were(102.2±9.1)and(55.7±7.0),both significantly lower than[(118.3±10.5)and(62.0±6.7),respectively,P<0.05]in the control;serum total cholestero,triglyceride and low-density lipoprotein cholesterol levels were(4.8±0.8)mmol/L,(1.6±0.3)mmol/L and(2.7±0.4)mmol/L,all much lower than[(5.5±0.9)mmol/L,(2.8±0.3)mmol/L and(4.1±0.6)mmol/L,respectively,P<0.05],while serum high-density lipoprotein cholesterol level was(1.3±0.3)mmol/L,much higher than[(1.1±0.2)mmol/L,P<0.05]in the control group.Conclusion The administration of liraglutide and atorvastatin calcium combination in the treatment of patients with NAFLD with abnormal glucolipid metabolism could modulate the disordered glucolipid metabolism,alleviate the liver steatosis,and reduce the visceral fat accumulation,and the long-term efficacy needs further observation.