Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who ...Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences,Tehran,Iran awere diagnosed as NAFLD entered into analysis.Exclusion criteria were having diabetes mellitus and fasting blood glucose over126 mg/dL,active hepatitis B virus infection,having hepatitis C virus positive serology,and to be under corticosteroid therapy.ALT levels were considered pathologically high when it was over30 IU/L for men and over 19 IU/L for women.Results:Bivariate analyses using t test and chisquare test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations(P=0.003).Moreover,these patients represented significantly higher homeostatic model assessment levels(P=0.003),levels of serum insulin(P=0.002),fasting blood glucose(P<0.001),and uric acid(P=0.02).The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations.Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD(P=0.027)and insulin resistance(P=0.013)were the only variables significantly associated with abnormal ALT levels.Conclusions:This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before.By excluding diabetic patients from our population,we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations.Further studies are needed to confirm our results.展开更多
目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治...目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治疗。比较2组治疗前后血糖相关指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、血脂[低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]水平、胰岛功能[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、淀粉样蛋白A(SAA)]、外周血磷脂酰肌醇激酶(PI3K)/蛋白激酶B(Akt)信号通路相关蛋白表达水平,统计2组不良反应发生情况。结果治疗8、16周后,观察组HOMA-β高于对照组,HOMA-IR、FPG、2 h PG、HbA1c、TG、LDL-C、TC水平低于对照组(P<0.05,P<0.01)。治疗8、16周后,观察组IL-6、SAA、TNF-α、PI3K、Akt低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论甘精胰岛素联合利拉鲁肽治疗T2DM具有一定安全性,有助于改善患者胰岛功能,调控血糖、血脂水平,其机制可能与微炎症状态及外周血PI3K/Akt信号通路改善有关。展开更多
基金financially supported by Baqiyatallah University of Medical Sciences
文摘Objective:To explore demographic and metabolic factors associated with increased alanine aminotransferase(ALT)activity in non-diabetic non-alcoholic fatty liver disease(NAFLD)patients.Methods:Overall 372 patients who consecutively attended to Gastroenterology Clinic of Baqiyatallah University of Medical Sciences,Tehran,Iran awere diagnosed as NAFLD entered into analysis.Exclusion criteria were having diabetes mellitus and fasting blood glucose over126 mg/dL,active hepatitis B virus infection,having hepatitis C virus positive serology,and to be under corticosteroid therapy.ALT levels were considered pathologically high when it was over30 IU/L for men and over 19 IU/L for women.Results:Bivariate analyses using t test and chisquare test showed that patients with pathologically augmented ALT levels had significantly higher NAFLD grades in their ultrasonographic evaluations(P=0.003).Moreover,these patients represented significantly higher homeostatic model assessment levels(P=0.003),levels of serum insulin(P=0.002),fasting blood glucose(P<0.001),and uric acid(P=0.02).The prevalence of insulin resistance was also higher in patients with increased serum ALT concentrations.Multifactorial logistic regression models showed that ultrasonographic grading of NAFLD(P=0.027)and insulin resistance(P=0.013)were the only variables significantly associated with abnormal ALT levels.Conclusions:This study shows that the associations of increased ALT serum levels in NAFLD patients are different from what are supposed before.By excluding diabetic patients from our population,we find that increased ALT levels are not associated with dyslipidemias but are independently associated with insulin resistance and NAFLD grading on ultrasonographic evaluations.Further studies are needed to confirm our results.
文摘目的探讨甘精胰岛素联合利拉鲁肽治疗2型糖尿病(T2DM)的效果及安全性。方法回顾性分析2019年10月-2021年2月收治的T2DM 80例,根据治疗方案分为观察组和对照组,每组40例。对照组予以甘精胰岛素治疗,观察组予以甘精胰岛素联合利拉鲁肽治疗。比较2组治疗前后血糖相关指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、血脂[低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)]水平、胰岛功能[胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、淀粉样蛋白A(SAA)]、外周血磷脂酰肌醇激酶(PI3K)/蛋白激酶B(Akt)信号通路相关蛋白表达水平,统计2组不良反应发生情况。结果治疗8、16周后,观察组HOMA-β高于对照组,HOMA-IR、FPG、2 h PG、HbA1c、TG、LDL-C、TC水平低于对照组(P<0.05,P<0.01)。治疗8、16周后,观察组IL-6、SAA、TNF-α、PI3K、Akt低于对照组(P<0.05,P<0.01)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论甘精胰岛素联合利拉鲁肽治疗T2DM具有一定安全性,有助于改善患者胰岛功能,调控血糖、血脂水平,其机制可能与微炎症状态及外周血PI3K/Akt信号通路改善有关。
