利拉鲁肽联合二甲双胍对2型糖尿病合并非酒精性脂肪肝病肝脂肪变的影响

Effects of Liraglutide combined with Metformin in type 2 diabetic patients with nonalcoholic fatty liver disease

摘要:

目的  探讨利拉鲁肽联合二甲双胍对2型糖尿病（T2DM）合并非酒精性脂肪肝病（NAFLD）患者血清肿瘤坏死因子-α（TNF-α）及肝脂肪变的影响。方法  选取T2DM合并NAFLD患者42例，随机分为治疗组与对照组，每组各21例。治疗组予以利拉鲁肽联合二甲双胍治疗，对照组予以甘精胰岛素联合二甲双胍治疗，疗程12周。治疗前及治疗12周后，所有患者行肝脏CT检查，比较两组生化指标及TNF-α变化。结果  治疗12周后，与治疗前比较，治疗组体重指数（BMI）、三酰甘油（TG）、血清总胆固醇（TC）、TNF-α均降低，治疗组总有效率高于对照组；与对照组治疗后比较，治疗组BMI、TG、TC、TNF-α降低，总有效率升高，差异有统计学意义（P <0.05）。治疗组肝脂肪变的程度与BMI、TG、TC、TNF-α呈正相关（P <0.05）。结论  利拉鲁肽联合二甲双胍治疗T2DM合并NAFLD疗效明确，能降低TNF-α水平，减少肝脏脂肪变程度，且低血糖发生率低，疗效优于甘精胰岛素联合二甲双胍。

Abstract:

Objective To investigate the effects of Liraglutide combined with Metformin on the serum TNF-α and liver steatosis in type 2 diabetic patients with nonalcoholic fatty liver disease. Methods Forty type 2 diabetic patients with nonalcoholic fatty liver disease were randomly divided into two groups: control group (n = 21), received insulin glargine combined with Metformin for 12 weeks; the treatment group (n = 21), received Liraglutide combined with Metformin for 12 weeks. Hepatic CT was performed for all the patients, and TNF-α and biochemical parameters were measured before treatment and 12 weeks after treatment. Results BMI, TG, TC and TNF-α in the treatment group were significantly decreased after treatment compared to the original values (P < 0.05). The total effective rate of the treatment group was higher than that of the control group (P < 0.05). Correlation analysis showed that the degree of liver steatosis was positively correlated with BMI, TG, TC and TNF-α (P < 0.05). Conclusions Liraglutide combined with Metformin is effective in the treatment of type 2 diabetes with nonalcoholic fatty liver disease.