摘要
目的观察二甲双胍对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)患者肝脏炎症、肝纤维化和胰岛素抵抗的影响。方法选取2011年6月至2016年5月收治的70例T2DM合并NAFLG患者,按随机数字表法分为观察组和对照组,每组35例。对照组仅给予饮食运动治疗,观察组患者在饮食运动疗法上给予二甲双胍,治疗12周后,观察比较2组患者治疗前后肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和超敏C-反应蛋白(hs-CRP)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、丙氨酸转移酶(ALT)和门冬氨酸氨基转移酶(AST)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、层连蛋白(LN)、空腹血糖(FPG)、2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、空腹胰岛素(Fins)及计算胰岛素抵抗指标(HOMA-IR)和不良反应发生情况。结果治疗后2组患者血清中炎症因子指标(TNF-α、IL-6、hs-CRPG)、血脂和肝功能指标(TC、TG、LDL-C、ALT、AST)、肝纤维化指标(PCⅢ、IV-C、LN、HA),血糖及胰岛素指标(FPG、2 h PG、Fins、Hb A1c和HOMA-IR)较治疗前显著降低(P<0.05),且观察组患者上述指标均显著低于对照组(P<0.05),而HDL-C指标显著高于对照组(P<0.05),治疗期间2组患者不良反应发生率比较,差异无统计学意义(χ~2=1.726,P>0.05)。结论二甲双胍能够显著改善T2DM合并NAFLD患者肝脏炎症反应,缓解肝脏纤维化,减轻机体胰岛素抵抗,有利于平稳控制血糖,且不增加患者不良反应。
Objective To investigate the effects of metformin on hepatic inflammation,liver fibrosis and insulin resistance in patients with type 2 diabetes mellitus（ T2 DM） complicated by nonalcoholic fatty liver disease（ NAFLD）.Methods A total of 70 patients with T2 DM complicated by NAFLG who were admitted and treated in our hospital from June2011 to May 2016 were divided into observation group（ n = 35） and control group（ n = 35） according to random number table. The patients in control group were treated by diet and exercise only,however,the patients in observation group,on the basis of control group,were treated by oral metformin. After 12-week treatment,the levels of tumor necrosis factor-α（ TNF-α）,interleukin 6（ IL-6）,high sensitivity C reactive protein（ hs-CRP）,triglyceride（ TG）,total cholesterol（ TC）,high density lipoprotein（ HDL-C）,low density lipoprotein（ LDL-C）,alanine transferase（ ALT）,aspartate aminotransferase（ AST）,type Ⅲ procollagen（ PCⅢ）,type Ⅳ collagen（ Ⅳ-C）,hyaluronic acid（ HA）,laminin（ LN）,fasting plasma glucose（ FPG）,2 h postprandial blood sugar glucose（ 2 h PG）,glycosylated hemoglobin（ Hb A1 c）,fasting insulin（ Fins）,insulin resistance index（ HOMA-IR） and incidence of adverse reactions before and after treatment were observed and compared between the two groups. Results After treatment,the indexes of serum inflammatory factors（ TNF-α,IL-6,hsCRP）,indexes of blood lipid and liver function（ TC,TG,LDL-C,ALT,AST）,indexes of liver fibrosis（ PCⅢ,Ⅳ-C,LN,HA） and indexes of blood glucose and insulin（ FPG,2 h PG,Fins,Hb A1 c and HOMA-IR） were significantly decreased in both groups,as compared with those before treatment（ P〈 0. 05）. Moreover these indexes mentioned above in observation group were significantly lower than those in control group（ P〈 0. 05）,however the levels of HDL C in observation group were significantly higher than those in control group（ P〈 0. 05）. In additi
作者
韩淑琴
刘润
刘俊霞
耿英桥
HAN Shuqin;LIU Run;LIU Junxia(The First Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)
出处
《河北医药》
CAS
2018年第12期1769-1773,共5页
Hebei Medical Journal
关键词
二甲双胍
2型糖尿病
非酒精性脂肪性肝病
肝纤维化
胰岛素抵抗
mefformin
type 2 diabetes mellitus
nonalcoholic fatty liver disease
liver fibrosis
insulin resistance
