摘要
目的探讨司美格鲁肽治疗2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的疗效及对氧化应激和炎症因子的影响。方法选择2021年7月至2022年12月新乡医学院第一附属医院内分泌科收治的80例T2DM合并NAFLD患者为研究对象,根据随机数字法将患者分为观察组和对照组,每组40例。对照组患者给予吡格列酮二甲双胍、达格列净治疗,观察组患者给予吡格列酮二甲双胍、达格列净和司美格鲁肽治疗。比较2组患者治疗前、治疗24周后的糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2hPG)、体质量、体质量指数(BMI)、腰围、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(GGT)、控制衰减指数(CAP)、肝硬度值(LSM)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)、脂质过氧化物(LPO)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平的变化。结果治疗24周后,观察组与对照组总有效率分别为92.5%(37/40)、72.5%(29/40),观察组患者的总有效率显著高于对照组(χ^(2)=5.541,P<0.05)。治疗前,2组患者的体质量、BMI、腰围、HbA1c、FBG、2hPG、ALT、AST、GGT、CAP、LSM、MDA、GSH-PX、LPO、TNF-α、IL-6、IL-10水平比较差异无统计学意义(P>0.05);2组患者治疗24周后的体质量、BMI、腰围、HbA1c、FBG、2hPG、ALT、AST、GGT、CAP、LSM、MDA、LPO、TNF-α、IL-6、IL-10水平均显著低于治疗前,GSH-PX显著高于治疗前(P<0.05);治疗24周后,观察组患者的体质量、BMI、腰围、HbA1c、FBG、2hPG、ALT、AST、GGT、CAP、LSM、MDA、LPO、TNF-α、IL-6、IL-10水平均显著低于对照组,GSH-PX显著高于对照组(P<0.05)。治疗期间,观察组与对照组不良反应发生率分别为17.5%(7/40)、12.5%(5/40),2组不良反应发生率的比较差异无统计学意义(P>0.05)。结论司美格鲁肽能够显著降低T2DM合并NAFLD患者的FBG、2hPG及HbA1c水平,减轻患者体质量并缩小腰围,降低肝酶�
Objective To explore the efficacy of semaglutide in the treatment of type 2 diabetes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD)and its effect on oxidative stress and inflammatory factors.Methods Totally 80 patients with T2DM accompanied by NAFLD admitted to the First Affiliated Hospital of Xinxiang Medical University from July 2021 to December 2022 were selected and randomly assigned to the observation group and the control group,with 40 patients in each group.Patients in the control group were treated with pioglitazone metformin and dapagliflozin,while patients in the observation group were treated with pioglitazone metformin,dapagliflozin,and semaglutide.The levels of glycated hemoglobin(HbA1c),fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPG),body mass,body mass index(BMI),waist circumference,alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(GGT),controlled attenuation parameter(CAP),liver stiffness measurement(LSM),malondialdehyde(MDA),glutathione peroxidase(GSH-PX),lipid peroxide(LPO),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-10(IL-10)before and after the treatment were compared.Results After 24 weeks of treatment,the overall response rate(ORR)in the observation group and control group was 92.5%(37/40)and 72.5%(29/40),respectively;and the ORR in the observation group was significantly higher than that in the control group(χ^(2)=5.541,P<0.05).Before treatment,there was no statistically significant difference in the body mass,BMI,waist circumference,HbA1c,FBG,2hPG,ALT,AST,GGT,CAP,LSM,MDA,GSH-PX,LPO,TNF-α,IL-6,and IL-10 of patients between the 2 groups(P>0.05);after 24 weeks of treatment,the body mass,BMI,waist circumference,HbA1c,FBG,2hPG,ALT,AST,GGT,CAP,LSM,MDA,LPO,TNF-α,IL-6,and IL-10 were significantly lower than before treatment,while GSH-PX was significantly higher than before treatment(P<0.05);after 24 weeks of treatment,the body mass,BMI,waist circumference,HbA1c,FBG,2hPG,ALT,AST,GGT,CAP,LSM,M
作者
孟祥雨
白立炜
尹清风
刘北彦
陈雪辉
徐云
王迪
王旭
耿锐娜
刘秋君
MENG Xiangyu;BAI Liwei;YIN Qingfeng;LIU Beiyan;CHEN Xuehui;XU Yun;WANG Di;WANG Xu;GENG Ruina;LIU Qiujun(Department of Endocrinology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
出处
《新乡医学院学报》
CAS
2024年第5期443-448,共6页
Journal of Xinxiang Medical University
基金
河南省医学科技攻关计划联合共建项目(编号:LHGJ20190458)。
关键词
2型糖尿病
非酒精性脂肪性肝病
司美格鲁肽
氧化应激
炎症因子
type 2 diabetes mellitus
non-alcoholic fatty liver disease
semaglutide
oxidative stress
inflammatory factors
