| 达格列净联合利拉鲁肽治疗非酒精性脂肪性肝病合并2型糖尿病患者短期疗效研究* |
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| 引用本文： | 孙峥,王笑烨,袁景,梁丽.达格列净联合利拉鲁肽治疗非酒精性脂肪性肝病合并2型糖尿病患者短期疗效研究*[J].实用肝脏病杂志,2022,25(6):796-799. |
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| 作者姓名： | 孙峥 王笑烨 袁景 梁丽 |
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| 作者单位： | 110000 沈阳市 中国医科大学附属辽宁省人民医院内分泌二科(孙峥,王笑烨,梁丽);内分泌三科(袁景) |
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| 基金项目： | *辽宁省科技厅科研基金资助项目(编号:2019LN10112) |
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| 摘 要： | 目的 探讨应用达格列净联合利拉鲁肽治疗非酒精性脂肪性肝病(NAFLD)合并2型糖尿病(T2MD)患者的短期疗效。方法 2017年9月～2020年10月我院收治的60例NAFLD合并T2MD患者,采用随机数字表法将其分为观察组30例和对照组,均常规接受生活方式干预和二甲双胍口服控制血糖,在此基础上给予对照组利拉鲁肽治疗,观察组在对照组治疗的基础上给予达格列净口服,两组均持续治疗观察3个月。常规检测空腹血糖(FPG)、餐后2 h血糖 (2h PG)、糖化血红蛋白 (HbA1c)及甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇 (LDL－C ) 和高密度脂蛋白胆固醇 (HDL－C)水平;使用自动免疫分析仪检测空腹胰岛素(Fins)和餐后2 h胰岛素(2hIns)水平,计算胰岛素抵抗指数(HOMA-IR);使用Fibrotouch检测肝脏脂肪受控衰减参数(CAP)。结果 在治疗3个月末,观察FPG、2hPG和HbA1水平分别为(5.8±0.7)mmol/L、(6.9±0.8)mmol/L和(6.3±0.9)%,显著低于对照组【分别为(6.6±0.6)mmol/L、(7.7±0.7)mmol/L和(7.2±1.0)%,P＜0.05】;观察组血清Fins、2hIns和HOMA-IR水平分别为(9.8±1.2)mIU/L、(20.2±1.7)mIU/L和(2.6±0.4)%,显著低于对照组【分别为(11.9±1.1)mmol/L、(24.8±1.6)mmol/L和(3.2±0.5)%,P＜0.05】;观察组血清TG水平为(2.6±0.4) mmol/L,显著低于对照组【(3.0±0.3)mmol/L,P＜0.05】,血清HDL-C水平为(1.6±0.2) mmol/L,显著高于对照组【(1.2±0.3)mmol/L,P＜0.05】,CAP为(249.2±7.5)dB/m,显著低于对照组【(264.7±8.6)dB/m,P＜0.05】;观察组血清AST水平为(39.9±3.8)U/L,显著低于对照组【(44.9±4.2)U/L,P＜0.05】。结论 应用达格列净联合利拉鲁肽治疗NAFLD合并T2MD患者可取得短期疗效,帮助有效控制血糖和血脂水平,减轻胰岛素抵抗,改善肝功能,显示出良好的疾病治疗前景。
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| 关 键 词： | 非酒精性脂肪性肝病 2型糖尿病 达格列净 利拉鲁肽 受控衰减参数 治疗 |
| 收稿时间： | 2021-12-10 |
Short-term efficacy of dapagliflozin and liraglutide combination in treatment of patients with non-alcoholic fatty liver disease and diabetes mellitus type 2 |
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| Sun Zheng,Wang Xiaoye,Yuan Jing,et al..Short-term efficacy of dapagliflozin and liraglutide combination in treatment of patients with non-alcoholic fatty liver disease and diabetes mellitus type 2[J].Journal of Clinical Hepatology,2022,25(6):796-799. |
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| Authors: | Sun Zheng Wang Xiaoye Yuan Jing |
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| Affiliation: | Second Department of Endocrinology, Provincial People's Hospital Affiliated to China Medical University, Shenyang, 110000, Liaoning Province, China |
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| Abstract: | Objective The aim of this study was to investigate the short-term efficacy of dapagliflozin and liraglutide combination in treatment of patients with non-alcoholic fatty liver disease (NAFLD) and diabetes mellitus type 2(T2MD). Methods 60 patients with NAFLD and T2MD were admitted to our hospital between September 2017 and October 2020, and were randomly divided into control and observation group, with 30 cases in each group. All the patients were supervised for routine lifestyle intervention and oral metformin administration for blood glucose control. In addition, the patients in the control group were treated with liraglutide intravenouly, and those in the observation group were treated with dapagliflozin and liraglutide combination. The regimen lasted for 3 months. The fasting plasma glucose (FPG), 2 hour-postprandial plasma glucose (2h PG) and glycated hemoglobin (HbA1c) as well as serum triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL－C) and high density lipoprotein cholesterol (HDL－C) levels were routinely obtained. Serum fasting insulin(Fins) and 2 h Ins levels were assayed, and the HOMA-IR was calculated. The controlled attenuation parameter (CAP) of livers was detected by FibroTouch. Results At the end of 3 month observation, the FPG, 2hPG and HbA1 levels in the observation group were(5.8±0.7)mmol/L, (6.9±0.8)mmol/L and (6.3±0.9)%, all significantly lower than (6.6±0.6)mmol/L,(7.7±0.7)mmol/L and (7.2±1.0)%, respectively, P＜0.05] in the control group; serum Fins, 2hIns and HOMA-IR levels were (9.8±1.2)mIU/L, (20.2±1.7)mIU/L and (2.6±0.4)%, significantly lower than (11.9±1.1)mmol/L, (24.8±1.6) mmol/L and (3.2±0.5)%, respectively, P＜0.05] in the control; serum TG level was (2.6±0.4) mmol/L, significantly lower than (3.0±0.3)mmol/L, P＜0.05], while serum HDL-C level was (1.6±0.2) mmol/L, significantly higher than (1.2±0.3)mmol/L, P＜0.05] in the control; the CAP was (249.2±7.5)dB/m, also significantly lower than (264.7±8.6)dB/m, P＜0.05] in the control; serum AST level was (39.9±3.8)U/L, significantly lower than (44.9±4.2)U/L, P＜0.05] in the control. Conclusion The application of dapagliflozin and liraglutide combination is efficacious in the treatment of patients with NAFLD and T2MD, which could effectively reduce blood glucose and lipid levels, improve liver function tests back to normal, with the ability of alleviation of insulin resistance. |
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| Keywords: | Non-alcoholic fatty liver disease Type 2 diabetes mellitus Dapagliflozin Liraglutide Controlled attenuation parameter Therapy |
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