利拉鲁肽治疗2型糖尿病合并非酒精性脂肪肝患者的临床观察

目的：观察2型糖尿病合并非酒精性脂肪肝（ NAFLD）患者使用利拉鲁肽治疗的疗效和安全性。方法随机筛选30例符合标准的初诊或血糖控制不佳2型糖尿病合并NAFLD患者，初诊患者仅予以利拉鲁肽治疗、其他患者停用所有降糖药物（二甲双胍除外），加用利拉鲁肽治疗12周。比较治疗前后血压、身高、体重、体质指数（BMI）、血糖、糖化血红蛋白（HbA1c）、血脂、空腹胰岛素（ FINS）、空腹C肽（ FC－P）、胰岛素抵抗指数（ HOMA－IR）、肝功能、血尿酸（ SUA）、尿白蛋白排泄率（ UAER）的变化，同时观察有无不良反应。结果患者体重、BMI、收缩压、FPG、2hPG、HbA1c、血脂、谷丙转氨酶、谷草转氨酶、谷氨酰转肽酶、SUA、HOMA－IR均较治疗前下降（P＜0．05）；FC－P、FINS水平变化差异无统计学意义（P＞0．05）；治疗过程中无低血糖及其他严重的不良反应。结论利拉鲁肽治疗2型糖尿病合并NAFLD患者，能够有效安全降糖，降低体重、血压、血脂，改善胰岛素抵抗。

Clinical Observation on Liraglutide in the Treatment of Type 2 Diabetes Mellitus Combined with Naonalcoholic Fatty Liver Disease

Objective To observe the efficacy and safety of liraglutide in the treatment of type 2 diabetes mellitus combined with naonalcoholic fatty liver disease.Methods 30 patients who were newly diagnosed type 2 diabetes mellitus combined with NAFLD or in poor glycemic control Randomly selected.Newly diagnosed patients only got liraglutide treatment,and the rest patients stoped all antidiabetic drug(except metformin),got liraglutide treatment for 12 weeks.The blood pressure, body mass index(BMI), blood glucose,glycosylated hemoglobin(HbA1c),blood lipid,fasting insulin(FINS)and fasting C peptide(FC-P),Insulin resistance index(HOMA-IR),liver function, blood uric acid (SUA), urinary albumin excretion rate (UAER) changes after treatment were compared, and the adverse reactions were observed.Results The levels of BMI,systolic pressure,FPG,2hPG,HbA1c,blood lipid,alanine aminotransferase,aspartate aminotransferase, gamma glutamyl transpeptidase,SUA,HOMA-IR were decreased obviously after 12 weeks of treatment(P<0.05).The levels of FC-P,FINS had no statistically significant difference(P>0.05).No hypoglycemia and other serious adverse reactions in the process of treatment were found.Conclusion Liraglutide can effective security hypoglycemic, decrease body weight, blood pressure, blood lipid, improve insulin resistance in patients with type 2 diabetes mellitus complicated with NAFLD.