利拉鲁肽对2型糖尿病合并非酒精性脂肪性肝病患者血清FGF-21水平的影响

目的：观察利拉鲁肽（Liraglutide）对2型糖尿病（T2DM）合并非酒精性脂肪性肝病（脂肪肝）患者血浆成纤维细胞生长因子-21（FGF-21）水平的影响。方法：采用酶联免疫法测定T2DM合并脂肪肝组、单纯性脂肪肝组及正常组人血浆FGF-21水平，比较各组转氨酶、血脂、血糖及BMI的水平。应用高胰岛素-正葡萄糖钳夹实验，评估胰岛素的敏感性。观察利拉鲁肽治疗前后T2DM合并脂肪肝患者血浆FGF-21水平的变化以及胰岛素敏感性的变化。结果：T2DM合并脂肪肝组血浆谷丙转氨酶、谷草转氨酶、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、BMI、FGF-21水平明显高于正常对照组，经利拉鲁肽治疗后上述生化指标均显著降低（P<0.05），而胰岛素敏感性则显著增高（P<0.05）。结论：T2DM合并脂肪肝患者血浆FGF-21水平改变可能与其代谢紊乱和胰岛素抵抗有关，并可能是利拉鲁肽作用的生物靶点之一。

Effects of Liraglufide on Plasma Fibroblast Growth Factor-21 Level in Patients with Type 2 Diabetes Mellitus Complicated Non-alcoholic Fatty Liver Disease

Objective: To investigate the effects of liraglutide on plasma fibroblast growth factor (FGF)-21 levels in patients with type 2 diabetes mellitus (T2DM) complicated non-alcoholic fatty liver disease (fatty liver). Methods: Enzyme linked immunosorbent assay (ELISA) was used to measure plasma FGF-21 level in patients with T2DM complicated fatty liver, patients with only fatty liver and normal controls. Relationship between plasma transaminase, blood fat, blood glucose and BMI was analyzed. Hyperinsulinaemic-euglycaemic clamp was established for the study of insulin sensitivity. After liraglutide treatment, plasma FGF-21 level and insulin sensitivity were observed in patients with T2DM complicated fatty liver. Results: Levels of ALT, AST, TG, TC, LDL-C, FBG, BMI and FGF-21 were higher in T2DM complicated fatty liver patients than those in normal control group. After liraglutide treatment, the levels of ALT, AST, TG, LDL-C, BMI, FBG and FGF-21 were significantly decreased in T2DM complicated fatty liver patients (P<0.05), but the insulin sensitivity was improved (P<0.05). Conclusion: The change of plasma FGF-21 level may be related to metabolic disturbance and insulin resistance in patients with T2DM complicated fatty liver. It might be the biological target of liraglutide.