吡格列酮对糖耐量异常合并非酒精性脂肪肝患者血浆瘦素水平及胰岛素抵抗的影响

目的观察吡格列酮对糖耐量异常（IGT）合并非酒精性脂肪肝（NAFLD）患者血浆瘦素（leptin）水平及胰岛素抵抗的影响。方法将80例IGT合并NAFLD患者回顾性分为对照组（饮食、运动治疗）与吡格列酮组（在饮食运动的基础上给予吡格列酮每天15 mg，治疗12周）。观察两组患者治疗前后血糖、血脂、肝功能、胰岛素抵抗指数（HOMA-IR）、空腹胰岛素（Fins）、血浆leptin水平的变化，以及超声形态学改善的情况。结果治疗12周后吡格列酮组与治疗前及对照组比较，患者TC、TG、LDL、血糖、HOMA-IR、Fins、血浆leptin下降明显，超声形态学改善明显，差异均有显著性（P<0.05）。结论吡格列酮治疗IGT合并NAFLD患者能有效改善患者血浆leptin水平及胰岛素抵抗。

Effect of Piglitazone on Plasma Leptin and Insulin Resistance in Patients with IGT Complicated by Nonalcoholic Fatty Liver

ObjectiveTo observe the effect of pioglitazone on plasma leptin and insulin resistance in patients with impaired glucose tolerance(IGT)complicated by nonalcoholic fatty liver(NAFL).MethodsEighty patients with IGT complicated by NAFL displayed by B-ultrasound were enrolled and divided into control group (treated with dietary and sports)and pioglitazone group(treated with pioglitazone,15mg once daily,for 12 weeks).Then the curative effects on two groups were compared in the aspects of blood glucose,blood lipid,liver functional tests,homeostasis assessment of insulin resistance(HOMA-IR),fasting blood insulin(Fins),plasma leptin,and liver B-ult-rasound values.ResultsCompared with the control group,the blood glucose,TC,TG,LDL,HOMA-IR,Fins,plasma leptin decreased and the B-ultrasound values improved significantly(P<0.05) in the patients of pioglitazone group.ConclusionPioglitazone shows a better efficacy in reduction of the plasma leptin and insulin resistance in the patients with IGT complicated by NAFL.