罗格列酮对非肥胖2型糖尿病合并脂肪肝的疗效观察

目的：观察罗格列酮治疗非肥胖2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）的疗效。方法：对102例合并NAFL的非肥胖2型糖尿病患者进行随机分组，即A组（基础治疗组＋罗格列酮药物组）和B组（基础治疗组），随访24周，观察两组患者治疗前后体重指数、血糖、餐后2小时血糖、肝功、血脂、胰岛素、HOMA-IR、肝脏影像学等变化并进行对比研究。结果：加用罗格列酮组治疗后，其Fins、AST、ALT、HoMA-IR较治疗前明显改善，TG较前好转；基础治疗组Fins、AST、ALT、TG、HoMA-IR指标有好转趋势，但无统计学差异；加用罗格列酮组治疗优于基础治疗组。结论：加用胰岛素增敏剂能明显改善胰岛素抵抗、肝脏酶学及影像学指标，也证明了胰岛素抵抗在非酒精性脂肪肝的发生和发展中起着重要的作用，罗格列酮可有效逆转 NAFLD，可能为非肥胖T2DM并NAFL组提供临床治疗参考。

Clinical observation on rosiglitazone in the treatment of nonobese type 2 diabetic mellitus with fatty liver

Objective： To observe the efficacy of rosiglitazone in the treatment of nonobese T2DM with NAFLD. Methods：102 cases of nonobese T2DM with NAFLD were randomly divided into groups, Group A（ basic treatment group and group treated with rosiglitazone） and Group B（basic treatment group）, followed up for 24 weeks. The changes of body mass index, blood glucose, 2-hour postprandial blood glucose, liver function, blood lipid, insulin, HOMA-IR, liver imaging before and after treatment were observed and comparatively researched. Results：after treatment of rosiglitazone, Fins、AST、ALT、HoMA-IR were obviously improved, TG was much better than before;the indicators of Fins、AST、ALT、TG、HoMA-IR in the basic treatment group tended to be improved but without significant difference;the efficacy of group with rosiglitazone was better than that of the basic treatment group. Conclusion：The treatment with insulin sensitizer can not only significantly improve insulin resistance, liver enzyme and imaging indexes, also proved that insulin resistance plays an important role in the occurrence and development of nonalcoholic fatty liver. Rosiglitazone can effectively reverse NAFLD, providing clinical reference for the treatment of nonobese T2DM with NAFLD.