二甲双胍治疗非酒精性脂肪肝时血清内脏脂肪素的变化

目的 观察血清脂肪因子内脏脂肪素在二甲双胍治疗非酒精性脂肪肝(NAFLD)前后的变化及与疾病的相关性.方法 将70例患者随机分为治疗组(n=40)和对照组(n=30),治疗组口服二甲双胍0.5g,每日3次,疗程12周;对照组用安慰剂.两组治疗前后分别测定血压、糖化血红蛋白(HbAtc)、总胆固醇(TC)、体重指数(BMI)、腰/臀比(WHR)、内脏脂肪素、胰岛素抵抗指数(HOMA - IR);并计算血清内脏脂肪素与非酒精性脂肪肝药物治疗疗效的相关性.结果 治疗组药物干预前后BMI,WHR,HOMA-IR、血清内脏脂肪素差异有统计学意义(P＜0.05);收缩压(SBP)和舒张压(DBP)差异无统计学意义(P＞0.05);对照组BMI,WHR,SBP,DBP,HOMA-IR、血清内脏脂肪素差异无统计学意义(P＞0.05).BMI,WHR,HOMA - IR的差异与血清内脏脂肪素的差异呈正相关(P＜0.05).结论 二甲双胍可能是通过调节血清内脏脂肪素来改善非酒精性脂肪肝的临床症状.

Study on Change of Serum Visfatin in Metformin Treatment of Nonalcoholic Fatty Liver Disease

Objective To investigate the change of serum adipokine visfatin level before and after metformin treatment of nonalcoholic fatty liver disease（NAFLD）and its correlation with disease.Methods 70 cases of NAFLD were randomized into two groups.The control group（n=30）received placebo only and the treatment group（n=40）was given oral metformin 0.5 g,3 times daily with the treatment course of 12 weeks.The body mass index（BMI）,waist hip rate（WHR）,glycosylated hemoglobin（HbA1C）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,visfatin,homeostasis model assessment-insulin resistance index（HOMA-IR）and total cholesterol（TC）were measured before and after treatment in both groups.Results In the treatment group,BMI,WHR,HOMA-IR,serum visfatin had statistical difference before and after treatment（P 0.05）.In the control group,no statistical differences existed in BMI,WHR,SBP,DBP,HOMA-IR and serum visfatin before and after treatment（P 〉 0.05）.The difference of BMI,WHR,HOMA-IR was positively correlated with the difference of visfatin（P 〈 0.05）.Conclusion Metformin may improve the clinical symptoms of NAFLD by mediating serum visfatin.