利拉鲁肽、利格列汀和二甲双胍治疗2型糖尿病合并非酒精性脂肪肝临床疗效的比较

周笑漪

doi:10.3969/j.issn.1671-038X.2019.03.09

利拉鲁肽、利格列汀和二甲双胍治疗2型糖尿病合并非酒精性脂肪肝临床疗效的比较

周笑漪^,

- 湖北省中医院内分泌科, 湖北武汉 430061

详细信息

作者简介:
周笑漪,女,硕士,主要研究方向:2型糖尿病和肥胖的中西医治疗

通讯作者: 周笑漪,E-mail:37828381@qq.com

中图分类号: R575.5

收稿日期: 2018-01-14

The comparative efficacy of liraglutide, linagliptin and metformin in the treatment of type 2 diabetes(T2DM) complicated with non-alcoholic fatty liver disease

ZHOU Xiao-yi^,

- Department of Endocrinology, Hubei Provincial Traditional Chinese Medical Hospital, Wuhan 430061, China

More Information

Corresponding author: ZHOU Xiao-yi, E-mail: 37828381@qq.com

Received Date: 14 January 2018

摘要

摘要: [目的]探讨利拉鲁肽、利格列汀和二甲双胍治疗2型糖尿病（T2DM）合并非酒精性脂肪肝（NAFLD）的有效性及疗效比较。[方法]选取90例T2DM合并NAFLD患者，随机分为利拉鲁肽组、利格列汀组及二甲双胍组，各30例，分别予以相应药物治疗，治疗12周后比较3组患者治疗前后体重、BMI、血糖（FPG，2hPG）、糖化血红蛋白（HbA1c）、胰岛素抵抗指数（HOMA-IR）、血脂（TC，TG，LDL-c）、肝功能（ALT，AST，GGT）及脂肪肝分级（通过肝脏CT诊断）。[结果]治疗前3组患者各项指标差异无统计学意义（P>0.05），治疗后除利格列汀组体重无显著变化（P>0.05），其余各项指标均较治疗前显著改善（P<0.05）；利拉鲁肽改善体重（W）、体质指数（BMI）、血糖、HbA1c、血脂、肝功能及脂肪肝分级程度较另2组更显著，而对HOMA-IR的改善与利格列汀差异无统计学意义；利格列汀组治疗后血糖、HbA1c、HOMA-IR、血脂、肝功能及脂肪肝分级程度较二甲双胍组改善更显著（P<0.05）。二甲双胍组有1例胃肠不适伴腹泻，减量后好转，其余组无显著不良反应，组间不良反应差异无统计学意义（P>0.05）。[结论]利拉鲁肽对T2DM合并NAFLD患者稳定血糖、改善血脂及肝功能以及降低脂肪肝等级作用优于利格列汀和二甲双胍，且与利格列汀比较，具有更好的减重作用，无显著不良反应，患者接受度高，值得临床推广。
- 利拉鲁肽 /
- 利格列汀 /
- 2型糖尿病 /
- 非酒精性脂肪肝
Abstract: [Objective] To compare the efficacy of liraglutide, linagliptin and metformin in the treatment of type 2 diabetes(T2DM) complicated with non-alcoholic fatty liver disease(NAFLD). [Methods] A total of 90 T2DM patients with NAFLD were selected and randomly divided into 3 group. Each group had 30 patients, and each group was received liraglutide, linagliptin, and metformin respectively for 12 weeks. Before and after the treatment, the body weight(W), body mass index(BMI), blood glucose(FPG, 2hPG), glycosylated hemoglobin(HbA1c), hemeostasis model assessment of insulin resistance(HOMA-IR), blood lipid(TC, TG, LDL-c), liver function(ALT, AST, GGT), and the classification of NAFLD(classified by liver CT scan) were monitored and compared. [Results] Before the treatment, there was no significant difference in the three groups of the indexes above, but after the treatment of 12 weeks, all the indexes except for W, BMI of the linaglitin group were significant ameliored compared to before; blood glucose, HbA1c, blood lipid, liver function and the alleviation of the NAFLD grade in the liraglutide group were significant superior to the other two groups(P<0.05), but the difference of HOMA-IR between the liraglutide and linagliptin groups was not significant; the blood glucose, HbA1c, HOMA-IR, blood lipid, liver function and alleviation of the NAFLD grade in the linagliptin group were superior to the metformin group(P<0.05). There was one patient suffered from gastrointestinal discomfort accompanied with diarrhoea in the metformin group, while no obvious side effect was discovered in the other groups, the differences were not significant(P>0.05). [Conclusion] Liraglutide can significantly ameliorate the blood glucose, HbA1c, blood lipid, liver function and the grade of NAFLD in T2DM with NAFLD, and is worthy of clinical recommending.
- liraglutide /
- linagliptin /
- type 2 diabetes /
- non-alcoholic fatty liver disease

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