艾塞那肽对2型糖尿病合并非酒精性脂肪肝患者肝脏脂肪含量及血清chemerin水平的影响

doi:10.6040/j.issn.1671-7554.0.2016.736

摘要/Abstract

摘要： 目的观察艾塞那肽对2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者血糖、肝脏脂肪含量及血清chemerin水平的影响。方法 T2DM合并NAFLD患者60例,随机分为2组,每组30例,艾塞那肽组在原治疗方案基础上加用艾塞那肽10 μg,早晚餐前1 h皮下注射,对照组加用甘精胰岛素,起始剂量0.2 U/kg或6~10 U。治疗12周,观察体质量(BW)、体质量指数(BMI)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂(TG、TC、HDL、LDL)、胰岛素抵抗指数(HOMA-IR)、肝酶学指标(ALT、AST)及血清chemerin水平,B超定量肝脏脂肪含量(LFC)变化。结果治疗12周后,艾塞那肽组BW、BMI、腰臀比(WHR)、HbA1c、FPG、TG,2hPG、ALT、AST水平均降低(P<0.05, P<0.01),FINS、HOMA-IR及chemerin水平亦降低(P<0.01),LFC减少(P<0.01)。对照组的HbA1c、FPG较治疗前降低(P<0.01)。相关回归分析显示BMI、TG、HOMA-IR、chemerin与LFC相关;多元逐步回归分析结果显示HOMA-IR、TG的下降纳入回归方程,是LFC下降的独立影响因子(β值分别为1.614、 1.360, P<0.05)。结论艾塞那肽能够改善糖脂代谢、肝功能,同时减轻体质量和肝脏脂肪含量,降低血清chemerin水平,有可能成为治疗T2DM合并NAFLD的有效药物。

关键词: 艾塞那肽, 肝脏脂肪含量, 2型糖尿病, 超声, Chemerin

Abstract: Objective To evaluate the effects of exenatide on the plasma glucose, liver fat content and serum chemerin in type 2 diabetic(T2DM)combined with non-alcoholic fatty liver disease(NAFLD)patients. Methods Sixty patients with T2DM and NAFLD were randomly divided into exenatide group(n=30)and control group(n=30). Exenatide group was treated by exenatide(10 μg subcutaneous injection one hour before breakfast and dinner), and the control group was treated by insulin glargine(the starting dose was 0.2 U/kg or 6-10 U)for 12 weeks. The changes of body weight(BW), body mass index(BMI), fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1c), blood lipid(including TG, TC, HDL and LDL), insulin resistance index(HOMA-IR), liver enzyme index(including ALT and AST)and serum chemerin levels were measured, and the change of liver fat content was quantitated by ultrasound. Results Treated for 12 weeks, the levels of BW, BMI, WHR, HbA1c, FPG, TG, 2hPG, ALT, AST in exenatide group were significantly declined(P<0.05, P<0.01), the levels of FINS, HOMA-IR, chemerin and LFC decresed(P<0.01); the levels of HbA1c and FPG decresed in control group(P<0.01). Correlation analysis showed that BMI, TG, HOMA-IR and chemerin were associated with LFC; the decrease of TG and HOMA-IR were 山东大学学报 (医学版)54卷11期 -于宁,等.艾塞那肽对2型糖尿病合并非酒精性脂肪肝患者肝脏脂肪含量及血清chemerin水平的影响 \=-independently impacting factors for LFC by multiple stepwise regression analysis(β=1.614, 1.360, P<0.05). Conclusion Exenatide can improve the glucolipid metabolism and liver function, and reduce BW, LFC and serum chemerin levels, which may be the effect drugs for the treatment of T2DM combined with NAFLD.

Key words: Liver fat contents, Exenatide, Type 2 diabetes mellitus, Ultrasound, Chemerin

中图分类号:

R587.1

于宁,高燕燕,咸玉欣,牛佳鹏,李莉,王静,曹彩霞. 艾塞那肽对2型糖尿病合并非酒精性脂肪肝患者肝脏脂肪含量及血清chemerin水平的影响[J]. 山东大学学报（医学版）, 2016, 54(11): 51-55.

YU Ning, GAO Yanyan, XIAN Yuxin, NIU Jiapeng, LI Li, WANG Jing, CAO Caixia. Effect of exenatide on serum chemerin level and liver fat contents in type 2 diabetes mellitus combined with non-alcoholic fatty liver disease patients[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(11): 51-55.

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