| 范国洽,刘 珊,樊静珊,郭鹏鹏,张丽娜,王慧娟.恩格列净对2型糖尿病合并非酒精性脂肪性肝病的影响[J].,2023,(19):3709-3713 |
| 恩格列净对2型糖尿病合并非酒精性脂肪性肝病的影响 |
| Effects of Empagliflozin on Liver in Patients with Type 2 Diabetes Mellitus Patients with Nonalcoholic Fatty Liver Disease |
| 投稿时间：2023-03-26 修订日期：2023-04-22 |
| DOI：10.13241/j.cnki.pmb.2023.19.022 |
| 中文关键词: 糖尿病 2型 非酒精性脂肪性肝病 钠-葡萄糖协同转运蛋白2抑制剂 胰岛素 |
| 英文关键词: Diabetes mellitus Type 2 Non-alcoholic fatty liver disease Sodium-Glucose Transporter 2 Inhibitors Insulin |
| 基金项目:河北省医学科学研究重点课题计划项目（20181036）；石家庄市科学技术研究与发展计划项目（211200903） |
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| 中文摘要: |
| 摘要 目的：探讨恩格列净单独及联合胰岛素治疗对2型糖尿病合并非酒精性脂肪性肝病（NAFLD）患者的影响。方法：本研究选择2021.3-2022.8于石家庄市第二医院门诊就诊的2型糖尿病合并NAFLD的300例患者作为研究对象，分为胰岛素治疗组（100例）、恩格列净单药治疗组（100例）及恩格列净联合胰岛素治疗组（100例），治疗48周，采集患者治疗前后体重、体质指数（BMI）、谷草转氨酶（AST）、谷丙转氨酶（ALT）、谷酰转肽酶（GGT）、血常规、HbA1c、肝脏脂肪含量等指标，计算患者NFS、FIB-4指标，比较不同治疗方案治疗前后患者临床特征的变化。观察三组临床治疗期间不良反应的发生情况。结果：应用胰岛素治疗的患者HbA1c及空腹血糖显著下降；BMI、ALT、AST、GGT、肝脏脂肪含量、NFS、FIB-4无变化。恩格列净单药治疗的患者，ALT、AST、GGT、NFS、FIB-4、肝脏脂肪含量均显著下降（P<0.05）；恩格列净联合胰岛素治疗的患者ALT、AST、GGT、NFS、FIB-4、肝脏脂肪含量显著下降（P<0.05）。多元线性回归提示应用恩格列净和肝脏脂肪含量的变化相关（P<0.05），BMI、HbA1c的变化和肝脏脂肪含量的变化无关（P<0.05）。三组患者治疗期间总不良反应发生率差异无统计学意义（P＞0.05）。结论：恩格列净单药治疗或联合胰岛素治疗均可降低2型糖尿病合并NAFLD患者肝脏脂肪含量均、转氨酶水平，改善肝纤维化。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of empagliflozin on the liver of type 2 diabetes patients with non-alcoholic fatty liver disease (NAFLD). Methods: Patients with type 2 diabetes mellitus and NAFLD treated in the outpatient department of the Second Hospital of Shijiazhuang from2021.3-2022.8 were selected as the research object. They were divided into insulin treatment group（n=100）, empagliflozin treatment group（n=100） and empagliflozin combined with insulin treatment group（n=100）, treated for 48 weeks. Body weight, body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamyl transpeptide (GGT), routineblood indexes, HbA1c, liver fat content and other indicators were collected before and after treatment. The NFS and FIB-4 indexes were calculated. The clinical characteristics of patients with different treatment regimens were compared before and after treatment. Results: Patients treated with insulin, HbA1c, fasting blood glucose decreased significantly, There were no significant changes in BMI, ALT, AST, GGT and liver fat content. Patients treated with empagliflozin, ALT, AST, GGT, Livr fat content decreased significantly. Patients treated with empagliflozin combined with insulin, ALT, AST, GGT, Liver fat content decreased significantly. NFS and FIB-4 all decreased significantly. Multivariate regression analysis showed the changes of BMI and blood glucose were not related to the changes of liver fat content. Conclusion: Empagliflozin therapy can reduce the liver fat content and transaminase level in patients with type 2 diabetes mellitus and NAFLD, and improve liver fibrosis. |
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