|
|
Effects of Metformin Combined with Liraglutide on Islet β Cell Function, Liver Function and Treg Cells in Peripheral Blood of Patients with T2DM and NAFLD |
WANG Yan-ni,LI Zhuan-xia |
Department of Endocrinology, the Second Hospital, Yulin City, Shaanxi Province, 719000 |
|
|
Abstract 【Objective】To investigate the effects of metformin combined with liraglutide on islet β cell function, liver function and Treg cells in peripheral blood of patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver (NAFLD).【Methods】From January 2015 to December 2016, 93 patients with T2DM complicated with NAFLD were selected and were randomly divided into the observation group (n=47) and the control group (n=46). Two groups of patients were treated with metformin, the observation group received subcutaneous injection of liraglutide, the control group were given subcutaneous injection of insulin glargine. The course of treatment was 3 months. The levels of HbAlcN, FPGN, 2hPGN, FINS, HOMA-IR, HOMA-β, ALT, AST, GGT, TC, TG, HDL-C, LDL-C, and the ratio of Treg cells in peripheral blood to CD4+ T cells were compared between the two groups before and after treatment, the decrease in the observation group was more significant than that in the control group (P<0.05). The Treg/CD4+ in peripheral blood of the two groups before treatment was 5.62 ±1.80 % and 5.74 ±1.53% respectively, there was no significant difference between the two groups (P>0.05).【Results】Compared with that before treatment, the level of HbAlc, FPG, 2hPG and HOMA-IR decreased after treatment in both groups (P<0.05) and the value of HOMA-βincreased significantly (P<0.05).The level of HbA1c in the observation was lower than that of the control group after treatment, the difference was significant (t=2.230, P=0.028), and the rest indexes has no statistical significance (P>0.05).There was no significant difference in liver function and lipid metabolism between the two groups before treatment (P>0.05). The levels of ALT, AST and GGT in the observation group were lower than those before treatment, and the difference was statistically significant (P<0.05). The levels of ALT, AST and GGT in the control group were not significantly different from those before treatment (P>0.05). The levels of TC, TG, HDL-C and LDL-C in the two groups were lower than those before treatment, the difference was statistically significant (P<0.05), and the Treg/CD4+ in the observation group was significantly lower than that in the control group (P<0.05), the difference was statistically significant (P<0.05).【Conclusion】Metformin combined with Lilalutide in the treatment of T2DM patients with NAFLD can effectively restore the function of islet β cells, reduce the degree of insulin resistance, and achieve the purpose of blood glucose control, which is worthy of clinical application.
|
Received: 24 August 2017
|
|
|
|
|
[1] 王珏云,杨高松,张显燕.化浊解毒中药联合利拉鲁肽治疗2型糖尿病合并非酒精性脂肪肝疗效及对血脂、肝功能的影响[J].现代中西医结合杂志,2017,26(22):2425-2428. [2] 廖涌.中国糖尿病的流行病学现状及展望[J].重庆医科大学学报,2015(7):1042-1044. [3] Cernea S,Cahn A,Raz I.Pharmacological management of nonalcoholic fatty liver disease in type 2 diabetes.Expert[J] .Rev Clin Pharmacol,2017,10(5):535-547. [4] Bouchi R,Nakano Y,Fukuda T,et al.Reduction of visceral fat by liraglutide is associated with ameliorations of hepatic steatosis,albuminuria,and micro-inflammation in type 2 diabetic patients with insulin treatment: a randomized control trial[J].Endocr J,2017,64(3):269-281. [5] 郭晓宇,王平,高宇,等.利拉鲁肽对高脂喂养大鼠肝脏内质网应激及脂质沉积影响的实验研究[J].中国糖尿病杂志,2017,25(1):76-80. [6] Smits MM,Tonneijck L,Muskiet MH,et al.Twelve week liraglutide or sitagliptin does not affect hepatic fat in type 2 diabetes: a randomised placebo-controlled trial[J].Diabetologia,2016,59(12):2588-2593. [7] 刘开渊.利拉鲁肽对2型糖尿病合并非酒精性脂肪肝病肝脂肪变的影响[J].中国中西医结合消化杂志,2017,25(3):195-198. [8] 孔亚坤,周艳红,赵建林,等.利拉鲁肽对2型糖尿病合并非酒精性脂肪性肝病患者血清FGF-21水平的影响[J].药学与临床研究,2016,24(6):464-466. [9] Barb D,Portillo-Sanchez P,Cusi K.Pharmacological management of nonalcoholic fatty liver disease[J].Metabolism,2016,65(8):1183-1195. [10] 李卫东,傅坤发,连燕舒,等.成人非酒精性脂肪肝与2型糖尿病发病关系的前瞻性队列研究[J].中国全科医学,2015,18(28):3426-3429. [11] 金惠琳,赵红燕,李媛红,等.利拉鲁肽在2型糖尿病合并脂肪肝治疗中的临床观察[J].哈尔滨医药,2014,34(4):279. [12] García Díaz E,Guagnozzi D,Gutiérrez V,et al.Effect of incretin therapies compared to pioglitazone and gliclazide in non-alcoholic fatty liver disease in diabetic patients not controlled on metformin alone: An observational,pilot study[J].Endocrinol Nutr,2016,63(5):194-201. [13] 沙莎.GLP-1类似物利拉鲁肽对高脂诱导肥胖小鼠的CD4+ T细胞亚群失衡的作用[D].山东大学,2016. [14] 程瑗,陈永平,金晓芝,等.非酒精性单纯性脂肪肝患者外周血CD4+CD25+调节性T细胞数量变化及临床意义[J].中华传染病杂志,2012,30(1):43-47. |
|
|
|