国际老年医学杂志2017，Vol.38Issue(6)：263-266,285,5.DOI:10.3969/j.issn.1674-7593.2017.06.006
厄贝沙坦和α-硫辛酸联合二甲双胍治疗2型糖尿病合并非酒精性脂肪肝的疗效及对患者胰岛素抵抗的影响
Effects of Irbesartan, α-lipoic Acid Combined with Metformin on Insulin Resistance in the Treatment of Type 2 Diabetes Mellitus with Nonalcoholic Fatty Liver
摘要
Abstract
Objective To investigate the clinical efficacy of irbesartan, α-lipoic acid combined with metformin on insulin resistance (IR) in the treatment of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver (NAFLD). Methods 156 T2DM patients with NAFLD in our hospital from December in 2014 to June in 2015 were selected and were divided into the control group (n=90) and the observation group (n=66) according to different treatment methods. The control group receicved routine treatment and observation group received irbesartan and α-lipoic acid on the basis of the control group. The courses of the treatment in the two groups were 3 months. The levels of serum glucose, lipid metabolism and liver function were measured before and after treatment.The serum insulin levels were measured, the insulin resistance index (HOMA-IR) was calculated and the improvement of IR was analyzed before and after treatment. Results After the treatment, the levels of serum fasting plasma glucose (FPG), 2h plasma glucose (2h PG), hemoglobin Alc (HbA1c), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterin (LDL-C), fasting insulin (FINS) and HOMA-IR in the two groups were significantly lower than those before the treatment (P<0.05 or P<0.01), and the ones in the observation group were significantly lower than those in the control group (P<0.05 or P<0.01). The level of serum free fatty acid (FFA) in the observation group was lower before the treatment than the control group (P<0.05). After the treatment, the total effective rate of liver steatosis was 71.21% in the observation group, which was significantly higher than that in the control group (35.56%) (P <0.01). After the treatment, the levels of serum alanine aminotransfease (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (GGT) in the two groups were significantly lower than those before the treatment (P<0.05 or P<0.01), and the ones in the observation group were significantly lower than those in the control group (P<0.05 or P<0.01). Conclusion Irbesartan, α-lipoic acid combined with metformin can effectively regulate the glucose and lipid metabolism disorders of T2DM patients with NAFLD, improve the IR effect of the body, inhibit the deterioration of fatty liver and protect the liver function of patients.关键词
2型糖尿病/非酒精性脂肪肝/厄贝沙坦/α-硫辛酸/二甲双胍/糖脂代谢/胰岛素抵抗Key words
Type 2 diabetes mellitus/Nonalcoholic fatty liver/Irbesartan/α-lipoic acid/Metformin/Glycolipid me-tabolism/Insulin resistance引用本文复制引用
李海玲,董陆玲,杨亚萍,杨秀红,张贵山..厄贝沙坦和α-硫辛酸联合二甲双胍治疗2型糖尿病合并非酒精性脂肪肝的疗效及对患者胰岛素抵抗的影响[J].国际老年医学杂志,2017,38(6):263-266,285,5.基金项目
张家口市科学技术项目(1521079D) （1521079D）
