摘要
Abstract
Objective To investigate the efficacy of sitagliptin combined with metformin in patients with type 2 diabetes melli-tus(T2DM)and nonalcoholic fatty liver disease(NAFLD),and its effect on myocardial injury and cardiac function.Methods A total of 522 T2DM patients with NAFLD who were treated at Anyang People's Hospital from January 2020 to December 2023 were randomly divided into two groups using a random number table method:a control group of 261 patients(treated with metformin)and a study group of 261 patients(treated with sitagliptin combined with metformin).The clinical treatment efficacy,blood glucose,liver func-tion,myocardial injury,heart function,and incidence of adverse reactions were compared between the two groups.Results Com-pared with the control group,the total effective rate of the study group was higher(90.80%vs 75.86%)(P<0.05).Compared with before treatment,both groups showed significant reductions in fasting blood glucose(FPG),2-hour plasma glucose(2hPG),glycated hemoglobin(HbA1c),aspartate aminotransferase(AST),alanine aminotransferase(ALT),gamma glutamyltransferase(GGT),N-terminal pro-B-type natriuretic peptide(NT proBNP),cardiac troponin T(cardiac troponin T),and cardiac troponin T(cTnT)after treatment(P<0.05).After treatment,the study group showed more significant decreases in fasting plasma glucose(FPG:5.97±1.23)mmol/L,2-hour plasma glucose(2hPG:8.87±1.3)mmol/L,glycated hemoglobin(HbA1c:7.69±1.28)%,aspartate amino-transferase(AST:34.82±7.52)IU/L,alanine aminotransferase(ALT:38.54±11.25)IU/L,gamma glutamyltransferase(GGT:36.81±7.05)IU/L,N-terminal pro-B-type natriuretic peptide(NT-proBNP:75.58±20.47)pg/mL,and cardiac troponin T(c-TnT:11.22±1.35)ng/L compared to the control group(P<0.05).Compared with before treatment,both groups showed a significant decrease in heart rate(HR)after treatment(P<0.05),a significant increase in the ratio of early diastolic peak velocity(E)to late diastolic peak velocity(A)of the mitral annulus(E/A),and left ventricular ejection fraction(LVEF)(P<0.05).After treatment,the left ventricular end diastolic dimension(LVDD)mm in the study group increased significantly(P<0.05).After treatment,the study group showed more significant changes in heart rate(HR:81.54±7.63)beats/min,the E/A ratio(1.06±0.19),and left ventricular ejection fraction(LVEF:64.44±1.59)%compared to the control group(P<0.05).There was no significant difference in the occur-rence of adverse reactions between the study group(12.64%)and the control group(8.81%)(P ˃ 0.05).Conclusion In patients with type 2 diabetes mellitus(T2DM)complicated by non-alcoholic fatty liver disease(NAFLD),the combination therapy of sita-gliptin with metformin can improve clinical outcomes,lower blood glucose levels,ameliorate liver function,reduce myocardial damage,and improve cardiac function,with a high level of safety.关键词
西格列汀/二甲双胍/非酒精性脂肪肝/2型糖尿病/心肌损伤/心功能Key words
Sigliptin/Metformin/Nonalcoholic fatty liver/Type 2 diabetes mellitus/Myocardial injury/Cardiac function分类
医药卫生
