Diabetes Care:曲格列嗪对2型糖尿病和非酒精性脂肪肝患者肝脏脂肪含量的影响!

2018-06-15 xing.T MedSci原创

由此可见,在2型糖尿病的标准治疗中加入曲格列嗪可以显著降低2型糖尿病和NAFLD患者肝脏脂肪含量,并改善ALT水平。

钠葡萄糖协同转运蛋白2(SGLT-2)抑制剂在动物模型中已被证明可以降低肝脏脂肪含量。关于SGLT-2抑制剂对人类肝脏脂肪影响的数据十分有限。近日,糖尿病领域权威杂志Diabetes Care上发表了一篇研究文章,该研究旨在利用MRI衍生的质子密度脂肪分数(MRI-PDFF)探讨曲格列嗪(一种SGLT-2抑制剂)对2型糖尿病和非酒精性脂肪性肝病(NAFLD)患者肝脏脂肪的影响。

研究人员将50例2型糖尿病和NAFLD患者随机分为曲格列嗪组(2型糖尿病标准治疗加曲格列嗪10mg每天)和对照组(标准治疗未添加曲格列嗪),治疗20周。测定MRI-PDFF得到肝脏脂肪改变情况。次要终点指标为谷丙转氨酶(ALT)、门冬氨酸转氨酶变化(AST)和γ-谷氨酰转移酶(GGT)水平的变化情况。

在2型糖尿病的标准治疗中,曲格列嗪可以显著降低肝脏脂肪含量(曲格列嗪组和对照组之间MRI-PDFF的差异为-4%;P<0.0001)。与基线相比,曲格列嗪组可以显著减少治疗结束后MRI-PDFF(16.2-11.3%;P<0.0001),对照组中未发现显著的变化(16.4-15.5%;P=0.057)。血清ALT水平的变化两组间存在显著差异(P=0.005),而AST(P=0.212)和GGT水平(P=0.057)之间无显著差异。

由此可见,在2型糖尿病的标准治疗中加入曲格列嗪可以显著降低2型糖尿病和NAFLD患者肝脏脂肪含量,并改善ALT水平。

原始出处:

Mohammad Shafi Kuchay,et al. Effect of Empagliflozin on Liver Fat in Patients With Type 2 Diabetes and Nonalcoholic Fatty Liver Disease: A Randomized Controlled Trial (E-LIFT Trial).Diabetes Care.2018. https://doi.org/10.2337/dc18-0165

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  8. [GetPortalCommentsPageByObjectIdResponse(id=1760711, encodeId=575a1e60711eb, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Mon Feb 25 03:10:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1638649, encodeId=4b971638649f6, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Tue Apr 02 12:10:00 CST 2019, time=2019-04-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902077, encodeId=b71619020e716, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Wed May 08 13:10:00 CST 2019, time=2019-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1980479, encodeId=c95d19804e9a2, content=<a href='/topic/show?id=099f9548ed7' target=_blank style='color:#2F92EE;'>#酒精性脂肪肝#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95487, encryptionId=099f9548ed7, topicName=酒精性脂肪肝)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=26a9200, createdName=yangshch, createdTime=Fri Sep 07 03:10:00 CST 2018, time=2018-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1676414, encodeId=892616e641494, content=<a href='/topic/show?id=397299e19c7' target=_blank style='color:#2F92EE;'>#非酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99719, encryptionId=397299e19c7, topicName=非酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d18c27357544, createdName=Tommy1958, createdTime=Fri Mar 15 00:10:00 CST 2019, time=2019-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1673407, encodeId=e41816e340705, content=<a href='/topic/show?id=757b954e922' target=_blank style='color:#2F92EE;'>#酒精性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95479, encryptionId=757b954e922, topicName=酒精性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=398f26933958, createdName=huiwelcome, createdTime=Sun Sep 02 19:10:00 CST 2018, time=2018-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603640, encodeId=34d816036407c, content=<a href='/topic/show?id=0018814e070' target=_blank style='color:#2F92EE;'>#肝脏脂肪#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81470, encryptionId=0018814e070, topicName=肝脏脂肪)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7dee19073592, createdName=fengting9, createdTime=Sun Jun 17 05:10:00 CST 2018, time=2018-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324602, encodeId=7a51324602a8, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Sat Jun 16 09:34:58 CST 2018, time=2018-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=324438, encodeId=82cc3244389c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Jun 15 15:24:48 CST 2018, time=2018-06-15, status=1, ipAttribution=)]
    2018-06-16 cscdliu

    学习了.谢谢

    0

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    2018-06-15 一个字-牛

    学习了谢谢分享

    0

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在探讨新型降糖药钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂恩格列(empagliflozin)对心血管事件和死亡率的影响。研究纳入7020 例2型糖尿病(T2DM)心血管事件高危患者,在标准治疗基础上1︰1︰1 随机给予恩格列净10 mg、恩格列净25 mg或安慰剂,平均随访3.1年。主要终点为心血管死亡、非致死性心梗和非致死性卒中组成的复合终点。主要的次要复合终点为主要终点+不稳定心绞痛住院。

Diabetes Obes Metab:钠-葡萄糖协同转运体-2抑制剂的短期和中期疗效分析!

由此可见,SGLT-2抑制剂具有良好的持久性效果,至少长达两年,显著优于DPP-4I。磺脲类药物在短期内有效,但长期效果欠佳。