Clinical effect of dipeptidyl peptidase-4 inhibitor in the treatment of patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease
FANG Qi-jin1 ZHANG Yu2 CHEN Mei-lian3 DENG Li2 ZHOU Shan-cun2 WANG Shao-bo2
1.Community Health Service Center of Houjie Town in Dongguan City,Guangdong Province,Dongguan 523900,China;
2.Department of Endocrinology, Houjie Hospital of Dongguan, Guangdong Province, Dongguan 523900, China;
3.Department of Laboratory, Houjie Hospital of Dongguan, Guangdong Province, Dongguan 523900, China
Abstract：Objective To investigate the clinical effect of dipeptidyl peptidase-4 (DPP-4) inhibitor in the treatment of patients with type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD).Methods From January 2017 to June 2018, 120 patients with T2DM complicated with NAFLD in Houjie Hospital of Dongguan were selected as objects and randomly divided into the control group and the observation group, 60 cases in each group.The control group was treated with Metformin plus placebo, and the observation group was treated with DPP-4 inhibitor Saxagliptin on the basis of Metformin.The levels of blood glucose indicators (fasting blood glucose [FBG], postprandial 2 h blood glucose [2 h PG], glycosylated hemoglobin [HbA1c]),blood lipid indicators (total cholesterol [TC], triglyceride[TG], high-density lipoprotein cholesterol [HDL-C],low-density lipoprotein cholesterol [LDL-C]), liver function indicators (alanine aminotransferase [ALT], aspartate aminotransferase [AST], glutamyl transpeptidase [GGT]), fibroblast growth factor 21 (FGF21) were compared between the two groups before treatment and after 3 months of treatment, and the incidence of adverse reactions in the two groups of patients was counted.Results There were no significant differences in the blood glucose levels between the two groups before treatment and after treatment (P>0.05).The levels of FBG, 2 h PG and HbA1c in the two groups after treatment were significantly lower than those before treatment, and the differences were statistically significant (P<0.05).There were no significant differences in the levels of blood lipid indicators between the two groups before treatment (P>0.05).The levels of TC, TG and LDL-C in the two groups after treatment were lower than those before treatment, the HDL-C level was higher than that before treatment, and the differences were statistically significant (P<0.05).The levels of TC,TG and LDL-C in the observation group after treatment were lower than those in the control group, the HDL-C level was higher than that in the control group, and the differences were statistically significant (P<0.05).There were no significant differences in the levels of liver function indicators between the two groups before treatment (P>0.05).The levels of AST, ALT and GGT in the two groups after treatment were significantly lower than those before treatment, and the differences were statistically significant (P<0.05).The levels of AST, ALT and GGT in the observation group after treatment were lower than those in the control group, and the differences were statistically significant (P<0.05).There was no significant difference in serum FGF21 level between the two groups before treatment (P>0.05).The serum level of FGF21 in the two groups after treatment was significantly lower than that before treatment, and the difference was statistically significant (P<0.05).The serum level of FGF21 in the observation group after treatment was lower than that in the control group, and the difference was statistically significant (P<0.05).There was no significant difference in the total incidence rate of adverse reactions between the two groups (P>0.05).Conclusion DPP-4 inhibitor has better effect on improving blood lipid in T2DM patients with NAFLD, which can significantly reduce the level of serum FGF21 and avoid liver function damage.
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