摘要
目的 探讨度拉糖肽联合生酮饮食治疗老年2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的效果。方法 纳入2021年2月至2023年2月收治的94例T2DM合并NAFLD患者,采用摸球法分组,奇数为对照组(n=47),偶数为观察组(n=47),对照组予以胰岛素联合生酮饮食治疗,观察组予以度拉糖肽联合生酮饮食治疗,比较两组临床疗效,评估治疗前后的血糖、血脂、肝功能及氧化应激反应,同时监测不良反应发生率。结果 观察组治疗有效率为97.87%(46/47),高于对照组的82.98%(39/47)。观察组FBG(6.10±1.22)mol/L、2hPBG(8.21±1.75)mol/L、HbA1c(6.21±1.25)%,低于对照组的(7.35±1.58)mol/L、(10.23±2.06)mol/L、(7.69±1.58)%。观察组TC(3.22±0.87)mol/L、TG(1.22±0.21)mol/L,低于对照组的(4.69±1.01)mol/L、(2.15±0.57)mol/L。观察组AST(23.54±3.59)U/L、ALT(41.32±4.76)U/L、GGT(31.62±4.01)U/L,低于对照组(32.78±4.27)U/L、(52.36±6.02)U/L、(49.86±5.75)U/L。观察MDA(642.51±90.27)mol/L、8-iso-PGF2α(125.35±11.05)pg/mL,低于对照组的(724.25±95.21)mol/L、(142.58±11.47)pg/mL,而GSH-Px(151.21±15.67)U/mL高于对照组(120.52±12.58)U/mL,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论 度拉糖肽与生酮饮食联合治疗老年T2DM伴NAFLD效果显著,能有效降低血糖、血脂及改善肝功能和氧化应激反应,与胰岛素联合生酮饮食相比,临床疗效更好,且安全性相当。
Objective To evaluate the therapeutic effects of dulaglutide in combination with a ketogenic diet in the management of elderly patients with type 2 diabetes mellitus(T2DM)complicated with non-alcoholic fatty liver disease(NAFLD).Methods From February 2021 to February 2023,94 patients with T2DM and NAFLD were enrolled in this study.Participants were randomly assigned to two groups:by random draw,the control group(n=47),receiving insulin and a ketogenic diet,and the observation group(n=47),treated with dulaglutide and a ketogenic diet.Clinical efficacy was assessed by comparing pre-and post-treatment levels of blood glucose,lipids,liver function,and oxidative stress markers between the two groups.Additionally,the incidence of adverse reactions was monitored.Results Post-treatment,the efficacy rate in the observation group was 97.87%,significantly higher than in the control group(82.98%).The observation group demonstrated significantly lower levels of fasting blood glucose(FBG)(6.10±1.22),2-hour postprandial blood glucose(2hPBG)(8.21±1.75),and HbA1c(6.21±1.25)compared to the control group(7.35±1.58,10.23±2.06,7.69±1.58,respectively).Lipid levels,including total cholesterol(TC)(3.22±0.87)and TG(1.22±0.21)were also lower in the observation group compared to the control group(4.69±1.01 and 2.15±0.57,respectively).Liver function markers such as AST(23.54±3.59),ALT(41.32±4.76),and GGT(31.62±4.01)were significantly reduced in the observation group compared to the control group(32.78±4.27,52.36±6.02,and 49.86±5.75,respectively).Additionally,oxidative stress markers,including MDA(642.51±90.27)and 8-iso-PGF2α(125.35±11.05),were lower,while GSH-Px(151.21±15.67)was higher in the observation group compared to the control group(724.25±95.21,142.58±11.47,and 120.52±12.58,respectively),with all differences being statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The combination of dulaglutide and a ketogenic diet significantly improves clinical outcomes in elderly patients with T2DM and NAFLD,effectively reducing blood sugar and lipid levels,enhancing liver function,and mitigating oxidative stress responses compared to insulin combined with a ketogenic diet,while maintaining a comparable safety profile.
作者
彭钰涵
刘子兰
张潇
PENG Yu-han;LIU Zi-lan;ZHANG Xiao(Department of Pharmacy,People’s Hospital of Jin Niu District,Chengdu 610000,China;Department of Pharmacy,Xi’an Jiaotong University Hospital,Shaanxi 710048,China;Department of Geriatrics,Xi’an High-tech Hospital,Shaanxi 710075,China)
出处
《肝脏》
2024年第9期1132-1136,共5页
Chinese Hepatology
基金
四川省科技厅科研基金资助项目(编号:2021LJ0240001)。
关键词
度拉糖肽
生酮饮食
老年2型糖尿病
非酒精性脂肪肝
Dulaglutide
Ketogenic diet
Elderly type 2 diabetes mellitus
Non-alcoholic fatty liver disease
