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首页> 外文期刊>Journal of Dhaka Medical College >Combined use of metformin and Pioglitazone than metformin alone in Glucose intolerance patients with Nonalcoholic fatty liver disease showed significant Radiological and Biochemical improvement
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Combined use of metformin and Pioglitazone than metformin alone in Glucose intolerance patients with Nonalcoholic fatty liver disease showed significant Radiological and Biochemical improvement

机译：非酒精性脂肪肝合并葡萄糖耐量异常的患者中，二甲双胍和吡格列酮联合使用比单用二甲双胍显示出显着的放射和生化改善

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Context: Non Alcoholic Fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. The pathogenesis of steatosis and cellular injury is thought to be related mostly to insulin resistance. Insulin sensitizing drugs showed promising results in number of trials. This was an open label clinical trial in newly detected glucose intolerant patients with NAFLD, to evaluate the effectiveness and superiority of pioglitazone and metformin combination to metformin alone. Methods: Forty nine patients with newly detected abnormal glucose tolerance, na?ve to any anti diabetic drug, were randomly selected, from the gastroenterology out-patient department of BIRDEM Hospital, Dhaka, with the findings of ultasonographic changes of fatty liver and raised ALT and assigned to 6 months treatment with pioglitazone 30 mg plus metformin 1700 mg daily (Group 1, n=27) or only metformin 1700 mg alone (Group 2, n=22). Results: Mean age of the study population was 45.80±8.54 years, Male female distribution of the study subjects were 65.3% and 34.7% respectively. Significant reduction of ALT, F, ABF, HbA1c, cholesterol, triglyceride of the study population were achieved either by metformin alone or with combination after six months (visit 1 vs visit 3, ALT: 97.99+22. vs 55±17.49 u/ l; Fasting sugar: 9.1+1.9 vs6.64±0.94, mmol/l; ABF: 13.3±2.5 vs 8.69±1.21 mmol/l; HBA1c: 8.1±0.9 vs 6.87±0.57%; Cholesterol: 205.9±30.1 vs 186.12±22.26 mg/dl; TG: 230.4+48.1 vs 166.2±31.82). In comparison between two groups, Group 1 had found to be significantly better glycemic control compared to their counterpart at the end of 6 months (Group 1 vs Group 2, FBG: 6.37±0.56 vs 6.98±1.2; ABF: 8.34±0.84 vs 9.1±1.46; serum cholesterol, TG, and ALT levels were also found to be significant change as Cholesterol: 178.89±18.59 vs 195±23.55 mg/dl; TG: 155.85±20.99 vs 178.91±38.24 mg/ dl; ALT: 55±17.49 vs 45.74±12.63 u/L. In final visit, ultrasonographic change also found to be significantlyimproved from fatty change to normal in patients with both metformin and pioglitazone group than patients on metformin alone. Conclusion: Treatment of NAFLD of newly detected Type 2 DM or IGT patients with high ALT by both metformin and pioglitazone is more effective in reduction of ALT and lipids and also able to reverse the severity of fatty changes of liver towards normal significantly. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21540 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 188-194
机译：背景：非酒精性脂肪性肝病（NAFLD）是代谢综合征的肝脏表现。人们认为脂肪变性和细胞损伤的发病机理主要与胰岛素抵抗有关。胰岛素增敏药物在许多试验中均显示出令人鼓舞的结果。这是一项针对新发现的糖耐量异常的NAFLD患者的开放标签临床试验，旨在评估吡格列酮和二甲双胍联合用药对单独使用二甲双胍的有效性和优越性。方法：从达卡BIRDEM医院消化内科门诊随机选择49名新发现的糖耐量异常，且未使用任何抗糖尿病药物的患者，并进行超声检查，发现脂肪肝和ALT升高并接受吡格列酮30 mg每天加二甲双胍1700 mg（第1组，n = 27）或仅单独服用二甲双胍1700 mg（第2组，n = 22）治疗6个月。结果：研究人群的平均年龄为45.80±8.54岁，研究对象的男性和女性分布分别为65.3％和34.7％。单独使用二甲双胍或六个月后联合使用二甲双胍可以显着降低研究人群的ALT，F，ABF，HbA1c，胆固醇，甘油三酯（访问1 vs访问3，ALT：97.99 + 22。vs 55±17.49 u / l） ;空腹糖：9.1 + 1.9 vs.6.64±0.94，mmol / l; ABF：13.3±2.5 vs 8.69±1.21 mmol / l; HBA1c：8.1±0.9 vs 6.87±0.57％;胆固醇：205.9±30.1 vs 186.12±22.26 mg / dl; TG：230.4 + 48.1对166.2±31.82）。在两组之间进行比较后，发现第1组在6个月末时的血糖控制水平明显优于对照组（第1组vs第2组，FBG：6.37±0.56 vs 6.98±1.2; ABF：8.34±0.84 vs 9.1 ±1.46;血清胆固醇，TG和ALT水平也有显着变化，胆固醇：178.89±18.59 vs 195±23.55 mg / dl; TG：155.85±20.99 vs 178.91±38.24 mg / dl; ALT：55±17.49 vs 45.74±12.63 u / L。在最后一次访视中，发现二甲双胍和吡格列酮组患者的超声检查结果从脂肪改变到正常也明显优于单独使用二甲双胍的患者结论：新发现的2型DM或NAFLD的治疗二甲双胍和吡格列酮对ALT较高的IGT患者在降低ALT和脂质方面更有效，并且还能够将肝脏脂肪改变的严重程度显着逆转为正常。DOI：http://dx.doi.org/10.3329/jdmc .v22i2.21540 J Dhaka医学院，Vol.22，No.2，2013年10月，第188-194

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