维生素D辅助还原型谷胱甘肽对2型糖尿病合并非酒精性脂肪性肝病患者肝脏脂肪沉积和肠道菌群的影响

doi:10.20047/j.issn1673-7210.2023.09.16

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摘要目的探讨维生素D辅助还原型谷胱甘肽治疗2型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）的效果及对肝脏脂肪沉积和肠道菌群的影响。方法选择2019年7月至2020年10月于新疆维吾尔自治区喀什地区第一人民医院内分泌科就诊的168例T2DM合并NAFLD患者为研究对象，按照随机数字表法将其分为对照组和观察组，每组84例。对照组予常规治疗和还原型谷胱甘肽，观察组在对照组基础上予维生素D辅助治疗。两组疗程均为3个月。比较两组NAFLD疗效，比较两组治疗前后的肝功能、肝脏脂肪沉积、肠道菌群和血糖指标。结果治疗过程中，对照组脱落2例，观察组脱落4例。观察组NAFLD疗效优于对照组（P＜0.05）。治疗后，两组谷丙转氨酶（GPT）、谷草转氨酶（GOT）、γ-谷氨酰基转移酶（GGT）、控制衰竭参数（CAP）、肝脏硬度测定值（LSM）、肝脏脂肪含量及大肠埃希菌、空腹血糖（FPG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）水平均低于治疗前，双歧杆菌、乳杆菌水平高于治疗前（P＜0.05）。治疗后，观察组GPT、GOT、GGT、CAP、LSM、肝脏脂肪含量及大肠埃希菌、FPG、2hPG、HbA1c水平均低于对照组，双歧杆菌、乳杆菌水平高于对照组（P＜0.05）。结论维生素D辅助还原型谷胱甘肽治疗T2DM合并NAFLD患者效果良好，能够提高临床效果，改善肝功能，减少肝脏脂肪沉积和调节肠道菌群。

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	热依汗尼沙·亚克亚祖力皮亚·努尔买买提依丽米热·努尔麦麦提

关键词 ：维生素D, 还原型谷胱甘肽, 2型糖尿病, 非酒精性脂肪性肝病, 肝脏脂肪沉积, 肠道菌群

Abstract：Objective To investigate the effect of vitamin D assisted reduced glutathione in the treatment of type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) and its influence on hepatic lipidosis and intestinal flora. Methods A total of 168 patients with T2DM complicated with NAFLD admitted to the Department of Endocrinology of the First People’s Hospital of Kashgar, Xinjiang Uygur Autonomous Region from July 2019 to October 2020 were selected as the study objects. According to the random number table method, they were divided into control group and observation group, with 84 cases in each group. The control group received conventional treatment and reduced glutathione, and the observation group received vitamin D assisted therapy on the basis of the control group. The treatment course of both groups was three months. The efficacy of NAFLD was compared between the two groups, and the liver function, liver fat deposition, intestinal flora, and blood glucose indexes before and after treatment were compared between the two groups. Results There were two cases in the control group and four cases in the observation group during the treatment. The efficacy of NAFLD in the observation group was better than that in the control group (P＜0.05). After treatment, glutamic pyruvic transaminase (GPT), glutamic oxaloacetic aminotransferase (GOT), γ-glutamyltransferase (GGT), controlled attenuation parameter (CAP), liver stiffness measurement (LSM), liver fat content, and levels of Escherichia coli, fasting blood glucose (FPG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) of two groups were lower than those before treatment, while levels of Bifidobacterium and Lactobacillus in two groups were higher than those before treatment (P＜0.05). After treatment, GPT, GOT, GGT, CAP, LSM, liver fat content, and levels of Escherichia coli, FPG, 2hPG, HbA1c in observation group were lower than those in control group, while levels of Bifidobacterium and Lactobacillus were higher than those in control group (P＜0.05). Conclusion Vitamin D-assisted reduced glutathione has a good effect in the treatment of T2DM patients with NAFLD, which can improve clinical effect, improve liver function, reduce liver lipidosis, and regulate intestinal flora.

Key words： Vitamin D Reduced glutathione Type 2 diabetes mellitus Non-alcoholic fatty liver disease Liver lipidosis Intestinal flora

基金资助:新疆维吾尔自治区健康青年医学科技人才专项科研项目（WJWY-202102）。

引用本文:

热依汗尼沙·亚克亚祖力皮亚·努尔买买提依丽米热·努尔麦麦提. 维生素D辅助还原型谷胱甘肽对2型糖尿病合并非酒精性脂肪性肝病患者肝脏脂肪沉积和肠道菌群的影响[J]. 中国医药导报, 2023, 20(9): 75-79.
Reyihannisha·Yakeya Zulipiya·Nuermaimaiti Yilimire·Nuermaimaiti. Influence of vitamin D assisted reduced glutathione on hepatic lipidosis and intestinal flora in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease. 中国医药导报, 2023, 20(9): 75-79.

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https://www.yiyaodaobao.com.cn/CN/10.20047/j.issn1673-7210.2023.09.16 或 https://www.yiyaodaobao.com.cn/CN/Y2023/V20/I9/75