Résumé
Objective:To explore the effects of linagliptin on blood glucose, islet function and liver stiffness measurement (LSM) in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM).Methods:During the period from January 2019 to April 2020, 102 patients with NAFLD and T2DM in the Second Affiliated Hospital of Suzhou University were enrolled and divided into study group and control group according to different treatment methods, with 51 cases in each group. The control group was treated with metformin, while study group was treated with linagliptin and metformin. The clinical curative effect on fatty liver was observed and compared between the two groups. The levels of fasting blood glucose (FBG), glycated hemoglobin (HbA 1c), homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of islet insulin cell function index β (HOMA-β), alanine aminotransferase (ALT), serum aspartate aminotransferase (AST), glutamyl transpeptidase (GGT) and LSM before and after treatment were compared between the two groups. The occurrence of adverse reactions during treatment in both groups was recorded. Results:The total response rate of fatty liver treatment in study group was significantly higher than that in control group: 96.1% (49/51) vs. 82.4% (42/51), and there was statistical difference ( P<0.05). After treatment, levels of FBG, HbA 1c, HOMA-IR, serum ALT, AST, GGT and LSM in study group were significantly lower than those in control group: (7.1 ± 1.0) mmol/L vs. (7.9 ± 0.9) mmol/L, (7.5 ± 0.7)% vs. (7.9 ± 1.0)%, 3.2 ± 0.2 vs. 4.7 ± 0.3, (56.7 ± 10.4) U/L vs. (62.8 ± 8.2) U/L, (73.2 ± 6.8) U/L vs. (81.1 ± 6.7) U/L, (56.4 ± 10.2) U/L vs. (62.3 ± 8.1) U/L, (10.5 ± 3.3) kPa vs. (13.4 ± 1.6), the level of HOMA-β was significantly higher than that in control group: 48.5 ± 8.3 vs. 41.2 ± 7.1, and there were statistical differences ( P<0.05). The incidence of adverse reactions during treatment was low in both groups, and the difference was not statistically significant between the two groups ( P>0.05). Conclusions:Linagliptin can improve clinical curative effect on fatty liver in patients with NAFLD and T2DM, control blood glucose level, and improve islet function, liver function and liver fibrosis, with higher medication safety.