非诺贝特对非酒精性脂肪性肝病合并2型糖尿病患者血脂、血管内皮功能和肝纤维化指标的影响*

doi:10.3969/j.issn.1672-5069.2020.01.015

Abstract

Abstract: Objective The aim of this study was to investigate the effects of fenofibrate on blood lipids, vascular endothelial functions and liver fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods 112 patients with NAFLD and T2MD were enrolled in our hospital between January 2017 and May 2018, and were randomly divided into two two groups, with 56 in each group. The patients in control group was treated with insulin at base of excised and diet modulation, and those in the observation were treated with fenofibrate at the basis of routine treatment in control. Results At the end of three month observation, blood TG levels were (1.9 ± 0.4) mmol/L vs. (3.5 ± 0.5) mmol/L, the TC levels were (4.9 ± 0.7) mmol/L vs. (6.4 ± 0.8), the HDLC levelswere (1.4±0.3) mmol/L vs. (1.2±0.4) mmol/L, and the LDLC levels were (2.4±0.3) mmol/L vs. (2.6±0.4) mmol/L, respectively, in the observation group and in the control group, with a significant difference (P<0.05); serum endothelin levels were (49.5±3.7) pg/mL vs. (52.4±6.8) pg/mL,the thromboxane levels were (184.5±92.6) pg/mL vs. (272.7±94.8) pg/mL, the epoprostenol were (32.1±18.4) pg/mL vs. (23.5±11.3) pg/mL, and the nitric oxide levels were (64.8±13.6) μmol/L vs. (53.2±12.4) μmol/L, respectively, with the difference being significant (P<0.05); serum laminin levels were (170.3 ± 65.3) μg/L vs. (208.7 ± 77.4)μg/L, the hyaluronic acid levels were (178.6 ± 83.4)μg/L vs. (233.6 ± 81.6)μg/L, the collage typeⅣ levels were (6.6±1.4)μg/L vs. (7.4±1.3)μg/L, and the procollagen type III levels were (118.4±22.9) μg/L vs. (132.5±31.7)μg/L, respectively, in the two groups, with the difference being significant (P<0.05). Conclusion Fenofibrate could effectively reduce the blood lipid levels, improve vascular endothelial functions and reduce the index of serum liver fibrosis in patients with NAFLD and type 2 diabetes mellitus, which is worthy of clinical application.

Key words: Nonalcoholic fatty liver diseases, Type 2 diabetes mellitus, Fenofibrate, Vascular endothelial functions, Hepatic fibrosis

Mao Chongshan, Yin Hui, Xiao Erhui, et al. Effects of fenofibrate on blood lipids, vascular endothelial functions and liver fibrosis in patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus[J]. Journal of Practical Hepatology, 2020, 23(1): 50-53.

References

[1] Iglay K, Hannachi H, Howie P J, et al. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin, 2016, 32(7):1.
[2] Mccarty D J. Albiglutide for the treatment of type 2 diabetes mellitus. Nurse Pract, 2017, 42(2):10.
[3] Nie F, Wu D, Du H, et al. Serum klotho protein levels and their correlations with the progression of type 2 diabetes mellitus. J Diabetes Complicat, 2017, 31(3):594-598.
[4] 许勇,陶颖,苟小军. 非酒精性脂肪性肝病中医病因病机探析. 中华中医药学刊,2016,34(11):2586-2589.
[5] Hallsworth K, Thoma C, Hollingsworth K G, et al. Modified high-intensity interval training reduces liver fat and improves cardiac function in non-alcoholic fatty liver disease: a randomized controlled trial. Clin Sci, 2015, 129(12):1097-1105.
[6] 赵泽华,范建高. 2016年美国肝病年会非酒精性脂肪性肝病深度报道. 实用肝脏病杂志,2017,20(1):21-24.
[7] Zhang Z, Wang J, Wang H. Correlation of blood glucose, serum chemerin and insulin resistance with NAFLD in patients with type 2 diabetes mellitus. Exp Ther Med, 2018, 15(3):2936-2940.
[8] Fukuda T , Hamaguchi M , Kojima T , et al. The impact of non-alcoholic fatty liver disease on incident type 2 diabetes mellitus in non-overweight individuals. Liver Int, 2016, 36(2):275-283.
[9] 陈玉帅,王炳元,厉有名. 非酒精性脂肪性肝病与酒精性肝病2016研究进展. 中华肝脏病杂志, 2017, 25(3):181-186.
[10] Takahashi Y, Fukusato T. Histopathology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. Metabolism, 2016, 65(8):1080-1086.
[11] Armstrong M J , Adams L A , Canbay A , et al. Extrahepatic complications of nonalcoholic fatty liver disease. Hepatology, 2016, 20(2):387-401.
[12] Pár A, Pár G. Advances in the pathogenesis of non alcoholic fatty liver disease. Orv Hetil, 2017, 158(23):882.
[13] Arab J P, Arrese M, Trauner M. Recent insights into the pathogenesis of nonalcoholic fatty liver disease. Annu Rev Pathol, 2018, 13(1):321-350.
[14]Hironori K , Guanliang C , Yinhua N , et al. Nonalcoholic fatty liver disease and insulin resistance: new insights and potential new treatments. Nutrients, 2017, 9(4):387.
[15] Yu J, Sharon M, Hu J, et al. The pathogenesis of nonalcoholic fatty liver disease: interplay between diet, gut microbiota, and genetic background. Gastroenterol Res Pract, 2016, 2016(6):1-13.
[16] Yaghoubi M , Jafari S , Sajedi B , et al. Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol, 2017, 29(12):1385.
[17] Smirnova E , Shulkina S , Loran E , et al. Relationship between skin blood flow regulation mechanisms and vascular endothelial growth factor in patients with metabolic syndrome. Clin Hemorheol Microcirc, 2017,25:1-14.
[18] Yao Y , Bao J , Lu Y , et al. Biomarkers of liver fibrosis detecting with electrochemical immunosensor on clinical serum. Sensor Actuat B Chem, 2016, 222(1):127-132.
[19] Nallagangula K S, Nagaraj S K, Venkataswamy L, et al. Liver fibrosis: a compilation on the biomarkers status and their significance during disease progression. Future Sci OA, 2018, 4(1):250.
[20] Yang X Z , Gen A W , Xian J C , et al. Diagnostic value of various noninvasive indexes in the diagnosis of chronic hepatic fibrosis. Eur Rev Med Pharmacol Sci, 2018, 22(2):479-485.

Effects of fenofibrate on blood lipids, vascular endothelial functions and liver fibrosis in patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	Ye Xirong, Lyu Zhihong, Jiang Feng, et al. Clinical value of transient elastography and two-dimensional shear wave elastography in the diagnosis of liver fibrosis in patients with chronic hepatitis B [J]. Journal of Practical Hepatology, 2020, 23(1): 18-21.
[2]	Chen Lili, Fu Maoxiong, Meng Xubiao, et al. Clinical value of fasting C-peptide in assessing the progression of liver fibrosis in patients with NAFLD and T2DM [J]. Journal of Practical Hepatology, 2020, 23(1): 38-41.
[3]	Huang Hanjun, Lu Fengrong, Zhang Can. Changes of apparent diffusion coefficient from MRI and serum vitamin D levels in predicting hepatic fibrosis in patients with hepatitis C [J]. Journal of Practical Hepatology, 2020, 23(1): 143-144.
[4]	. Consensus on the diagnosis and therapy of hepatic fibrosis [J]. Journal of Practical Hepatology, 2019, 22(6): 793-803.
[5]	Min Feng, Huang Wenqi, Wu Weibing, et al.. Implications of serum adipocytokine levels in patients with chronic hepatitis B [J]. Journal of Practical Hepatology, 2019, 22(6): 824-827.
[6]	Chen Meimei, Duan Xiaoyan, Cao Haixia, et al.. Improvement of clinical symptoms and serum hepatic fibrosis markers in patients with primary biliary cirrhosis by compound Biejiaruangan tablets [J]. Journal of Practical Hepatology, 2019, 22(6): 880-883.
[7]	Wu Yaping, Zhou Bingqing, Jiang Peili. Risk factors of severe hepatic fibrosis in patients with chronic hepatitis C with previous paid blood donation [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(2): 196-199.
[8]	Zhong Yan, Su Shuting, Mi Yuqiang.. Treatment of patients with nonalcoholic fatty liver disease [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(1): 145-148.
[9]	Liu Enqiang, Chen Guo, Liao Xiuyong, et al.. Inhibition of TGF-β1/Smad/ERK passway by astaxanthin in rats with CCl₄-induced liver fibrosis [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(6): 842-846.
[10]	Huang Faguang, Li Xiaocheng, Gong Jianping, et al.. Research on insulin resistance related protein molecules in human liver tissues by comprehensive gene expression profiling analysis [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(6): 872-876.
[11]	Pu Yonglan, Chen Yuanwen, Fan Jiangao.. Gluten intestinal disease and nonalcoholic fatty liver: One case report [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(6): 981-982.
[12]	Pan Gaofeng, Fu Maoying, Gao Yufeng.. Endoplasmic reticulum stress in pathogenesis of hepatic fibrosis [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(6): 987-990.
[13]	Zeng Minde. Mechanisms of lipotoxicity in pathogenesis of nonalcoholic fatty liver diseases [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(2): 153-156.
[14]	Wang Qian,Guo Ping. Application of fibroscan and anthropometric parameters in diagnosis of patients with nonalcoholic fatty liver diseases [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(6): 754-755.
[15]	Li Yan，Wang Caihua.. Hot spots in dietary therapy in patients with non-alcoholic fatty liver disease [J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2017, 20(5): 529-531.