The effect of semaglutide combined with metformin on liver inflammation and pancreatic beta-cell function in patients with type 2 diabetes and non-alcoholic fatty liver disease.

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2024-12-09 DOI:10.1016/j.jdiacomp.2024.108932

Rong Ren, Yanxia Pei, Lufei Kong, Yixin Shi

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Abstract

Background: Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) were often coexistent conditions driven by insulin resistance and systemic inflammation. Effective management strategies that address both metabolic disorders were urgently needed. This study investigates the effect of combining semaglutide, a glucagon-like peptide-1 receptor agonist, with metformin on liver inflammation and pancreatic beta-cell function in patients with T2DM and NAFLD.

Methods: This retrospective study analyzed 261 patients with T2DM and NAFLD treated at our institution from January 2021 to December 2023. Patients were divided into two groups: 127 received metformin alone (M group), and 134 received a combination of semaglutide and metformin (SAM group). Liver inflammation and fibrosis were assessed using alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GTP), and the FIB-4 index. Pancreatic beta-cell function and insulin sensitivity were evaluated using the Matsuda index, HbA1c, fasting glucose, and the oral disposition index (DIo).

Results: Post-treatment, the SAM group showed significantly greater improvements in liver inflammation markers (ALT: 23.59 ± 5.67 U/L in SAM vs. 25.56 ± 5.46 U/L in M; AST: 18.97 ± 3.94 U/L in SAM vs. 20.15 ± 3.95 U/L in M), reduced fibrosis (FIB-4 index: 1.05 ± 0.44 in SAM vs. 1.16 ± 0.51 in M), and enhanced beta-cell function (Matsuda index: 5.18 ± 1.09 in SAM vs. 4.84 ± 1.15 in M; DIo: 0.18 ± 0.06 in SAM vs. 0.16 ± 0.05 in M). Glycemic control, as indicated by reduced HbA1c, was also superior in the SAM group.

Conclusion: The combination of semaglutide and metformin significantly improves liver inflammation, fibrosis, and beta-cell function in patients with T2DM and NAFLD compared to metformin alone.

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西马鲁肽联合二甲双胍对2型糖尿病合并非酒精性脂肪肝患者肝脏炎症和胰腺β细胞功能的影响

背景：2型糖尿病（T2DM）和非酒精性脂肪性肝病（NAFLD）通常是由胰岛素抵抗和全身炎症驱动的共存疾病。迫切需要针对这两种代谢紊乱的有效管理策略。本研究探讨了胰高血糖素样肽-1受体激动剂semaglutide与二甲双胍联合使用对T2DM和NAFLD患者肝脏炎症和胰腺β细胞功能的影响。方法：本回顾性研究分析了2021年1月至2023年12月在我院治疗的261例T2DM和NAFLD患者。将患者分为两组：单独使用二甲双胍127例（M组），semaglutide联合使用二甲双胍134例（SAM组）。采用丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、γ-谷氨酰转移酶（γ-GTP）和FIB-4指数评估肝脏炎症和纤维化程度。采用松田指数、糖化血红蛋白（HbA1c）、空腹血糖和口腔处置指数（DIo）评估胰腺β细胞功能和胰岛素敏感性。结果：治疗后，SAM组肝脏炎症指标明显改善(ALT: SAM组23.59±5.67 U/L vs M组25.56±5.46 U/L；AST: SAM为18.97±3.94 U/L， M为20.15±3.95 U/L)，纤维化减少（FIB-4指数：SAM为1.05±0.44，M为1.16±0.51），细胞功能增强(Matsuda指数：SAM为5.18±1.09，M为4.84±1.15；SAM组的DIo: 0.18±0.06 vs. M组的DIo: 0.16±0.05)，血糖控制（HbA1c降低）也优于SAM组。结论：与单用二甲双胍相比，西马鲁肽联合二甲双胍可显著改善T2DM和NAFLD患者的肝脏炎症、纤维化和β细胞功能。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.