Objective To investigate the change of serum adipokine visfatin level before and after metformin treatment of nonalcoholic fatty liver disease(NAFLD) and its correlation with disease. Methods 70 cases of NAFLD were randomized into two groups. The control group (n = 30) received placebo only and the treatment group (re = 40) was given oral metformin 0.5 g,3 times daily with the treatment course of 12 weeks. The body mass index(BMl), waist hip rate(WHR), glycosylated hemoglobin(HbA1c), systolic blood pressure (SBP),diastolic blood pressure (DBP), visfatin, homeostasis model assessment - insulin resistance index(HOMA - IR) and total cholesterol (TC) were measured before and after treatment in both groups. Results In the treatment group,BMI, WHR,HOMA-IR,serum visfatin had statistical difference before and after treatment (P 0. 05). In the control group.no statistical differences existed in BMI, WHR,SBP, DBP, HOMA - 1R and serum visfatin before and after treatment( P > 0. 05). The difference of BMI, WHR,HOMA - IR was positively correlated with the difference of visfatin( P <0.05). Conclusion Metformin may improve the clinical symptoms of NAFLD by mediating serum visfatin.%目的 探讨托吡酯预防治疗偏头痛,对患者体重、体重指数、血清瘦素、胰岛素、游离脂肪酸(FFA)和脂联素的影响及其相互关系.方法 随机选取32例接受托吡酯预防治疗的偏头痛患者,于用药前和用药3个月后测定并计算体重、体重指数、血清甘油三酯、总胆固醇、血清脂联素、胰岛素敏感指数(SI)、血清瘦素、游离脂肪酸水平.结果 使用托吡酯治疗3个月后,患者体重、体重指数、甘油三酯、胆固醇、游离脂肪酸分别为(59.36±9.39)kg,(19.02±2.36)kg/m2,(1.25±0.38)mmoL/L,(4.13±1.10)mmol/L,(289.2±89.1 )mmol/L,均比治疗前显著降低(P＜0.05或P＜0.01);脂联素、胰岛素敏感指数分别为(22.14±10.72)mg/mL和(8.48±2.18)×10-4,则比治疗前显著升高(P＜ 0.01);瘦素水平为(2.77±0.68)μg/L,比治疗前无明显变化(P＞0.05).Spearman相关性分析表明,治疗后体重、体重指数与脂联素水平呈明显负相关(P＜0.001),与胰岛素敏感指数水平亦呈负相关(P＜0.05),与游离脂肪酸水平呈明显正相关(P＜0.05或P＜0.01).在以体重为应变量的多元回归方程中,脂联素、胰岛素敏感指数和游离脂肪酸进入方程(r2=0.27,P＜0.001).结论 托吡酯预防治疗偏头痛会导致代谢改变,表现为体重和体重指数下降.在此过程中,脂联素、胰岛素敏感指数和游离脂肪酸的改变可能起到重要作用,而瘦素则可能与此无关.
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