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Evaluation of the effects of dapagliflozin, a sodium-glucose co-transporter-2 inhibitor, on hepatic steatosis and fibrosis using transient elastography in patients with type 2 diabetes and non-alcoholic fatty liver disease.
使用瞬时弹性成像评估钠-葡萄糖 co-transporter-2 抑制剂 dapagliflozin 对 2 型糖尿病和非酒精性脂肪肝患者的脂肪肝和纤维化的影响。
dapagliflozin liver fibrosis non-alcoholic fatty liver disease transient elastography type 2 diabetes
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摘要

AIMS:To investigate the effects of dapagliflozin on liver steatosis and fibrosis evaluated in patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD).
MATERIALS AND METHODS:In a randomized, active-controlled, open-label trial, 57 patients with type 2 diabetes and NAFLD were randomized to a dapagliflozin group (5 mg/d; n = 33) or a control group (n = 24) and were treated for 24 weeks. Hepatic steatosis and fibrosis were assessed using transient elastography to measure controlled attenuation parameter (CAP) and liver stiffness, respectively.
RESULTS:Baseline liver stiffness measurement (LSM) was positively correlated with several markers and scoring systems for liver fibrosis. In week 24, there was a significant decrease in CAP from 314 ± 61 to 290 ± 73 dB/m (P = 0.0424) in the dapagliflozin group, while there was no significant change in the control group. In addition, LSM tended to decrease from 9.49 ± 6.05 to 8.01 ± 5.78 kPa in the dapagliflozin group. In 14 patients from this group with LSM values ≥8.0 kPa, indicating significant liver fibrosis, LSM decreased significantly from 14.7 ± 5.7 to 11.0 ± 7.3 kPa (P = 0.0158). Furthermore, serum alanine aminotransferase and γ-glutamyltranspeptidase levels decreased in the dapagliflozin group, but not in the control group, and visceral fat mass was significantly reduced in the dapagliflozin group.
CONCLUSIONS:Based on these findings, the sodium-glucose co-transporter-2 inhibitor dapagliflozin improves liver steatosis in patients with type 2 diabetes and NAFLD, and attenuates liver fibrosis only in patients with significant liver fibrosis, although the possibility cannot be excluded that a reduction in body weight or visceral adipose tissue by dapagliflozin may be associated with a decrease of liver steatosis or fibrosis.

译文

目的: 探讨达格列净对 2 型糖尿病和非酒精性脂肪性肝病 (NAFLD) 患者脂肪肝和纤维化的影响。
材料和方法: 在一项随机、主动对照、开放标签试验中,57 名 2 型糖尿病和非酒精性脂肪性肝病患者被随机分为达格列净组 (5 毫克/天; n = 33) 或对照组 (n = 24),治疗 24 周。肝脏脂肪变性和纤维化的评估使用瞬时弹性成像测量控制衰减参数 (CAP) 和肝硬度,分别。
结果: 基线肝硬度测量 (LSM) 与几个肝纤维化标记和评分系统呈正相关。在 314 周,达格列净组的 CAP 从 290 ± 61 显著降低到 0.0424 ± 73 dB/m (P =), 而对照组没有显著变化。此外,在 dapagliflozin 组中,LSM 有从 9.49 ± 6.05 降低到 8.01 ± 5.78 kPa 的趋势。在该组的 14 名患者中,LSM 值 ≥ 8.0 kPa,表明明显的肝纤维化,LSM 从 14.7 ± 5.7 显著下降到 11.0 ± 7.3 kPa (P = 0.0158)。此外,dapagliflozin 组的血清丙氨酸氨基转移酶和 γ-谷氨酰转肽酶水平下降,而对照组则没有,dapagliflozin 组的内脏脂肪量显著减少。
结论: 基于这些发现,钠-葡萄糖 co-transporter-2 抑制剂达格列净改善 2 型糖尿病和非酒精性脂肪性肝病 (NAFLD) 患者的肝脏脂肪变性,并仅在明显的肝纤维化患者中减轻肝纤维化,尽管不能排除 dapagliflozin 减少体重或内脏脂肪组织的可能性可能与肝脏脂肪变性或纤维化的减少有关。

transient elastography

消化 肝脏硬度值测量 诊断方式
概述  :  

瞬时弹性成像技术( transient elastography,TE)是通过超声波测量剪切波在肝组织中的传播速度,来测量肝脏硬度值(liver stiffness measurement,LSM),从而反映肝纤维化程度的一项技术。目前常用的TE技术包括 FibroTouch和 FibroScan 两种。在美国, FibroScan公司的振动控制瞬时弹性成像技术(vibration controlled transient elastography,VCTE)

transient 英 /ˈtrænziənt/  美 /ˈtrænʃnt/

释义   adj. 短暂的;路过的n. 瞬变现象

例句   Consumer pleasures are transient. They engulf us for a short period and then they fade, like a drug. 消费快乐是短暂的,像毒品一样,短时间内会吞没了我们,然后就很快消失了。


elastography 

释义   n.弹性成像

例句   In a small study of 80 women, the technique - called "elastography" - distinguished harmless lumps from malignant ones with nearly 100 percent accuracy. 在一项对80名妇女的小型研究中,这项技术——称为“弹性成像”——以接近100%的准确率将无害肿块与恶性肿块区分开来。


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