DPP-4 inhibitors improve liver dysfunction in type 2 diabetes mellitus.
DPP-4 inhibitors improve liver dysfunction in type 2 diabetes mellitus.
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DOI：
10.12659/msm.890989
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发表时间：
2014-09-17
期刊：
影响因子：
--
通讯作者：
Sugimoto T
中科院分区：
文献类型：
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作者：
Kanazawa I;Tanaka K;Sugimoto T
二肽基肽酶-4 （DPP-4）抑制剂可能具有多效性，因为肠促胰岛素受体存在于包括肝脏在内的多种组织中。我们研究了DPP-4抑制剂是否会影响2型糖尿病患者的肝功能。对459例使用DPP-4抑制剂的2型糖尿病患者进行了回顾性研究。在排除了乙型或丙型肝炎患者、类固醇使用以及其他可能影响肝功能和糖尿病的疾病后，224例患者被纳入分析。以谷草转氨酶（AST）或谷丙转氨酶（ALT）高于40 U/L为标准的肝损伤44例（19.6%）。在肝损伤患者中，自DPP-4处方之日起6个月后，AST和ALT显著降低，平均变化分别为- 6.2 U/L[95%可信区间(CI) - 10.9至- 1.4,p=0.012]和- 11.9 U/L （95%CI - 19.5至- 4.2,p=0.003）。AST百分比变化与AST和ALT基线呈显著负相关（r= - 0.27, p<0.001和r= - 0.23, p=0.002）， ALT百分比变化与AST和ALT基线呈显著负相关（r= - 0.23, p=0.001和r= - 0.27, p<0.001）。DPP-4抑制剂改善2型糖尿病患者肝功能障碍。
Dipeptidyl peptidase-4 (DPP-4) inhibitors might have pleiotropic effects because receptors for incretin exist in various tissues, including liver. We examined whether DPP-4 inhibitors affect liver function in patients with type 2 diabetes. A retrospective review of 459 patients with type 2 diabetes who were prescribed DPP-4 inhibitors was performed. After exclusion of patients with hepatitis B or C, steroid use, and other diseases that might affect liver function and diabetes status, 224 patients were included in the analysis. Forty-four patients (19.6%) with liver injury defined by aspartate transaminase (AST) or alanine transaminase (ALT) over the normal level of 40 U/L. In the patients with liver injury, AST and ALT were significantly decreased after 6 months from the first date of DPP-4 prescription, with mean changes of −6.2 U/L [95% confidence interval (CI) −10.9 to −1.4, p=0.012] and of −11.9 U/L (95%CI −19.5 to −4.2, p=0.003), respectively. Percent changes in AST were significantly and negatively correlated with baseline AST and ALT (r=−0.27, p<0.001 and r=−0.23, p=0.002, respectively), and percent changes in ALT were also negatively correlated with them (r=−0.23, p=0.001 and r=−0.27, p<0.001, respectively). DPP-4 inhibitors improved liver dysfunction in patients with type 2 diabetes.