Efficacy analysis of dagliflozin combined with silymarin in the treatment of type 2 diabetes mellitus combined with nonalcoholic fatty liver disease
Zhang Li
Wang Chenfei
Lu Chunhui
Yuwen Binya
Abstract：Objective To investigate the therapeutic effect of dagliflozin combined with silymarin in patients with type 2 diabetes mellitus combined with non-alcoholic fatty liver disease(NAFLD).Methods One hundred and four pa-tients with type 2 diabetes mellitus combined with NAFLD were collected and treated in the Department of Endocrinology of the Fifth Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2022,and were divided into 52 patients in the control group and 52 patients in the study group according to the method of randomized numerical table,and the patients in the two groups were given conventional treatment and metformin hypoglycemic treatment,and the study group was given dagliflozin on top of this treatment.The study group was given dagliflozin combined with silymarin treat-ment on this basis.After 6 months of treatment,changes in glycemic and lipid metabolism indexes,liver function,liver hard-ness,tumor necrosis factor-alpha(TNF-alpha),superoxide dismutase(SOD),and adiponectin(APN)levels of the patients in the two groups were compared before and after treatment.Results glycated hemoglobin,fasting glucose,2 h postprandial glucose,and insulin resistance index(HOMA-IR)decreased in the two groups after treatment compared with the pre-treat-ment level,and the study group was lower than the control group(t/P= 3.411/<0.001,2.926/0.005,3.578/<0.001,2.672/0.015),and body mass index(BMI),waist-to-hip ratio,visceral fat area,total cholesterol(TC),triacylglycerol(TG),and low-density lipoprotein cholesterol(LDL-C)were significantly lower than that before treatment in the study group and were lower than that in the control group after treatment(t/P=2.873/0.008,2.435/0.013,4.878/<0.001,3.997/<0.001,2.265/0.025,1.997/0.038);aspartate aminotransferase(AST),alanine aminotransferase(ALT),and total bilirubin decreased significantly af-ter treatment compared with pretreatment in patients in the study group,and patients in the study group were lower than those in the control group(t/P=5.737/<0.001,4.971/<0.001,3.258/<0.001);patients in the study group had lower TNF-α and higher SOD and APN after treatment,and the magnitude of decrease/elevation in the study group was greater than that in the control group(t/P=2.453/0.021,3.842/<0.001,3.927/<0.001);during the treatment period,the incidence of adverse re-actions such as nausea and vomiting,diarrhea,abdominal distension,constipation,increase in body mass,anemia,and hy-poglycemia in the patients of the 2 groups were compared,and the differences were not statistically significant(P>0.05).Conclusion Dagliflozin combined with silymarin on the basis of metformin glucose-lowering therapy can significantly im-prove insulin resistance and liver function,reduce inflammatory factor level and oxidative stress injury,and improve APN level in patients with type 2 diabetes mellitus combined with NAFLD.
Keywords：Type 2 diabetes mellitusNon-alcoholic fatty liver diseaseDagliflozinSilymarinsilymarinGlycemic and lipid metabolismLiver function
Publication Date：2024-03-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 328-333 )