The Effect Of Silybin On Insulin Resistance In Patients With Type 2 Diabetes Mellitus Complicated With Non-alcoholic Fatty Liver Disease

Objective:With the development of the global economy and the improvement of living conditions,the number of patients with type 2 diabetes mellitus(T2DM)is gradually increasing.Non-alcoholic fatty liver disease(NAFLD)is often regarded as one of the complications of T2 DM,which significantly increases the risk of complications in patients with T2 DM.There is currently no drug approved for the treatment of T2 DM complicated with NAFLD,silybin is one of the commonly used drugs in the treatment of NAFLD,this study aims to evaluate the effect of silybin on insulin resistance in patients with T2 DM complicated with NAFLD and the efficacy of interventional treatment on patients,and provide new ideas for the treatment of T2 DM complicated with NAFLD.Method:Ninety-seven patients with T2DM complicated with NAFLD were selected,including thirty-eight cases in the control group and fifty-nine cases in the observation group.Patients in the control group were only given dietary exercise treatment and lifestyle guidance intervention,patients in the observation group were given silybin capsules on the basis of dietary exercise treatment and lifestyle guidance intervention [three times a day,three capsules each time(each capsule contains 35 mg of silybin)].After twenty-four weeks of treatment and follow-up to forty-eight weeks,glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),fasting insulin(Fins),fasting C-peptide,insulin resistance index(HOMA-IR),high sensitivity C-reactive protein(hs-CRP),blood lipid indexes included triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),the liver function indexes included aspartate aminotransferase(AST),alanine aminotransferase(ALT),alkaline phosphatase(ALP),glutamyl transpeptidase(GGT),blood uric acid(BUA)and urine microalbumin before and after treatment and follow-up were observed and compared between the two groups of patients.Results:1.The average age of all patients was 51.71±10.82 years old,there were no significant differences in gender,age,BMI,course of diabetes mellitus,history of hypertension,history of coronary heart disease,history of infectious diseases,history of drug allergy,smoking history,HbA1 c,FPG,Fins,fasting C-peptide,HOMA-IR,hs-CRP,TG,TC,LDL-C,HDL-C,ALP,BUA and urine microalbumin indicators between the two groups of patients(all P>0.05).However,there were significant differences in AST,ALT and GGT indicators(P<0.05).2.Compared with the control group,the HbA1c,FPG,Fins,fasting C-peptide,HOMA-IR,hs-CRP,TG,ALP and urine microalbumin indicators of patients in the observation group after treatment and forty-eight weeks of follow-up were significantly reduced,and the HDL-C indicators were significantly increased,the difference was statistically significant(P<0.05),there were no significant differences in TC,LDL-C and BUA indicators(P>0.05).3.Compared with before treatment,the HbA1c,FPG,Fins,fasting C-peptide,HOMA-IR,hs-CRP,TG,AST,ALT,ALP,GGT and urine microalbumin indicators of patients in the observation group after treatment were significantly reduced,and the HDL-C indicators were significantly increased,the difference was statistically significant(P <0.001),there were no significant differences in TC,LDL-C and BUA indicators(P>0.05);The urine microalbumin indicators of patients in the control group after treatment were significantly increased,the difference was statistically significant(P < 0.001),there were no significant differences in HbA1 c,FPG,Fins,fasting C-peptide,HOMA-IR,hs-CRP,TG,TC,LDL-C,HDL-C,AST,ALT,ALP,GGT and BUA indicators(all P>0.05).Conclusions:Silybin can improve insulin resistance,blood lipids and liver function in patients with T2 DM and NAFLD,suggesting that silybin can be used as an adjuvant drug for the treatment of patients with T2 DM and NAFLD.