Clinical Observation Of The Efficacy Of Liraglutide In Patients With Type 2 Diabetes Mellitus With Mild Cognitive Impairment

Objective To observe the therapeutic effect of liraglutide in patients with type 2 diabetes mellitus combined with mild cognitive impairment in a clinical setting.Methods Sixty-seven patients with type 2 diabetes mellitus combined with mild c ognitive impairment were selected and divided into a control group（34 patients）and a liraglutide group（33 patients）.Before and 24 weeks after treatment,body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,fasting blood glucose（FPG）,2h postprandial blood glucose（2h PG）,glycated he moglobin(Hb A_1c),fasting insulin（FINS）,alanine transaminase（ALT）,aspartate a minotransferase（AST）,serum creatinine（Scr）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,total cholesterol（TC）,tri glycerides（TG）,serum interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and adiponectin（ADPN）were compared,homeostasis model assessment for insulin re sistance（HOMA-IR）was calculated,and the cognitive ability of patients was eva luated by Montreal Cognitive Assessment Scale（Mo CA）.Results In Blood pressure,blood sugar,blood lipid and weight,after treatment,F PG,2h PG,and Hb A_1cwere significantly lower in both groups than before treatm ent,and the difference was statistically significant（P<0.05）,and there was no significant difference between the two groups（P>0.05）.BMI,LDL-C,and HO MA-IR levels were reduced in the liraglutide group compared with those before treatment,and the differences were statistically significant[（26.68±2.92 vs 23.99±1.38）,（3.03±0.85 vs 2.37±0.66）,（4.34±1.47 vs 3.07±1.02）,P<0.05],whereas there were no significant changes in the control group after treatment compared with those before treatment,and the differences were not statistically significant（P>0.05）.There were no significant changes in SBP,DBP,TC,TG,HDL-C,A LT,AST and Scr in both groups after treatment compared with those before trea tment,and the differences were not statistically significant（P>0.05）.In For inf lammatory indexes and adiponectin,IL-6 and TNF-αlevels decreased and adipon ectin levels increased in the liraglutide group compared with those before treatme nt,with statistically significant differences[（38.36±2.76 vs 35.44±3.27）,（73.14±7.21 vs 68.37±5.61）,（8.90±3.04 vs 11.28±3.50）,P<0.05],while there was no sig nificant change in the control group after treatment compared to before treatment,and the difference was not statistically significant（P>0.05）.In cognitive funct ion,Mo CA scores were higher in the liraglutide group than before treatment,and the difference was statistically significant[（20.48±3.00 vs 22.06±2.57）,P<0.05],while there was no significant change in the control group before and after t reatment,and the difference was not statistically significant（P>0.05）.Pearson correlation analysis showed that Mo CA scores were negatively correlated with IL-6 and TNF-αafter liraglutide treatment（correlation coefficients of-0.521 and-0.508,respectively,P<0.05）.In terms of adverse events,there were 6 cases of mild and moderate hypoglycemia in liraglutide group and 9 cases of mild and m oderate hypoglycemia in control group,and no severe hypoglycemia occurred in both groups.There were 5 cases of nausea,2 cases of vomiting and 2 cases of diarrhea in liraglutide group,and one of them could not tolerate vomiting and di arrhea and withdrew from the study.Conclusion Liraglutide improves cognitive dysfunction in patients with type 2 dia betes mellitus,and its mechanism may be related to its weight loss,insulin resis tance and anti-inflammatory effects.