Effect Of Lilalutide On Left Ventricular Remodeling In Elderly Patients With TyPe 2 Diabetes And Its Protective Effect

Objective: To observe the effect of lilalutide on left ventricular remodeling in elderly Patients with ty Pe 2 diabetes(type 2 diabetes mellitus,T2DM)and its Protective effect.Methods: We selected elderly T2 DM patients who were hospitalized at Qingdao University Affiliated Hospital from July 1,2018 to July 1,2022.The control group received basic hypoglycemic treatment,while the liraglutide group received basic hypoglycemic combined with liraglutide treatment.Follow up patients’ weight,body mass index(BMI),fasting blood glucose(FBG),glycosylated hemoglobin A1c(Hb A1c),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and ventricular remodeling indicators,as well as whether major cardiovascular adverse events(MACE,including fatal cardiovascular disease,non fatal myocardial infarction,and non fatal stroke)occurred within 12 months of follow-up,To discuss the effect of liraglutide on left ventricular remodeling in elderly patients with type 2 diabetes and analyze the influencing factors of cardiovascular adverse events in elderly T2 DM patients.Results: A total of 298 patients were selected,including 88 males(57.1%)and 66females(42.9%)in the liraglutide group,aged 60-85 years,with an average age of(67.60± 6.77)years;There were 82 males(56.9%)and 62 females(43.1%)in the control group,aged 60-83 years,with an average age of(68.65 ± 5.75)years.The left ventricular end diastolic diameter(LVEDD),interventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),and left ventricular mass index(LVMI)in the lilalutide group decreased 6 months and 12 months after treatment,and the difference was statistically significant(P<0.05);Compared with 6 months after treatment,the above indicators showed a significant decrease,with a statistically significant difference(P<0.05).After 6 months of treatment,LVEDD,IVST,LVPWT,and LVMI in the control group all decreased compared to before treatment,with no statistically significant difference(P>0.05).At 12 months after treatment,the above indicators also significantly decreased compared to before treatment,with a statistically significant difference(P<0.05);Compared with 6 months after treatment,LVEDD,LVPWT,and LVMI significantly decreased 12 months after treatment(P<0.05),while the difference in IVST decrease was not significant(P>0.05).Compared with the control group at 6 and 12 months after treatment,the above indicators of LVEDD,IVST,LVPWT,and LVMI in the liraglutide group were significantly lower than those in the control group,with a statistically significant difference(P<0.05).The univariate analysis of the two groups of patients found that age,the course of diabetes,the application of angiotensin-converting enzyme inhibitors/Angiotensin II receptor antagonists,application of sodium glucose cotransporter2 inhibitors,whether smoking,lilalutide,and LVMI were the possible influencing factors for major cardiovascular adverse events in elderly T2 DM patients(P<0.05).Further binary logistic regression analysis of related indicators found that the course of diabetes(OR=1.05,P<0.01),smoking history(OR=5.99,P<0.01)Liraglutide(OR=0.39,P<0.01),SGLT2i(OR=0.82,P<0.01),and LVMI(OR=1.04,P<0.01)are the main influencing factors for cardiovascular adverse events(P<0.05).Conclusions: Liraglutide can significantly improve left ventricular remodeling in elderly T2 DM patients,and its mechanism of action may be achieved through weight loss,lipid regulation,hypoglycemia,etc.Liraglutide is a protective factor for the main cardiovascular adverse events in elderly T2 DM patients,and has better benefits compared to sodium glucose cotransporter 2 inhibitors.