| Objective: Compare the effects of benaglutide and liraglutide on blood pressure fluctuation and heart rate variability in adult type 2 diabetic patients.Methods: Based on inclusion and exclusion criteria,this study selected 37 adults with type 2 diabetes(meets the 1999 WHO diabetes diagnosis and typing criteria)who were treated in the Dalian Central Hospital from November 2018 to May 2020.All patients were treated with metformin monotherapy or metformin combined with sulfonylurea,and Hb Alc reached 7.0-12.0%.The treatment regimen was not changed in the past 3 months.The introduction period was two weeks.These patients discontinued sulfonylurea and maintained metformin at the original dose after enrollment.They were randomly divided into benaglutide and liraglutide groups.At baseline and after 14 weeks of observation,general information such as age,height,weight,BMI,systolic blood pressure,diastolic blood pressure,heart rate,history of previous diseases and medicationswere collected.All the patients need to monitor clinical biochemical indicators,including blood glucose,Hb A1 c,blood lipids,liver function,kidney function,ion levels and so on.All patients in wore Sun Tech ambulatory blood pressure monitor and i Tengo+Holter monitor to record 24 h ambulatory blood pressure fluctuations and heart rate variability.The indexes of blood pressure fluctuation included:24h SBP(the average systolic blood pressure of 24 hours)、24h DBP(the average diastolic blood pressure of24 hours)、d SBP(the average systolic blood pressure of the day)、d DBP(the average diastolic blood pressure of the day)、n SBP(the average systolic blood pressure of the night)、n DBP(the average diastolic blood pressure of the night)、24h SBP-SD(The systolic blood pressure standard deviation of 24 hours)、24h DBP-SD(The diastolic blood pressure standard deviation of 24 hours)24h SBP-CV(The systolic blood pressure coefficient of variation of 24 hours)、 24 h DBP-CV(The diastolic blood pressure coefficient of variation of 24 hours)、d SBP-SD(The systolic blood pressure standard deviation of the day)、d DBP-SD(The diastolic blood pressure standard deviation of the day)、d SBP-CV(The systolic blood pressure coefficient of variation of the day)、d DBP-CV(The diastolic blood pressure coefficient of variation of the day)、n SBP-SD(The systolic blood pressure standard deviation of the night)、n DBP-SD(The diastolic blood pressure standard deviation of the night)、n SBP-CV(The systolic blood pressure coefficient of variation of the night)、 n DBP-CV(The diastolic blood pressure coefficient of variation of the night).The indexes of heart rate variability :SDNN(24 h standard deviation of all normal to normal R-R intervals)、SDNN Idx(Mean of standard deviation of 5 min mean R-R intervals)、SDANN(standard deviation of 5 min mean RR intervals)、p NN50(percentage of successive normal RR intervals exceeding 50 ms)、r MSSD(the square root of the mean of the sum of the squares of differences between adjacent RR intervals)、average heart rate.Results:1.Comparison at baseline:A total of 37 patients with T2 DM were included in this study,including 2 patients in the benaglutide group and 1 patient in the liraglutide group who withdrew halfway due to nausea and vomiting and intolerance of the drug reaction after treatment.A totalof 34 patients completed the experiment example.There was no significant difference in general information,routine biochemical indicators,average blood pressure level,blood pressure variability,average heart rate and heart rate variability between the two groups of patients(P> 0.05).2.Comparison of follow-up:With the extension of treatment time,the systolic and diastolic blood pressure levels in the benaglutide group gradually decreased,and the systolic blood pressure level decreased more significantly;The average heart rate of the benaglutide group showed a downward trend;the average heart rate of the liraglutide group showed an upward trend.3.Comparison within the group before and after treatment:3.1After treatment with benaglutide and liraglutide,FPG,2h PG,Hb A1 c,and GA were significantly lower than before treatment,and the difference was statistically significant(P<0.05);3.2 24 h SBP,24 h DBP,d SBP,d DBP,n SBP,and n DBP in the benaglutide group were significantly lower than before,and the differences were statistically significant(P<0.05);There was no statistical difference in blood pressure variability before and after treatment(P> 0.05).The blood pressure level and blood pressure variability of the liraglutide group were not statistically significant before and after treatment(P> 0.05).3.3 The heart rate variability index of the benaglutide group was not statistically different before and after treatment(P> 0.05).The average heart rate of the liraglutide group after treatment was faster than that before treatment,the SDNN Idx and SDANN were lower than before treatment.These differences were statistically significant.(P<0.05).4.Comparison between the two groups after treatment:4.1At the end of the treatment,there was no significant difference in the reduction of blood glucose index between the two groups(P> 0.05).4.2Compared with the liraglutide group,the d SBP of the benaglutide group was reduced,and the difference was statistically significant(P<0.05).There was no statistical difference in blood pressure variability and the ratio of dipper change between the twogroups(P> 0.05).4.3Compared with the liraglutide group,the SDNN,SDNN Idx,SDANN,and r MSSD of the benaglutide group were significantly increased;the average heart rate of the benaglutide group was lower than the liraglutide group,and these differences were statistically significant.(P <0.05).5.Correlation and regression analysis:5.1 In the overall population,Pearson correlation analysis showed that SDNN,SDNN Idx,SDANN,r MSSD were negatively correlated with average heart rate(r=-0.378,P=0.028;r=-0.538,P=0.001;r=-0.446,P=0.008;r=-0.379,P=0.027).5.2 Linear regression analysis showed that the average heart rate was negatively correlated with SDNN,SDNN Idx,SDANN,and r MSSD(P<0.05).Conclusion:1.Benaglutide can reduce 24 h SBP,24 h DBP,d SBP,d DBP,n SBP,n DBP.2.Liraglutide can increase the average heart rate and reduce heart rate variability.3.Benaglutide is better than liraglutide in reducing d SBP.4.Heart rate variability is inversely related to average heart rate.5.Benaglutide is similar to liraglutide in reducing glucose;... |
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