Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.
Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea.
Diabetes Metab J. 2019 Aug;43(4):495-503. doi: 10.4093/dmj.2018.0105. Epub 2019 Feb 20.
We performed this study to identify factors related to intact incretin levels in patients with type 2 diabetes mellitus (T2DM).
We cross-sectionally analyzed 336 patients with T2DM. Intact glucagon-like peptide 1 (iGLP-1) and intact glucose-dependent insulinotropic polypeptide (iGIP) levels were measured in a fasted state and 30 minutes after ingestion of a standard mixed meal. The differences between 30 and 0 minute iGLP-1 and iGIP levels were indicated as ΔiGLP-1 and ΔiGIP.
In simple correlation analyses, fasting iGLP-1 was positively correlated with glucose, C-peptide, creatinine, and triglyceride levels, and negatively correlated with estimated glomerular filtration rate. ΔiGLP-1 was positively correlated only with ΔC-peptide levels. Fasting iGIP showed positive correlations with glycosylated hemoglobin (HbA1c) and fasting glucose levels, and negative correlations with ΔC-peptide levels. ΔiGIP was negatively correlated with diabetes duration and HbA1c levels, and positively correlated with Δglucose and ΔC-peptide levels. In multivariate analyses adjusting for age, sex, and covariates, fasting iGLP-1 levels were significantly related to fasting glucose levels, ΔiGLP-1 levels were positively related to ΔC-peptide levels, fasting iGIP levels were related to fasting C-peptide levels, and ΔiGIP levels were positively related to ΔC-peptide and Δglucose levels.
Taken together, intact incretin levels are primarily related to C-peptide and glucose levels. This result suggests that glycemia and insulin secretion are the main factors associated with intact incretin levels in T2DM patients.
本研究旨在确定与 2 型糖尿病（T2DM）患者完整肠降血糖素水平相关的因素。
我们对 336 例 T2DM 患者进行了横断面分析。空腹和标准混合餐摄入 30 分钟后，测定完整胰高血糖素样肽 1（iGLP-1）和完整葡萄糖依赖性胰岛素释放肽（iGIP）水平。30 分钟与 0 分钟 iGLP-1 和 iGIP 水平的差值表示为ΔiGLP-1 和ΔiGIP。
在简单相关分析中，空腹 iGLP-1 与血糖、C 肽、肌酐和甘油三酯水平呈正相关，与估算肾小球滤过率呈负相关。ΔiGLP-1 仅与ΔC 肽水平呈正相关。空腹 iGIP 与糖化血红蛋白（HbA1c）和空腹血糖水平呈正相关，与ΔC 肽水平呈负相关。ΔiGIP 与糖尿病病程和 HbA1c 水平呈负相关，与Δ葡萄糖和ΔC 肽水平呈正相关。在调整年龄、性别和协变量的多变量分析中，空腹 iGLP-1 水平与空腹血糖水平显著相关，ΔiGLP-1 水平与ΔC 肽水平呈正相关，空腹 iGIP 水平与空腹 C 肽水平相关，ΔiGIP 水平与ΔC 肽和Δ葡萄糖水平呈正相关。
综上所述，完整肠降血糖素水平主要与 C 肽和葡萄糖水平相关。这一结果提示，血糖和胰岛素分泌是 T2DM 患者完整肠降血糖素水平相关的主要因素。
