Department of Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden.
Department of Biomedical Sciences and NNF Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Cardiovasc Diabetol. 2019 Jul 15;18(1):91. doi: 10.1186/s12933-019-0896-z.
Glucagon-like peptide-1 (GLP-1) treatment has been shown to reduce stroke incidence in diabetes and also to be neuroprotective in experimental stroke models. The prognostic value of endogenous levels of GLP-1 in the recovery phase after stroke remains to be elucidated. The aim of the study was to investigate the potential association between GLP-1 levels and functional outcome after stroke and to determine whether GLP-1 is altered in the acute phase of stroke compared to 3 months post stroke and to healthy controls.
Fasting GLP-1 was measured on hospital day 2-4 in patients without previously known diabetes (n = 59) that received recombinant tissue plasminogen activator (rtPA) for ischemic stroke. Fasting GLP-1 was measured again after 3 months and neurologic outcome was measured as modified Rankin Scale (mRS). mRS ≥ 2 was considered as unfavorable outcome. A control group of healthy individuals (n = 27) was recruited and their fasting GLP-1 was measured.
Fasting GLP-1 was higher in the patients that suffered a stroke compared to healthy controls (25.1 vs. 18.0 pmol/L; p = 0.004). The GLP-1 levels did not change significantly at the 3-month follow up OGTT (25.8 vs. 25.6; p = 0.80). There was no significant association between GLP-1 levels and unfavorable mRS (OR 1.03, 95% CI 0.95-1.12, p = 0.50).
Endogenous GLP-1 levels in patients that recently suffered an ischemic stroke are higher than in healthy controls and remained unchanged at the 3 months follow-up, possibly indicating an elevation of the levels of GLP-1 already pre-stroke. However, no association between endogenous GLP-1 and functional outcome of stroke 3 months post stroke was found.
胰高血糖素样肽-1（GLP-1）治疗已被证明可降低糖尿病患者的中风发病率，并且在实验性中风模型中具有神经保护作用。中风后恢复期内内源性 GLP-1 水平的预后价值仍有待阐明。本研究旨在探讨 GLP-1 水平与中风后功能结局之间的潜在关联，并确定 GLP-1 是否在中风的急性期与中风后 3 个月及健康对照组相比发生改变。
在接受重组组织纤溶酶原激活剂（rtPA）治疗的缺血性中风且无已知糖尿病的患者入院第 2-4 天测量禁食 GLP-1。在 3 个月后再次测量禁食 GLP-1，并测量神经功能结局作为改良 Rankin 量表（mRS）。mRS≥2 被认为是不良结局。招募了一组健康个体作为对照组（n=27），并测量了他们的禁食 GLP-1。
与健康对照组相比，患有中风的患者的禁食 GLP-1 水平更高（25.1 比 18.0 pmol/L；p=0.004）。在 3 个月的 OGTT 随访中，GLP-1 水平没有显著变化（25.8 比 25.6；p=0.80）。GLP-1 水平与不良 mRS 之间没有显著相关性（OR 1.03，95%CI 0.95-1.12，p=0.50）。
近期发生缺血性中风的患者内源性 GLP-1 水平高于健康对照组，并且在 3 个月的随访中没有变化，这可能表明 GLP-1 水平在中风前已经升高。然而，没有发现内源性 GLP-1 与中风后 3 个月的功能结局之间存在关联。
