新诊断2型糖尿病患者的餐后胰高血糖素样肽-1分泌与尿白蛋白排泄相关。

Postprandial glucagon-like peptide 1 secretion is associated with urinary albumin excretion in newly diagnosed type 2 diabetes patients.

作者信息

Song Lu-Lu, Wang Na, Zhang Jin-Ping, Yu Li-Ping, Chen Xiao-Ping, Zhang Bo, Yang Wen-Ying

机构信息

Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China.

出版信息

World J Diabetes. 2023 Mar 15;14(3):279-289. doi: 10.4239/wjd.v14.i3.279.

DOI:10.4239/wjd.v14.i3.279

PMID:37035218

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10075041/

Abstract

BACKGROUND

Microalbuminuria is an early and informative marker of diabetic nephropathy. Our study found that microalbuminuria developed in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

AIM

To investigate the association between glucagon-like peptide 1 (GLP-1) and microalbuminuria in newly diagnosed T2DM patients.

METHODS

In total, 760 patients were recruited for this cross-sectional study. The GLP-1 levels during a standard meal test and urinary albumin-creatinine ratio (UACR) were determined.

RESULTS

Patients with microalbuminuria exhibited lower GLP-1 levels at 30 min and 120 min during a standard meal test than patients with normal albuminuria (30 min GLP-1, 16.7 ± 13.3 pmol 19.9 ± 15.6 pmol, = 0.007; 120 min GLP-1, 16.0 ± 14.1 pmol 18.4 ± 13.8 pmol, = 0.037). The corresponding area under the curve for active GLP-1 (AUCGLP-1) was also lower in microalbuminuria patients (2257, 1585 to 3506 2896, 1763 to 4726, pmol × min, = 0.003). Postprandial GLP-1 levels at 30 min and 120 min and AUCGLP-1 were negatively correlated with the UACR ( = 0.159, = 0.132, = 0.206, respectively, < 0.001). The prevalence of microalbuminuria in patients with newly diagnosed T2DM was 21.7%, which decreased with increasing quartiles of AUCGLP-1 levels (27.4%, 25.3%, 18.9% and 15.8%). After logistic regression analysis adjusted for sex, age, hemoglobin A1c, body mass index, systolic blood pressure, estimated glomerular filtration rate, homeostasis model assessment of insulin resistance, AUC and AUC, patients in quartile 4 of the AUCGLP-1 presented a lower risk of microalbuminuria compared with the patients in quartile 1 (odds ratio = 0.547, 95% confidence interval: 0.325-0.920, = 0.01). A consistent association was also found between 30 min GLP-1 or 120 min GLP-1 and microalbuminuria.

CONCLUSION

Postprandial GLP-1 levels were independently associated with microalbuminuria in newly diagnosed Chinese T2DM patients.

摘要

背景

微量白蛋白尿是糖尿病肾病的早期且有意义的标志物。我们的研究发现，新诊断的2型糖尿病（T2DM）患者会出现微量白蛋白尿。

目的

探讨新诊断的T2DM患者中胰高血糖素样肽1（GLP-1）与微量白蛋白尿之间的关联。

方法

本横断面研究共纳入760例患者。测定标准餐试验期间的GLP-1水平和尿白蛋白肌酐比值（UACR）。

结果

微量白蛋白尿患者在标准餐试验期间30分钟和120分钟时的GLP-1水平低于正常白蛋白尿患者（30分钟GLP-1：16.7±13.3 pmol对19.9±15.6 pmol，P = 0.007；120分钟GLP-1：16.0±14.1 pmol对18.4±13.8 pmol，P = 0.037）。微量白蛋白尿患者中活性GLP-1的相应曲线下面积（AUCGLP-1）也较低（2257，1585至3506对2896，1763至4726，pmol×min，P = 0.003）。30分钟和120分钟时的餐后GLP-1水平及AUCGLP-1与UACR呈负相关（分别为P = 0.159、P = 0.132、P = 0.206，均P < 0.001）。新诊断的T2DM患者中微量白蛋白尿的患病率为21.7%，其随AUCGLP-1水平四分位数的增加而降低（27.4%、25.3%、18.9%和15.8%）。在对性别、年龄、糖化血红蛋白、体重指数、收缩压、估计肾小球滤过率、胰岛素抵抗稳态模型评估、AUC和AUC进行逻辑回归分析调整后，AUCGLP-1四分位数4中的患者与四分位数1中的患者相比，微量白蛋白尿风险较低（比值比 = 0.547，95%置信区间：0.325 - 0.920，P = 0.01）。在30分钟GLP-1或120分钟GLP-1与微量白蛋白尿之间也发现了一致的关联。