Section for Nutrition Research, Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
Population Health & Genomics, School of Medicine, University of Dundee, Dundee DD1 9SY, UK.
J Clin Endocrinol Metab. 2024 Aug 13;109(9):e1697-e1707. doi: 10.1210/clinem/dgae119.
The role of glucagon-like peptide-1 (GLP-1) in type 2 diabetes (T2D) and obesity is not fully understood.
We investigate the association of cardiometabolic, diet, and lifestyle parameters on fasting and postprandial GLP-1 in people at risk of, or living with, T2D.
We analyzed cross-sectional data from the two Innovative Medicines Initiative (IMI) Diabetes Research on Patient Stratification (DIRECT) cohorts, cohort 1 (n = 2127) individuals at risk of diabetes; cohort 2 (n = 789) individuals with new-onset T2D.
Our multiple regression analysis reveals that fasting total GLP-1 is associated with an insulin-resistant phenotype and observe a strong independent relationship with male sex, increased adiposity, and liver fat, particularly in the prediabetes population. In contrast, we showed that incremental GLP-1 decreases with worsening glycemia, higher adiposity, liver fat, male sex, and reduced insulin sensitivity in the prediabetes cohort. Higher fasting total GLP-1 was associated with a low intake of wholegrain, fruit, and vegetables in people with prediabetes, and with a high intake of red meat and alcohol in people with diabetes.
These studies provide novel insights into the association between fasting and incremental GLP-1, metabolic traits of diabetes and obesity, and dietary intake, and raise intriguing questions regarding the relevance of fasting GLP-1 in the pathophysiology T2D.
胰高血糖素样肽-1（GLP-1）在 2 型糖尿病（T2D）和肥胖中的作用尚未完全阐明。
我们研究了代谢、饮食和生活方式参数与空腹和餐后 GLP-1 之间的关系，这些参数与 T2D 高危人群或患者有关。
我们分析了创新药物倡议（IMI）糖尿病患者分层（DIRECT）两个队列的横断面数据，队列 1（n=2127）为糖尿病高危人群；队列 2（n=789）为新发 T2D 人群。
我们的多元回归分析显示，空腹总 GLP-1 与胰岛素抵抗表型相关，并观察到与男性、肥胖程度增加和肝脂肪密切相关的独立关系，尤其是在糖尿病前期人群中。相比之下，我们发现，在糖尿病前期人群中，空腹 GLP-1 的增量与血糖恶化、更高的肥胖程度、肝脂肪、男性和胰岛素敏感性降低有关。在糖尿病前期人群中，空腹总 GLP-1 与全谷物、水果和蔬菜摄入减少有关，而与糖尿病患者中红肉类和酒精摄入增加有关。
这些研究为空腹和增量 GLP-1 与糖尿病和肥胖的代谢特征以及饮食摄入之间的关系提供了新的见解，并提出了关于空腹 GLP-1 在 T2D 病理生理学中的相关性的有趣问题。
