Jacquier Marine, Tavernier Annabelle, Quenot Jean-Pierre, Masson David, Ksiazek Elea, Fournel Isabelle, Grober Jacques
Service de Médecine Intensive-Réanimation, CHU Dijon, Bourgogne, France.
Equipe Lipness, Centre de Recherche INSERM UMR1231 et LabEx LipSTIC, Université de Bourgogne-Franche Comté, Dijon, France.
PLoS One. 2025 May 27;20(5):e0323709. doi: 10.1371/journal.pone.0323709. eCollection 2025.
Elevated plasma levels of glucagon-like peptide-1 (GLP-1) have been associated with poor clinical outcome in patients with sepsis. This study investigated the association between GLP-1 levels, and survival at 90 days in a large cohort of critically ill patients.
All patients aged ≥ 18 years admitted to the intensive care unit (ICU) in a large university hospital, and receiving ≥1 life support therapy for organ failure were eligible for inclusion. Plasma samples were taken within 24h of ICU admission. We measured GLP-1 using a commercial ELISA kit. Cumulative probability of death at 90 days (D90) was plotted using the Kaplan-Meier method by quartiles of GLP-1. The effect of GLP-1 quartile on D90 survival was analyzed using a Cox proportional hazards model.
A total of 507 patients had GLP-1 dosage; mean age 64.5 ± 14.5 years; 179 (35.3%) women. GLP-1 levels ranged from 0.03 to 129.2 (median 7.3[IQR:3.3;19.1]). Higher mean age, SOFA, SAPS II, and LPS 3HM were found in patients with higher GLP-1 quartile by univariate analysis. Overall, 229 patients (45.2%) died within 90 days. The cumulative probability of death was significantly associated with GLP-1 quartile (p log rank<0.0001). After adjustment for age, SOFA, renal replacement therapy and vasopressor treatment, a significantly increased risk was observed only for patients with the highest quartile of GLP-1 (adjusted hazard ratio 1.65 [1.06; 2.56] for 4th vs 1st quartile of GLP-1).
After adjusting for demographic and clinical characteristics, only the highest quartile of GLP-1 remained independently associated with an increased risk of death at 90 days after admission to ICU.
脓毒症患者血浆中胰高血糖素样肽-1（GLP-1）水平升高与临床预后不良相关。本研究调查了一大群重症患者中GLP-1水平与90天生存率之间的关联。
所有年龄≥18岁、入住大型大学医院重症监护病房（ICU）且因器官衰竭接受≥1种生命支持治疗的患者均符合纳入标准。在入住ICU后24小时内采集血浆样本。我们使用商用ELISA试剂盒测量GLP-1。采用Kaplan-Meier法按GLP-1四分位数绘制90天死亡累积概率（D90）图。使用Cox比例风险模型分析GLP-1四分位数对D90生存的影响。
共有507例患者检测了GLP-1水平；平均年龄64.5±14.5岁；179例（35.3%）为女性。GLP-1水平范围为0.03至129.2（中位数7.3[四分位间距：3.3；19.1]）。单因素分析显示，GLP-1四分位数较高的患者平均年龄、序贯器官衰竭评估（SOFA）评分、简化急性生理学评分（SAPS）II及脂多糖结合蛋白（LPS）3HM较高。总体而言，229例患者（45.2%）在90天内死亡。死亡累积概率与GLP-1四分位数显著相关（对数秩p<0.0001）。在对年龄、SOFA评分、肾脏替代治疗和血管升压药治疗进行校正后，仅GLP-1最高四分位数的患者观察到风险显著增加（GLP-1第4四分位数与第1四分位数相比，校正后风险比为1.65[1.06；2.56]）。
在对人口统计学和临床特征进行校正后，仅GLP-1最高四分位数仍与入住ICU后90天死亡风险增加独立相关。
