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

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

doi:10.4239/wjd.v14.i3.279

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

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

Authors

Lu-Lu Song¹, Na Wang¹, Jin-Ping Zhang¹, Li-Ping Yu¹, Xiao-Ping Chen¹, Bo Zhang¹, Wen-Ying Yang²

Affiliations

¹ Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China.
² Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China. ywy_1010@163.com.

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 vs 19.9 ± 15.6 pmol, P = 0.007; 120 min GLP-1, 16.0 ± 14.1 pmol vs 18.4 ± 13.8 pmol, P = 0.037). The corresponding area under the curve for active GLP-1 (AUCGLP-1) was also lower in microalbuminuria patients (2257, 1585 to 3506 vs 2896, 1763 to 4726, pmol × min, P = 0.003). Postprandial GLP-1 levels at 30 min and 120 min and AUCGLP-1 were negatively correlated with the UACR (r = 0.159, r = 0.132, r = 0.206, respectively, P < 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_glucose and AUC_glucagon, 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, P = 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.

Keywords: Glucagon-like peptide 1; Microalbuminuria; Nephropathy; Type 2 diabetes.

Publication types

Clinical Trial