GLP-1 Levels Predict Mortality in Patients with Critical Illness as Well as End-Stage Renal Disease - 27/09/17
Abstract |
Background |
Glucagon-like peptide 1 (GLP-1) is an incretin hormone, which stimulates glucose-dependent insulin secretion from the pancreas and holds immune-regulatory properties. A marked increase of GLP-1 has been found in critically ill patients. This study was performed to elucidate the underlying mechanism and evaluate its prognostic value.
Methods |
GLP-1 plasma levels were determined in 3 different patient cohorts: 1) critically ill patients admitted to our intensive care unit (n = 215); 2) patients with chronic kidney disease on hemodialysis (n = 173); and 3) a control group (no kidney disease, no acute inflammation, n = 105). In vitro experiments were performed to evaluate GLP-1 secretion in response to human serum samples from the above-described cohorts.
Results |
Critically ill patients presented with 6.35-fold higher GLP-1 plasma level in comparison with the control group. There was a significant correlation of GLP-1 levels with markers for the severity of inflammation, but also kidney function. Patients with end-stage renal disease displayed 4.46-fold higher GLP-1 concentrations in comparison with the control group. In vitro experiments revealed a strong GLP-1-inducing potential of serum from critically ill patients, while serum from hemodialysis patients only modestly increased GLP-1 secretion. GLP-1 levels independently predicted mortality in critically ill patients and patients with end-stage renal disease.
Conclusions |
Chronic and acute inflammatory processes like sepsis or chronic kidney disease increase circulating GLP-1 levels. This most likely reflects a sum effect of increased GLP-1 secretion and decreased GLP-1 clearance. GLP-1 plasma levels independently predict the outcome of critically ill and end-stage renal disease patients.
Le texte complet de cet article est disponible en PDF.Keywords : Chronic kidney disease, CKD, Critically ill, GLP-1, Hemodialysis, Inflammation, Kidney function, Mortality, Prognosis, Sepsis
Plan
| Funding: This study was supported by grants from the Hans Lamers Foundation and the Marga und Walter Boll Foundation. |
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| Conflict of Interest: NM is a speaker and/or advisory board member of the following companies: Astra-Zeneca, MSD, NovoNordisk, BMS. The other authors declare no conflicts of interest. |
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| Authorship: CL: experimental design, wrote the first draft of the manuscript; GS: experimental design, edited the first draft of the manuscript, performed statistical analysis, provided the end-stage renal disease cohort; JM and FK performed GLUTag experiments and reviewed/edited the manuscript; MS collected cardiovascular biobank samples and reviewed/edited the manuscript; JM collected sepsis samples and reviewed/edited the manuscript; ND end-stage renal disease samples and reviewed/edited the manuscript; AK collected sepsis samples and reviewed/edited the manuscript; CT, JF, and NM carried out critical discussion of results and reviewed/edited the manuscript; FT carried out experimental design, performed statistical analysis, provided the critically ill cohort, and carried out critical discussion of the results and editing of the manuscript; ML carried out experimental design, wrote the manuscript, and is the guarantor of this work, and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. |
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| CL and GS contributed equally. |
Vol 130 - N° 7
P. 833 - juillet 2017 Retour au numéro
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