Clinical Trials Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2023; 14(3): 279-289
Published online Mar 15, 2023. 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
Lu-Lu Song, Na Wang, Jin-Ping Zhang, Li-Ping Yu, Xiao-Ping Chen, Bo Zhang, Wen-Ying Yang
Lu-Lu Song, Na Wang, Jin-Ping Zhang, Li-Ping Yu, Xiao-Ping Chen, Bo Zhang, Wen-Ying Yang, Department of Endocrinology, China-Japan Friendship Hospital, Beijing 100029, China
Author contributions: Song LL analyzed the data the data and drafted the manuscript; Zhang JP and Wang N collected the data and performed the literature review; Yu LP provides ideas and commentary in the process of writing the article; Chen XP and Zhang B coordinated the implementation of the study; Yang WY was the principal investigator of the study; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved China-Japan Friendship Hospital Institutional Review Board (Approval No. 2008-23).
Clinical trial registration statement: This trial was registered at ChiCTR (registration: No. ChiCTR-TRC-08000231).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Ying Yang, MD, Professor, Department of Endocrinology, China-Japan Friendship Hospital, No. 2 Yinghua East Street, Chaoyang District, Beijing 100029, China, ywy_1010@163.com
Received: October 27, 2022
Peer-review started: October 27, 2022
First decision: December 12, 2022
Revised: December 21, 2022
Accepted: February 16, 2023
Article in press: February 16, 2023
Published online: March 15, 2023
Processing time: 139 Days and 14 Hours
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, AUCglucose and AUCglucagon, 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: Microalbuminuria; Glucagon-like peptide 1; Type 2 diabetes; Nephropathy

Core Tip: The association between the microalbuminuria and glucagon-like peptide 1 (GLP-1) response after a standard meal load in newly diagnosed Chinese type 2 diabetes mellitus patients was identified. Patients with microalbuminuria showed lower postprandial GLP-1 levels than those without microalbuminuria. The prevalence of microalbuminuria decreased with increasing quartiles of 30 min and 120 min and area under the curve for active GLP-1 levels after a standard meal. The highlights of our study are that the patients were newly diagnosed, which excluded the influence of glucose-lowering therapies. Furthermore, we assessed the fasting and postprandial GLP-1 levels in response to a standard meal, not oral glucose. Third, the GLP-1 determined in our study was active GLP-1, not total GLP-1.