| Objective:To investigate the relationship between serum glucagon-like peptide-1(GLP-1)levels and amelioration of hyperglycemia in 167 patients with type 2 diabetes mellitus(T2DM)and the related factors.Methods:This study enrolled 167 T2DM patients with poor control on blood glucose in the Department of Endocrinology and Metabolism,the First Affiliated Hospital of Zhejiang University Medical College from November 2015 to April 2016.Of all patients,2 hours postprandial blood glucose(2hPG)>11.1 mmol/L and glycated hemoglobin A1c(HbA1c)>7.0%,were defined as glucotoxicity.The basic information of patients after their admission were collected and blood samples were collected in the fasting state to test total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)concentrations,low-density lipoprotein cholesterol(LDL-C)concentrations,Alanine aminotransferase(ALT),Creatinine(Cr)and HbA1c.2ml venous blood was drew to measure serum GLP-1 levels.A 75g glucose OGTT was given to every participant 3-4 days after admission,and HOMA-IR was calculated.2ml fasting venous blood was left to detect serum GLP-1 levels once again when patients with stable blood glucose control,that is fasting plasma glucose(FPG)maintained at 5.0-7.0mmol/L,postprandial blood glucose maintained at 8.0-10.0mmol/L,which meant patients with glucotoxicity amelioration.Date analyses were carried out using Statistical Package for Social Sciences version 20(SPSS 20.0),the normal distribution data were expressed as mean ± standard deviation,and comparison between groups using independent t test,the group comparison using the paired t test;.The non-normal distribution data were described by quadratic distance M(Q25,Q75),and non-parametric test was used between groups.The influencing factors were analyzed by logistic regression analysis.P<0.05 was considered to be statistically significant.The changes of serum GLP-1 levels were compared before and after glucotoxicity amelioration,and the elevated group was recorded as GA group while others was recorded as GB group to explore the related factors.Results1.Serum GLP-1 levels(ng/ml)were respectively 14.63(11.45,20.59)and 18.49(12.08,26.58)before and after glucotoxicity amelioration in T2DM patients enrolled.The level of serum GLP-1 was higher than before,and the difference was statistically significant(P<0.001).2.There was no significant difference in serum GLP-1 level between the Underweight and normal weight patients before and after glucotoxicity amelioration(P>0.05).The levels of serum GLP-1 in overweight patients were respectively 15.34(11.81,21.67)and 19.40(13.96,27.64)before and after glucotoxicity amelioration,while obese patients were 14.33(11.30,20.49)and 20.06(11.89,30.94).The difference was statistically significant(P<0.05).3.The levels of serum GLP-1 were 15.50(12.28,22.85)and 23.10(17.76,31.27)before and after glucotoxicity amelioration in patients with a course of disease among 0-5 years.The difference was statistically significant(P<0.001).There was no significant difference in serum GLP-1 levels in patients over 5 years(P>0.05).4.The levels of serum GLP-1 in patients with abdominal obesity was 13.99(11.42,17.95)and 18.31(11.79,24.96)before and after glucotoxicity amelioration,the difference was statistically significant(P<0.001).There was no significant difference in serum GLP-1 levels in patients with non-abdominal obesity(P>0.05).5.The mean duration(years)of the GA group was shorter than that of the GB group,respectively were 54.63± 13.73 and 60.40±10.57(P<0.01),and the average age(years)of the GA group was lower than that of the GB group,5.00(0.50,10.00),10.00(6.00,15.25)respectively.(P<0.01).6.There was significant difference in ALT and Cr between GA group and GB group(P<0.05).7.The serum GLP-1 levels were most closely related to the course of disease.The shorter the course of the patients,the higher level of serum GLP-1 levels after glucotoxicity amelioration,while in the longer course,elevated serum GLP-1 levels were not observed after glucotoxicity amelioration(P = 0.005,OR = 0.925).Conclusion1.Serum GLP-1 levels were increased after glucotoxicity amelioration in T2DM,especially in patients with BMI greater than 25 kg/m2,abdominal obesity,younger age,T2DM duration less than 5 years,and in patients without severe heart,liver and kidney diseases or chronic complications of diabetes.2.The elevated serum GLP-1 levels in T2DM are closely related to the course of diabetes,the shorter the course of the disease,especially in 0 to 5 years,the more obvious the increase in serum GLP-1 levels after glucotoxicity amelioration,and the longer the duration of the patients,especially for more than 5 years,the less chance to see elevated serum GLP-1 levels after glucotoxicity amelioration. |
