Abstract 18944: Decreased Postprandial Active Glucagon-Like Peptide-1 Levels Correlate with Coronary Spastic Angina
Background: Coronary endothelial dysfunction plays an important pathogenic role in coronary spastic angina (CSA). Glucagon-like peptide-1 (GLP-1), a gut-derived peptide hormone, has attracted remarkable attention from clinical practice for diabetes care. Vascular cells express a GLP-1 receptor and exogenous GLP-1 infusion improves endothelial function in human and animal models, however, impact of endogenous active GLP-1 (aGLP-1) in CSA have not been clinically examined. Aim of the present study was to investigate association between plasma levels of aGLP-1 and CSA.
Methods and Results: At fasting state or during 75g-oral glucose tolerance test (OGTT), we measured plasma levels of aGLP-1 sampled from peripheral vein in 33 CSA patients without obstructive coronary artery disease (age 58±16, female 48%), and 31 gender-, comorbidity-matched patients without ischemic heart disease (non-IHD, age 65±10, female 48%). There were no significant differences in clinical characteristics between CSA patients and non-IHD patients, except for age. The rate of patients with undetectable fasting aGLP-1 (<2.0 pmol/L) was similar between CSA and non-IHD patients [6 (18%) vs. 5 (16%), P=0.83]. Fasting aGLP-1 levels were similar between CSA and non-IHD patients (3.6 [2.7-4.7] vs. 3.9 [2.7-5.0] pmol/L, p=0.58). During 75g-oral glucose tolerance test (OGTT) in non-diabetic patients, the aGLP-1 levels after glucose ingestion were significantly lower in CSA patients (n=30) than non-IHD patients (n=26) (30 min; 6.7 [4.8-12.4] vs. 12.0 [8.4-18.5], p=0.03, 60 min; 5.3 [3.0-10.7] vs. 7.6 [6.2-10.1] pmol/L, p=0.04). Area under the curve of aGLP-1 during OGTT was significantly smaller in CSA patients than non-IHD patients (697 [436-1022] vs. 941 [815-1602] pmol/L*min, p=0.03). Multivariate logistic regression analysis revealed that the lower aGLP-1 levels at 30 minutes during OGTT (below median, 9.0pmol/L) were independently associated with the presence of CSA (odds ratio; 0.17, 95%-confidence interval 0.04-0.65, p=0.01).
Conclusions: Plasma levels of aGLP-1 during OGTT were significantly reduced in CSA patients. Decreased postprandial levels of endogenous aGLP-1 might play a key role in pathogenesis of CSA.
- © 2012 by American Heart Association, Inc.