Abstract 16156: Decreased Plasma Levels of Active Glucagon-Like Peptide-1 Correlate With Heart Failure
Background: Diabetes and abnormal glucose metabolism is involved in pathogenesis of heart failure (HF). Glucagon-like peptide-1 (GLP-1) is an incretin hormone which has been shown to exert beneficial effects on type-2 diabetes mellitus and cardiovascular systems. Cardiomyocytes express a GLP-1 receptor and GLP-1 could exhibit cardioprotective effects in animal models, however, impact of endogenous active GLP-1 (aGLP-1) in HF have not been clinically examined. Aim of the present study was to investigate association between plasma levels of aGLP-1 and HF.
Methods and Results: At fasting state, we measured plasma levels of B-type natriuretic peptide (BNP) and aGLP-1 sampled from peripheral vein in 191 stable patients with symptomatic HF (New York Heart Association class-II: n=134, class-III, IV; n=57, age 67±11, left ventricular ejection fraction (LVEF) 51±15%, BNP 195 [57-476] pg/ml, hemoglobin A1c (HbA1c) 6.1 [5.8-6.8] %), and age- and gender-matched subjects without HF (non-HF, n=53). Fasting aGLP-1 (F-aGLP-1) were undetected (<2.0pmol/L) in significantly more patients with HF than non-HF [40 (21%) vs. 4 (8%), P=0.03]. F-aGLP-1 levels were significantly lower in HF patients than non-HF patients (3.2 [2.4-4.1] vs. 3.9 [3.2-6.4] pmol/L, p<0.001). F-aGLP-1 levels were similar in HF patients with or without coronary artery disease (CAD) and in HF patients with or without reduced LVEF (EF<50%). During 75g-oral glucose tolerance test (OGTT) in non-diabetic patients, the aGLP-1 levels were lasting significantly lower in HF patients (n=111) than non-HF patients (n=42) (60 min; 5.9 [4.0-10.1] vs. 9.7 [5.7-13.7], 120 min; 5.2 [3.7-8.1] vs. 7.0 [5.2-8.9] pmol/L, p<0.01, respectively). Multivariate logistic regression analysis, including the presence of diabetes, fasting blood glucose, and insulin levels showed that the F-aGLP-1 levels were independently associated with the presence of HF [odds ratio (OR); 0.69, 95%-confidence interval (CI) 0.55-0.87,p<0.01]. Even if diabetic patients were excluded, this association was still significant (OR; 0.70, 95%-CI 0.49-1.00, p=0.04)
Conclusions: Plasma levels of aGLP-1 at fasting state or during OGTT were significantly reduced in HF patients. Endogenous aGLP-1 could be correlated with pathogenesis of HF.
- © 2013 by American Heart Association, Inc.