Secretion of glucagon-like peptide-1 in patients with type 2 diabetes mellitus: systematic review and meta-analyses of clinical studies

被引:194
作者
Calanna, S. [1 ,2 ]
Christensen, M. [1 ]
Holst, J. J. [1 ,3 ]
Laferrere, B. [4 ]
Gluud, L. L. [1 ]
Vilsboll, T. [1 ]
Knop, F. K. [1 ,3 ]
机构
[1] Univ Copenhagen, Diabet Res Div, Dept Internal Med, Gentofte Hosp, DK-2900 Hellerup, Denmark
[2] Univ Catania, Dept Clin & Mol Biomed, Catania, Italy
[3] Univ Copenhagen, Panum Inst, Dept Biomed Sci, DK-2200 Copenhagen, Denmark
[4] Columbia Univ Coll Phys & Surg, Obes Nutr Res Ctr, St Lukes Roosevelt Hosp Ctr, New York, NY 10032 USA
关键词
Glucagon-like peptide-1 (GLP-1); Gut hormones; Incretin secretion; Meta-analysis; Systematic review; Type 2 diabetes mellitus; GASTRIC-INHIBITORY POLYPEPTIDE; ORAL GLUCOSE; 7-36; AMIDE; INCRETIN HORMONES; BYPASS-SURGERY; OBESE-PATIENTS; GLP-1; INGESTION; IV; MEAL;
D O I
10.1007/s00125-013-2841-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims/hypothesis We carried out a systematic review of clinical studies investigating glucagon-like peptide-1 (GLP-1) secretion in patients with type 2 diabetes and non-diabetic controls and performed meta-analyses of plasma total GLP-1 concentrations during an OGTT and/or meal test. Methods Random effects models for the primary meta-analysis and random effects meta-regression, subgroup and regression analyses were applied. Results Random effects meta-analysis of GLP-1 responses in 22 trials during 29 different stimulation tests showed that patients with type 2 diabetes (n=275) and controls without type 2 diabetes (n=279) exhibited similar responses of total GLP-1 (p=NS) as evaluated from peak plasma concentrations (weighted mean difference [95% CI] 1.09 pmol/l [-2.50, 4.67]), total AUC (tAUC) (159 pmol/lxmin [-270, 589]), time-corrected tAUC (tAUC min(-1)) (0.99 pmol/l [-1.28, 3.27]), incremental AUC (iAUC) (-122 pmol/lxmin [-410, 165]) and time-corrected iAUC (iAUC min(-1)) (-0.49 pmol/l [-2.16, 1.17]). Fixed effects meta-analysis revealed higher peak plasma GLP-1 concentrations in patients with type 2 diabetes. Subgroup analysis showed increased responses after a liquid mixed meal test (peak, tAUC and tAUC min(-1)) and after a 50 g OGTT (AUC and tAUC min(-1)), and reduced responses after a solid mixed meal test (tAUC min(-1)) among patients with type 2 diabetes. Meta-regression analyses showed that HbA(1c) and fasting plasma glucose predicted the outcomes iAUC and iAUC min(-1), respectively. Conclusions/interpretation The present analysis suggests that patients with type 2 diabetes, in general, do not exhibit reduced GLP-1 secretion in response to an OGTT or meal test, and that deteriorating glycaemic control may be associated with reduced GLP-1 secretion.
引用
收藏
页码:965 / 972
页数:8
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