Secretion of incretin hormones in people having risk factors for type 2 diabetes mellitus


Cite item

Full Text

Abstract

AIM. To study the secretion of glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and glucagon-like peptide 2 (GLP-2) in response to a carbohydrate load in people with risk factors for type 2 diabetes mellitus (DM2) in relation to the type of carbohydrate metabolic disturbances and age. MATERIALS AND METHODS. One hundred and twenty-seven patients having DM2 risk factors who had not previously received glucose-lowering therapy underwent an oral glucose tolerance test (OGTT). The plasma levels of glucose, insulin, glucagon, GLP-1, GIP, and GLP-2 were determined at 0, 30, and 120 minutes of the test. RESULTS. According to the findings, the patients were divided into 3 groups: 1) normal glucose tolerance; 2) prediabetic states (impaired glucose tolerance and/or impaired fasting glycemia); 3) new-onset DM2. OGTT showed that the secretion of GLP-1 was lower and that of GIP and GLP-2 was higher in patients with DM2. GLP-1 secretion decreased with patient age. CONCLUSION. During OGTT, there is a statistically significantly difference in the secretion of incretin hormones in persons with varying degrees of carbohydrate metabolic disturbances: the peak GLP-1 secretion is the highest in healthy individuals and lowest in the patients with DM2; on the contrary, the peak GLP2 and GIP secretions are the highest in the patients with DM2. This may suggest that GLP-1 and the two other hormones (GLP-2 and GIP) show opposite effect in the regulatory mechanisms of carbohydrate metabolism. GLP-1 secretion is decreased with age, which may be one of the reasons for the higher prevalence of DM2 among the elderly.

About the authors

E A Shestakova

ФГБУ "Эндокринологический научный центр" Минздрава России

Email: katiashestakova@mail.ru

A V Il'in

ФГБУ "Эндокринологический научный центр" Минздрава России

M V Shestakova

ФГБУ "Эндокринологический научный центр" Минздрава России; ГБОУ ВПО "Первый МГМУ им. И.М. Сеченова" Минздрава России, Москва

I I Dedov

ФГБУ "Эндокринологический научный центр" Минздрава России

References

  1. Toft-Nielsen M.B., Damholt M.B., Madsbad S. et al. Determinants of the impaired secretion of glucagon-like peptide-1 in type 2 diabetic patients. J Clin Endocrinol Metab 2001; 86: 3717-3723.
  2. Meier J.J., Nauck M.A., Pott A. et al. Glucagon-like peptide 2 stimulates glucagon secretion, enhances lipid absorption, and inhibits gastric acid secretion in humans. Gastroenterology 2006; 130 (1): 44-54.
  3. Knop F.K., Vilsbøll T., Madsbad S. et al. Inappropriate suppression of glucagon during OGTT but not during isoglycaemic i.v. glucose infusion contributes to the reduced incretin effect in type 2 diabetes mellitus. Diabetologia 2007; 50: 797-805.
  4. Shah P., Vella A., Basu A. et al. Lack of suppression of glucagon contributes to postprandial hyperglycemia in subjects with type 2 diabetes mellitus. J Clin Endocrinol Metab 2000; 85: 4053-4059.
  5. Ørskov C., Jeppesen J., Madsbad S., Holst J.J. Proglucagon products in plasma of noninsulin-dependent diabetics and nondiabetic controls in the fasting state and after oral glucose and intravenous arginine. J Clin Inves 1991; 87: 415-423.
  6. Vilsbøll T., Krarup T., Sonne S. et al. Incretin secretion in relation to meal size and body weight in healthy subjects and people with type 1 and type 2 diabetes mellitus. J Clin Endocrinol Metab 2005; 88: 2706 -2713.
  7. Laakso M., Zilinskaite J., Hansen T. et al. Insulin sensitivity, insulin release and glucagon-like peptide-1 levels in persons with impaired fasting glucose and/or impaired glucose tolerance in the EUGENE2 study. Diabetologia 2008; 51: 502-511.
  8. Vollmer K., Holst J.J., Baller B. et al. Predictors of incretin concentrations in subjects with normal, impaired, and diabetic glucose tolerance. Diabetes 2008; 57: 678-687.
  9. Zhang F., Tang X., Cao H. et al. Impaired secretion of total glucagon-like peptide-1 in people with impaired fasting glucose combined impaired glucose tolerance. Intern J Med Scie 2012; 9 (7): 574-581.
  10. Mannucci E., Tesi F., Bardini G. et al. Effects of metformin on glucagon-like peptide-1 levels in obese patients with and without Type 2 diabetes. Diabetes Nutr Metab 2004; 17 (6): 336-342.
  11. Faerch K., Vaag A., Holst J.J. et al. Impaired fasting glycaemia vs impaired glucose tolerance: similar impairment of pancreatic alpha and beta cell function but differential roles of incretin hormones and insulin action. Diabetologia 2008. 51: 853-861.
  12. Theodorakis M.J., Carlson O., Muller D.C., Egan J.M. Elevated plasma glucose-dependent insulinotropic polypeptide associates with hyperinsulinemia in impaired glucose tolerance. Diabetes Care 2004; 27 (7): 1692-1698.
  13. Meier J.J., Nauck M.A., Pott A. et al. Glucagon-like peptide 2 stimulates glucagon secretion, enhances lipid absorption, and inhibits gastric acid secretion in humans. Gastroenterology 2006; 130 (1): 44-54.

Copyright (c) 2014 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies