Endogenous glucagon‐like peptide‐1 system response is impaired during ST‐elevation myocardial infarction in type 2 diabetes patients

• Published in: Diabetes, obesity & metabolism Vol. 21; no. 1; pp. 194 - 198
• Main Authors: Elbaz‐Greener, Gabby, Bloch, Olga, Kumets, Ilya, Blatt, Alex, Rapoport, Micha J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2019; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Aged, 80 and over; Angina; Angina pectoris; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Dipeptidyl Peptidase 4 - metabolism; Dipeptidyl-peptidase IV; endogenous GLP‐1 system; Female; Glucagon; Glucagon-Like Peptide 1 - blood; Glucagon-Like Peptide 1 - metabolism; Heart attacks; Humans; Ischemia; Male; Middle Aged; Myocardial infarction; Peptidase; Peptides; Plasma levels; soluble DPP4; ST Elevation Myocardial Infarction - complications; ST Elevation Myocardial Infarction - epidemiology; ST Elevation Myocardial Infarction - metabolism; ST‐elevation myocardial infarction; type 2 diabetes; endogenous GLP-1 system; ST-elevation myocardial infarction; soluble DPP4; type 2 diabetes
• ISSN: 1462-8902; 1463-1326; 1463-1326
• DOI: 10.1111/dom.13490

We previously demonstrated increased glucagon‐like peptide‐1 (GLP‐1) secretion during acute ST elevation myocardial infarction (STEMI) in non‐diabetic (ND) patients. Whether the endogenous GLP‐1 system response is different in patients with type 2 diabetes (T2D) during STEMI is unknown. Patients with STEMI (20 ND, 13 T2D) and 3 control groups (non‐STEMI [14 ND, 13 T2D], stable angina pectoris [SAP] [8 ND, 10 T2D] patients and healthy subjects) (n = 25) were studied. Plasma levels of total and active GLP‐1 and soluble dipeptidyl peptidase‐4 (sDPP4) were estimated by enzyme‐linked immunosorbent assay on admission and at 24 and 48 hours after percutaneous coronary intervention in all patients. Sharply elevated levels of total and active GLP‐1 were found in ND STEMI patients at 24 h (P < 0.05 and P < 0.005, respectively), but not in T2D STEMI patients. All patients demonstrated decreased sDPP4 levels compared with healthy controls (P < 0.0005) accompanied by increased active/total GLP‐1 ratio regardless of their ischemic state. These data demonstrate that T2D patients fail to further upregulate their endogenous GLP‐1 system during STEMI. This may underlie their worse cardiovascular outcome.