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Effects of glucagon-like peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease

Nystrom, T (author)
Karolinska Institutet
Gutniak, MK (author)
Zhang, QM (author)
Karolinska Institutet
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Zhang, F (author)
Karolinska Institutet
Holst, JJ (author)
Ahrén, Bo (author)
Lund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
Sjoholm, A (author)
Karolinska Institutet
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 (creator_code:org_t)
American Physiological Society, 2004
2004
English.
In: American Journal of Physiology: Endocrinology and Metabolism. - : American Physiological Society. - 1522-1555 .- 0193-1849. ; 287:6, s. 1209-1215
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • GLP-1 stimulates insulin secretion, suppresses glucagon secretion, delays gastric emptying, and inhibits small bowel motility, all actions contributing to the anti-diabetogenic peptide effect. Endothelial dysfunction is strongly associated with insulin resistance and type 2 diabetes mellitus and may cause the angiopathy typifying this debilitating disease. Therefore, interventions affecting both endothelial dysfunction and insulin resistance may prove useful in improving survival in type 2 diabetes patients. We investigated GLP-1's effect on endothelial function and insulin sensitivity (S-I) in two groups: 1) 12 type 2 diabetes patients with stable coronary artery disease and 2) 10 healthy subjects with normal endothelial function and S-I. Subjects underwent infusion of recombinant GLP-1 or saline in a random crossover study. Endothelial function was measured by postischemic FMD of brachial artery, using ultrasonography. S-I [in (10(-4) dl.kg(-1).min(-1))/(muU/ml)] was measured by hyperinsulinemic isoglycemic clamp technique. In type 2 diabetic subjects, GLP-1 infusion significantly increased relative changes in brachial artery diameter from baseline FMD(%) (3.1 +/- 0.6 vs. 6.6 +/- 1.0%, P < 0.05), with no significant effects on S-I (4.5 &PLUSMN; 0.8 vs. 5.2 &PLUSMN; 0.9, P = NS). In healthy subjects, GLP-1 infusion affected neither FMD(%) (11.9 &PLUSMN; 0.9 vs. 10.3 &PLUSMN; 1.0%, P = NS) nor S-I (14.8 &PLUSMN; 1.8 vs. 11.6 &PLUSMN; 2.0, P = NS). We conclude that GLP-1 improves endothelial dysfunction but not insulin resistance in type 2 diabetic patients with coronary heart disease. This beneficial vascular effect of GLP-1 adds yet another salutary property of the peptide useful in diabetes treatment.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Fysiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Physiology (hsv//eng)

Keyword

nitric oxide
insulin resistance

Publication and Content Type

art (subject category)
ref (subject category)

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