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Research Article|Articles in Press, 110636

Circulating levels of gastrointestinal hormones in prediabetes reversing to normoglycemia or progressing to diabetesin a year– a cross-sectional and prospective analysis

  • Carlotta Hoffmann
    Affiliations
    Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
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  • Peter E. Schwarz
    Affiliations
    Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, University Hospital and Faculty of Medicine, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    German Center for Diabetes Research (DZD e.V.), IngolstädterLandstrasse 1,85764Neuherberg, Germany
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  • Christos S. Mantzoros
    Affiliations
    Department of Medicine, Boston VA Healthcare System and Beth Israel Deaconess Medical Center, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
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  • Andreas Birkenfeld
    Affiliations
    German Center for Diabetes Research (DZD e.V.), Department of Internal Medicine IV, Department of Endocrinology, Diabetology and Nephrology, University Hospital of Eberhard-Karls-University Tübingen,Geissweg 3, 72076 Tübingen, Germany

    Diabetes and Nutritional Sciences, King's College London, Strand, London WC2R 2LS, UK

    Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard-Karls University of Tübingen, Geissweg 3, 72076 Tübingen Germany
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  • Christian Wolfrum
    Affiliations
    Laboratory of Translational Nutrition Biology, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zürich, Schorenstrasse 16, 8603 Schwerzenbach, Switzerland
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  • Michele Solimena
    Affiliations
    Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, University Hospital and Faculty of Medicine, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    German Center for Diabetes Research (DZD e.V.), IngolstädterLandstrasse 1,85764Neuherberg, Germany
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  • Stefan R. Bornstein
    Affiliations
    Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, University Hospital and Faculty of Medicine, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    German Center for Diabetes Research (DZD e.V.), IngolstädterLandstrasse 1,85764Neuherberg, Germany

    Diabetes and Nutritional Sciences, King's College London, Strand, London WC2R 2LS, UK
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  • Nikolaos Perakakis
    Correspondence
    Corresponding author at: Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
    Affiliations
    Department of Internal Medicine III, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, University Hospital and Faculty of Medicine, TU Dresden, Fetscherstraße 74, 01307 Dresden, Germany

    German Center for Diabetes Research (DZD e.V.), IngolstädterLandstrasse 1,85764Neuherberg, Germany
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      Highlights

      • Postprandial glicentin and GLP-1 levels are lower in patients with diabetes.
      • Progression to diabetes shows reduction of postprandial glicentin and GLP-1.
      • Glucagon concentrations correlate with visceral fat mass and liver fat%
      • Changes in glicentin and GLP-1 levels correlate with changes in beta cell function.
      • Incretin concentrations in prediabetic state cannot predict future glycaemic traits.

      Abstract

      Aims

      Weaimed to compare theconcentrations of GLP-1, glucagon and GIP (established regulators of glucose homeostasis) and glicentin (emerging new metabolic marker)during an OGTT in patients with normal glucose tolerance (NGT), prediabetes and diabetes at onset, and one-year before, when all had prediabetes.

      Methods

      GLP-1, glucagon, GIP and glicentin concentrations were measured and compared with markers of body composition, insulin sensitivity and β-cell function at a 5-timepoint OGTT in 125 subjects (30 diabetes, 65 prediabetes, 30 NGT) and in 106 of them one-year before, when all had prediabetes.

      Results

      At baseline, when all subjects were in prediabetic state, hormonal levels did not differ between groups. One year later, patients progressing to diabetes had lower postprandial increases of glicentin and GLP-1, lower postprandial decrease of glucagon, and higher levels of fasting GIP compared to patients regressing to NGT. Changes in glicentin and GLP-1 AUC within this year correlated negatively with changes in Glucose AUC of OGTT and with changes in markers of beta cell function.

      Conclusion

      Incretins, glucagon and glicentin profiles in prediabetic state cannot predict future glycemic traits, but prediabetes progressing to diabetes is accompanied by deterioration of postprandial increases of GLP-1 and glicentin.

      Keywords

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