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Metabolic syndrome is associated with higher postprandial glucagon-like peptide-1 in type 1 diabetes mellitus

Metabolic syndrome (MS) is an important predictor of microvascular complications in type 1 diabetes mellitus (T1DM). Glucagon-like peptide 1 (GLP-1) analogues improve insulin resistance and other MS parameters. Higher plasma GLP-1 concentration was described in patients with MS, indicating GLP-1 resistance. Promising therapeutic effect of GLP-1 analogues in T1DM patients was proved, but there are no data regarding endogenous GLP-1 concentrations in T1DM patients with MS. We studied the relationship between plasma GLP-1 concentration and MS in a cross-sectional study including 30 T1DM patients, median age 37 years (20-59) and median disease duration of 22 (3-45) years. Fasting and postprandial (30 minutes) total GLP-1 concentrations was measured by ELISA (ALPCO, USA). MS was defined according to the NCEP: ATPIII criteria. Nonparametric statistics was used, with α level<0.05. The group of patients with MS (n=10) had higher postprandial GLP-1 concentrations compared to patients without MS (n=20), z=-2.26, p=0.023. Patients with MS were older and had longer disease duration. There was no difference in fasting total GLP-1 concentrations, glucoregulation (HbA1c) and calorie intake between the groups. We found higher postprandial total GLP-1 concentration in T1DM patients with MS. It could reflect a state of GLP-1 resistance, as already described in patients with MS, but without diabetes. Further studies are needed to clarify the pathophysiology of the finding.

type 1 diabetes; metabolic syndrome; glucagon-like peptide-1

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