Relationship Between Fasting Plasma Glucagon Level and Renal Function-A Cross-Sectional Study in Individuals With

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Jian-Jun Liu1, Sylvia Liu1, Resham L Gurung1

  • 1Clinical Research Unit, Khoo Teck Puat Hospital, Republic of Singapore.

Journal of the Endocrine Society
|January 10, 2019
PubMed
Abstract

Insights

Fasting glucagon levels increase with worsening kidney function in type 2 diabetes patients, even in early chronic kidney disease (CKD). Insulin resistance also impacts glucagon levels.

Area of Science:

  • Endocrinology
  • Nephrology
  • Metabolic Diseases

Background:

  • The kidney is the primary site for glucagon clearance.
  • Hyperglucagonemia in end-stage renal disease may not solely stem from intact glucagon.
  • The relationship between glucagon and early chronic kidney disease (CKD) is not well-defined.

Purpose of the Study:

  • To investigate the association between fasting glucagon and renal function across various glomerular filtration rates (GFRs).
  • To examine glucagon levels in individuals with type 2 diabetes and differing stages of CKD.

Main Methods:

  • Cross-sectional study of 326 participants with type 2 diabetes and CKD stages 1-5.
  • Quantification of fasting full-length plasma glucagon using a novel ELISA.

Main Results:

  • Fasting plasma glucagon increased linearly with CKD progression (CKD stage 1 to 5).
  • Elevated glucagon was observed as early as CKD stage 2 compared to stage 1.
  • Estimated GFR and insulin resistance were key determinants of fasting glucagon levels, explaining significant variance.

Conclusions:

  • Fasting full-length glucagon levels rise with declining renal function in type 2 diabetes, including early CKD.
  • Renal function and insulin sensitivity are primary factors influencing glucagon levels.
Keywords:
chronic kidney diseaseglucagonrenal functiontype 2 diabetes mellitus

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