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Greater glucagon-like peptide-1 responses to oral glucose are associated with lower central and peripheral blood
Julie R Lundgren1,2, Kristine Færch3, Daniel R Witte4,5
1Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark. Julie.lundgren@sund.ku.dk.
Insights
Higher glucose-stimulated glucagon-like peptide-1 (GLP-1) responses are linked to lower blood pressure in individuals at risk for diabetes and cardiovascular disease (CVD). This suggests a potential benefit of GLP-1 in managing hypertension and reducing CVD risk.
Area of Science:
- Endocrinology
- Cardiovascular Science
- Metabolic Health
Background:
- Cardiovascular diseases (CVDs) are a leading global cause of mortality, with hypertension as a major risk factor.
- Glucagon-like peptide-1 (GLP-1) receptor agonists are known to reduce blood pressure and CVD risk.
- Endogenous GLP-1's role in cardiovascular haemodynamics requires further investigation, particularly in at-risk populations.
Purpose of the Study:
- To investigate the association between endogenous GLP-1 responses to oral glucose and haemodynamic measures.
- To assess the relationship between GLP-1 secretion and central/peripheral blood pressure and aortic stiffness.
- To explore the potential of GLP-1 as a biomarker for cardiovascular risk.
Main Methods:
- Cross-sectional study of 837 Danish individuals (ADDITION-PRO cohort) without diagnosed diabetes or hypertension treatment.
- Oral glucose tolerance test with GLP-1 measurements at 0, 30, and 120 minutes.
- Assessment of aortic stiffness via pulse wave velocity (PWV) and blood pressure (BP); analysis using linear regression adjusted for age and sex.
Main Results:
- A greater GLP-1 response was significantly associated with lower central systolic BP (-1.17 mmHg) and diastolic BP (-0.74 mmHg).
- Lower brachial systolic BP (-1.27 mmHg) and diastolic BP (-1.00 mmHg) were also observed with higher GLP-1 responses.
- No significant association was found between GLP-1 release and PWV; however, the highest GLP-1 quartile showed clinically relevant lower BP measures.
Conclusions:
- Enhanced glucose-stimulated GLP-1 secretion is linked to lower central and peripheral blood pressure.
- These findings support the beneficial role of GLP-1 in cardiovascular health and may indicate reduced CVD and mortality risk.
- Endogenous GLP-1 response could serve as a biomarker for cardiovascular risk stratification.
Background And Aim:
Cardiovascular diseases (CVDs) are globally the leading cause of death and hypertension is a significant risk factor. Treatment with glucagon-like peptide-1 (GLP-1) receptor agonists has been associated with decreases in blood pressure and CVD risk. Our aim was to investigate the association between endogenous GLP-1 responses to oral glucose and peripheral and central haemodynamic measures in a population at risk of diabetes and CVD.
Methods:
This cross-sectional study included 837 Danish individuals from the ADDITION-PRO cohort (52% men, median (interquartile range) age 65.5 (59.8 to 70.7) years, BMI 26.1 (23.4 to 28.5) kg/m2, without antihypertensive treatment and known diabetes). All participants received an oral glucose tolerance test with measurements of GLP-1 at 0, 30 and 120 min. Aortic stiffness was assessed by pulse wave velocity (PWV). The associations between GLP-1 response and central and brachial blood pressure (BP) and PWV were assessed in linear regression models adjusting for age and sex.
Results:
A greater GLP-1 response was associated with lower central systolic and diastolic BP of - 1.17 mmHg (95% confidence interval (CI) - 2.07 to - 0.27 mmHg, P = 0.011) and - 0.74 mmHg (95% CI - 1.29 to - 0.18 mmHg, P = 0.009), respectively, as well as lower brachial systolic and diastolic BP of - 1.27 mmHg (95% CI - 2.20 to - 0.33 mmHg, P = 0.008) and - 1.00 (95% CI - 1.56 to - 0.44 mmHg, P = 0.001), respectively. PWV was not associated with GLP-1 release (P = 0.3). Individuals with the greatest quartile of GLP-1 response had clinically relevant lower BP measures compared to individuals with the lowest quartile of GLP-1 response (central systolic BP: - 4.94 (95% CI - 8.56 to - 1.31) mmHg, central diastolic BP: - 3.05 (95% CI - 5.29 to - 0.80) mmHg, brachial systolic BP: - 5.18 (95% CI - 8.94 to - 1.42) mmHg, and brachial diastolic BP: - 2.96 (95% CI - 5.26 to - 0.67) mmHg).
Conclusion:
Greater glucose-stimulated GLP-1 responses were associated with clinically relevant lower central and peripheral blood pressures, consistent with beneficial effects on the cardiovascular system and reduced risk of CVD and mortality. Trial registration ClinicalTrials.gov Identifier: NCT00237549. Retrospectively registered 10 October 2005.
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