TY - JOUR

T1 - GLP-1 secretion in acute ischemic stroke: association with functional outcome and comparison with healthy individuals

AU - Larsson, Martin

AU - Patrone, Cesare

AU - von Euler, Mia

AU - Holst, Jens J.

AU - Nathanson, David

PY - 2019

Y1 - 2019

N2 - BackgroundGlucagon-like peptide-1 (GLP-1) treatment has been shown to reduce stroke incidence in diabetes and alsoto be neuroprotective in experimental stroke models. The prognostic value of endogenous levels of GLP-1 in the recovery phase after stroke remains to be elucidated. The aim of the study was to investigate the potential association between GLP-1 levels and functional outcome after stroke and to determine whether GLP-1 is altered in the acute phase of stroke compared to 3months post stroke and to healthy controls.MethodsFasting GLP-1 was measured on hospital day 2-4 in patients without previously known diabetes (n=59) that received recombinant tissue plasminogen activator (rtPA) for ischemic stroke. Fasting GLP-1 was measured again after 3months and neurologic outcome was measured as modified Rankin Scale (mRS). mRS >= 2 was considered as unfavorable outcome. A control group of healthy individuals (n=27) was recruited and their fasting GLP-1 was measured.ResultsFasting GLP-1 was higher in the patients that suffered a stroke compared to healthy controls (25.1 vs. 18.0pmol/L; p=0.004). The GLP-1 levels did not change significantly at the 3-month follow up OGTT (25.8 vs. 25.6; p=0.80). There was no significant association between GLP-1 levels and unfavorable mRS (OR 1.03, 95% CI 0.95-1.12, p=0.50).ConclusionsEndogenous GLP-1 levels in patients that recently suffered an ischemic stroke are higher than in healthy controls and remained unchanged at the 3months follow-up, possibly indicating an elevation of the levels of GLP-1 already pre-stroke. However, no association between endogenous GLP-1 and functional outcome of stroke 3months post stroke was found.

AB - BackgroundGlucagon-like peptide-1 (GLP-1) treatment has been shown to reduce stroke incidence in diabetes and alsoto be neuroprotective in experimental stroke models. The prognostic value of endogenous levels of GLP-1 in the recovery phase after stroke remains to be elucidated. The aim of the study was to investigate the potential association between GLP-1 levels and functional outcome after stroke and to determine whether GLP-1 is altered in the acute phase of stroke compared to 3months post stroke and to healthy controls.MethodsFasting GLP-1 was measured on hospital day 2-4 in patients without previously known diabetes (n=59) that received recombinant tissue plasminogen activator (rtPA) for ischemic stroke. Fasting GLP-1 was measured again after 3months and neurologic outcome was measured as modified Rankin Scale (mRS). mRS >= 2 was considered as unfavorable outcome. A control group of healthy individuals (n=27) was recruited and their fasting GLP-1 was measured.ResultsFasting GLP-1 was higher in the patients that suffered a stroke compared to healthy controls (25.1 vs. 18.0pmol/L; p=0.004). The GLP-1 levels did not change significantly at the 3-month follow up OGTT (25.8 vs. 25.6; p=0.80). There was no significant association between GLP-1 levels and unfavorable mRS (OR 1.03, 95% CI 0.95-1.12, p=0.50).ConclusionsEndogenous GLP-1 levels in patients that recently suffered an ischemic stroke are higher than in healthy controls and remained unchanged at the 3months follow-up, possibly indicating an elevation of the levels of GLP-1 already pre-stroke. However, no association between endogenous GLP-1 and functional outcome of stroke 3months post stroke was found.

KW - Glucagon like peptide-1

KW - Ischemic stroke

KW - Modified Rankin Scale (mRS)

KW - Hyperglycemia

U2 - 10.1186/s12933-019-0896-z

DO - 10.1186/s12933-019-0896-z

M3 - Journal article

C2 - 31307484

VL - 18

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

SN - 1475-2840

M1 - 91

ER -