Key result
Plasma GLP-1 concentrations did not predict incident congestive heart failure (fGLP-1 HR 0.98; 95% CI 0.4-2.4), but correlated cross-sectionally with left ventricular diastolic function.
Why the study?
Do plasma levels of GLP-1 predict the incidence of hospitalized congestive heart failure or associate with left ventricular diastolic function in 71-year-old men?
Cohort (n=498)
Do plasma levels of GLP-1 predict the incidence of hospitalized congestive heart failure or associate with left ventricular diastolic function in 71-year-old men?
Hazard Ratio: 0.98 (95% CI 0.4–2.4)
Endogenous GLP-1 levels do not predict incident heart failure hospitalization but are cross-sectionally associated with left ventricular diastolic function in elderly men.
GLP-1 levels should not inform HF risk assessment in elderly men; leaves open prospective diastolic function links.
AIMS: Congestive heart failure is a major cause of morbidity and mortality in diabetes. Besides the glycaemic effects of glucagon-like peptide 1 (GLP-1) mimetics, their effects on the heart are of interest. METHODS: We aimed to investigate longitudinal relationships between plasma levels of fasting GLP-1 (fGLP-1), 60-min oral glucose tolerance test-stimulated GLP-1 levels (60GLP-1), and the dynamic GLP-1 response after oral glucose tolerance test (ΔGLP-1 = 60GLP-1 - fGLP-1) and incidence of hospitalized congestive heart failure, during a follow-up time of a maximum of 9.8 years in 71-year-old men. We also investigated, cross-sectionally, the association between GLP-1 and left ventricular function as estimated by echocardiography. R: During the follow-up period, 16 of 290 participants with normal glucose tolerance experienced a congestive heart failure event (rate 0.7/100 person-years at risk), as did eight of 136 participants (rate 0.8/100 person-years at risk) with impaired glucose tolerance and nine of 72 participants (rate 1.7/100 person-years at risk) with Type 2 diabetes mellitus. Although GLP-1 concentrations did not predict congestive heart failure (fGLP-1: HR 0.98, 95% CI 0.4-2.4; 60GLP-1: HR 1.1, 95% CI 0.4-2.6; ΔGLP-1: HR 0.9, 95% CI 0.3-2.3), there was an association between left ventricular diastolic function (E/A ratio) and fGLP-1 (r = 0.19, P = 0.001), 60GLP-1 (r = 0.20, P < 0.001) and ΔGLP-1 (r = 0.18, P = 0.004). There was a lack of differences in plasma levels of GLP-1 between the groups with Type 2 diabetes and normal glucose tolerance. CONCLUSIONS: There were no longitudinal associations between GLP-1 levels and incidence of hospitalization for congestive heart failure. However, without any causality proven, GLP-1 levels did correlate, cross-sectionally, with left ventricular diastolic function in this cohort, suggesting that pathways including GLP-1 might be involved in the regulation of cardiac diastolic function.
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Nathanson et al. (2010) conducted a cohort in Congestive heart failure (n=498). Plasma levels of GLP-1 (fGLP-1, 60GLP-1, and ΔGLP-1) was evaluated on incidence of hospitalized congestive heart failure (HR 0.98, 95% CI 0.4-2.4). Plasma GLP-1 concentrations did not predict incident congestive heart failure (fGLP-1 HR 0.98; 95% CI 0.4-2.4), but correlated cross-sectionally with left ventricular diastolic function.
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