Changes Of Intestinal GLP-1 Receptor Expression In Relation To The Development Of Diabetes Mellitus And Obesity

Objective : Glucagon-like peptide-1(GLP-1)is a gut peptide hormone that is secreted mainly by the intestinal L cells.Due to the short half-life of natural GLP-1 and the shortcomings of rapid metabolism,clinical applications are limited.At present,mainly used in clinical GLP-1 receptor agonists and analogs,such as exenatide and liraglutide overcome these shortcomings,mainly through its receptor glucagon-like peptide-1receptor(Glucagon-like peptide-1 receptor,GLP-1R)binding achieved.In addition to the presence of the pancreas,GLP-1R is now found to be widespread in the gastrointestinal tract,heart,kidneys,brainstem,thalamus,hypothalamus,lungs,and adipose tissue.The study found that patients with type 2 diabetes have improved blood glucose after receiving GLP-1 receptor agonists.With the improvement of living standards,obesity and its complications have reached a relatively large proportion of the prevalence,the proportion of obesity in the population has continued to increase,the current heavy obesity,especially obesity with type 2 diabetes in patients with weight loss treatment in addition to surgery,There are more popular GLP-1R agonists and their analogues.It is not clear whether the GLP-1 receptor expression level in the intestine of patients with diabetes is decreasing.In this study,GLP-1 receptor expression levels in the intestine of normal subjects,those with impaired glucose tolerance,diabetes,and obesity were measured to further investigate changes in GLP-1 receptor expression in diabetic and obese patients,and further explore risk factors associated with GLP-1R.The relationship of expression.Method:To choose patients who were treated in our hospital between January 2017 and September 2017,there are 40 patients who underwent colon surgery in our general surgery and underwent colon surgery were selected and patients' consent was obtained.1.Collect general patient data: gender,age,height,weight,waist circumference,hip circumference and calculate body mass index(BMI),body fat percentage(BF),waist-to-hip ratio(WHR),and collect blood parameters including fasting blood glucose.(FPG),2 hPG(blood glucose 2 hours after glucose loading),TC(blood total cholesterol),TG(blood triglycerides),HbA1C(glycosylated hemoglobin),LDL-c(low densitylipoprotein cholesterol).2,according to FPG,2hPG,BMI,WHR,BF is divided into A normal control group B simple obesity group C simple glucose tolerance group D simple type 2 diabetes group,10 cases in each group.3.Collect normal pathological sections of the patient's intestine(ecliptic part-transverse colon),first perform HE staining to confirm that there is no abnormal proliferation such as inflammation,and observe the distribution and quantification of GLP-1 receptors in intestinal tissues by immunohistochemistry.4.An independent sample t-test was performed on the AB,AC,AD,and CD groups to analyze the height,weight,waist circumference,hip circumference,BMI,WHR,FPG,2hOGTT,TC,TG,HbA1 C,and LDL-c indexes.The correlation with GLP-1 receptor expression levels in the intestine,while a stepwise linear regression analysis was performed on each index.Results:According to FPG,2hPG,BMI,BF,and WC,patients were grouped and compared,among which 1)There was no statistical difference between age group,height,hip circumference,TG,TC,HbA1 C,FPG,and 2hPG groups between the simple obesity group and the normal control group.Significance(P>0.05),Weight(t=-6.492,P=0.009),BMI(t=-15.886,P=0.007),Waist circumference(t=-5.906,P=0.002),Hip circumference(t=2.845(P=0.013),WHR(t=-6.236,P=0.009),BF(t=-8.492,P=0.003),and GLP-1R expression(t=6.565,P=0.007)were statistically significant between the two groups.Difference;2)abnormal glucose tolerance group and normal control group: FPG(t =-10.422,P = 0.006),2hPG(t =-8.626,P = 0.004)were statistically different between the two groups,GLP-1R(t =6.038,P=0.005)There was a significant difference between the two groups,other indicators had no significant difference between the two groups(P>0.05);3)Diabetes group and normal control group: FPG(t=-8.720,P=0.005)and2hPG(t=-6.940,P=0.003)were significantly different between the two groups.GLP-1R(t=11.401,P=0.007)was significantly different between the two groups.There was no significant difference between the groups(P>0.05 4)Compared with diabetes group,abnormal glucose tolerance group: FPG(t=-6.245,P=0.0002),2hPG(t=-5.306,P=0.0002)was statistically different between the two groups,GLP-1R was in two groups;There was a significant difference between the two groups(t=7.235,P=0.006).There was no significant difference between the other two groups(P>0.05).Spearman correlationanalysis and partial correlation analysis,after adjusting for age and gender factors,GLP-1R was negatively correlated with FPG,2hPG,WHR,BF,and waist circumference.Multiple stepwise regression analysis showed that the expression of GLP-1R in the colon was related to the changes of FPG,BMI and BF.Conclusion:The expression of GLP-1R in the colon has a certain relationship with the changes of FPG,BMI and BF.It may be one of the signs of the occurrence and development of diabetes,obesity and obesity.Meaning:This article analyzes the correlation between the expression of GLP-1R in obese and impaired glucose tolerance and diabetes mellitus and the indicators of diabetes and obesity.It was found that FPG,BMI,BF are related to the expression of GLP-1R in colon.Provides an aid for early screening for obesity and diabetes.It provides a new theoretical basis for the use of GLP-1 and its receptor agonists for the treatment of type 2diabetes and obesity in the clinic.