Serum Total GLP-1 Levels In Patients With Sepsis:Analysis Of Influencing Factors

BACKGROUND AND OBJECTIVE: Glucagon-like peptide 1(glucagon-like peptide,GLP-1)is an endogenous polypeptide produced by L-cells in the intestinal mucosa.It regulates blood sugar,protects islet cells,promotes insulin secretion,etc..Recent studies have found that GLP-1 also plays an important role in the inflammatory-metabolic pathway and plays an important protective role in a variety of adaptive changes.Previous studies have found that a variety of factors can affect the serum total GLP-1 levels,such as endotoxin levels,inflammatory response,diabetes,chronic kidney disease.Studies have shown that blood levels of GLP-1 are significantly elevated in patients with sepsis,but the relevant factors affecting their elevation are unknown.We collected the endotoxin levels,infection sites,inflammation levels,diabetes,renal function and other indicators in patients with sepsis,to analyze the relationship between different factors and serum total GLP-1 levels,and to explore the possible causes of elevated serum total GLP-1 in septic patients.METHODS: 36 patients with sepsis from September 2018 to February 2019 in our department were enrolled in this prospective study.Fasting blood samples of acute and remission phase were collected and were used to detect serum total GLP-1 levels.We also collected basic information,physical and chemical indicators,vital signs data and other sets of clinical data through the hospital information database.Statistical analysis was used to compare the relationship between endotoxin levels,infection site,inflammation,renal function,disease severity,diabetes and other factors with serum total GLP-1 levels to explore the inner relationship with increased serum total GLP-1 in sepsis.Finally,we compared both groups based on the level of serum total GLP-1 to determine the effect of different levels of serum total GLP-1 on sepsis patients.RESULTS: Serum total GLP-1 levels were not associated with circulating endotoxin levels in patients with sepsis(p=0.338),regardless of the presence of Gram-negative infections(p=0.697);serum GLP-1 levels were different in patients with different infection sources,The mean value of the gut-origin-sepsis group was 6.8 times of the control group,while the respiratory,abdominal and other infection groups were 2.64-3.49 times of the control group;the relationship between inflammation and serum total GLP-1 level in sepsis patients was not clear;Renal function level,severity of sepsis,etc.were correlated with serum total GLP-1 levels(p<0.05);patients with higher serum total GLP-1 levels were younger and had higher platelet levels than patients with lower levels.CONCLUSIONS: Serum total GLP-1 levels in patients with sepsis are associated with the source of infection.Further studies are urged in investigating the cause of elevated serum total GLP-1 levels in sepsis.