Glucagon secretion is increased in patients with Type 2 diabetic nephropathy

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• 作者：Xiaoyu Wang^a ; ^b ; ¹ ; Juhong Yang^a ; ¹ ; Baocheng Chang^a ; Chunyan Shan^a ; Yanguang Xu^a ; Miaoyan Zheng^a ; Ying Wang^a ; Huizhu Ren^a ; Liming Chen^a ; ^{xfx22081@vip.163.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Glucagon ; C-peptide ; Diabetic nephropathy ; Diabetes mellitus ; Type 2
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：30
• 期：3
• 页码：488-493
• 全文大小：385 K

文摘

Currently little is known about the relationship between renal function, albuminuria and glucagon; we analyzed the secretion of glucagon (GLA) and C-peptide in Type 2 diabetic patients with different degrees of nephropathy.

2">Methods

357 patients with Type 2 diabetes including 119 cases without nephropathy and 238 cases with nephropathy were divided into four groups according to the stages of diabetic nephropathy. Patients with diabetic nephropathy were further classified according to the level of estimated glomerular filtration rate (eGFR). OGTT and insulin, C-peptide, glucagon releasing tests were performed in all patients. Characteristics of glucagon and C-peptide secretion in different groups were compared. Glucagon/glucose ratio (GLA/GLU) and glucagon/insulin ratio (GLA/INS) were used to represent the inhibition of glucose or insulin on glucagon secretion, respectively.

Results

With the progress of diabetic nephropathy, glucagon level increased significantly; the glucagon peak after glucose load delayed from 60 min to 120 min, whereas C-peptide level decreased significantly. Related factors analysis suggested that glucagon was independently correlated with eGFR. Further analysis showed that glucagon level was higher in group with eGFR < 60 ml/min compared with that in group with eGFR ≥ 60 ml/min. In addition, both GLA/INS and GLA/GLU were higher in group with eGFR < 60 ml/min compared with those in group with eGFR ≥ 60 ml/min.

Conclusions

20">Patients with Type 2 diabetic nephropathy have worsened islet alpha and beta cell function. Therefore medications based on the regulation of glucagon secretion may improve glycemic control and also be beneficial for delaying the progress of diabetic nephropathy.