Abstract
Background and Aims: Recent data suggest that co-administration of gastrin and GLP-1 improves glucose homeostasis and increase β-cell mass in a rodent model of diabetes, we hypothesized that higher baseline levels of endogenous gastrin prior treatment could be a predictor of beta cell function and glucoregulation in newly diagnosed DMT2 patients. Patients and Methods: In this cross-sectional study 317 patients (116 males and 201 females) with new onset DMT2 were included. Patients treated with IPPs were excluded. Fasting plasma glucose (FPG), postprandial PG (PPG), HbA1c, fasting insulin, pancreatic B cell function (HOMA-B), insulin resistance index (HOMA-IR), c-peptide, CgA and gastrin levels were measured at the time of diagnosis, and after 6 months of follow-up. Results: Baseline Hba1c was 7,49±2,09%, average age of patients was 62.53 ±11.33 years. 65.7% of patients were overweight and obese. Parameters of glucoregulation were not significantly correlated with gastrin (all p> 0.05), while there was moderate negative correlation with HOMA-B (HbA1c r=-.58, p<0.01, FPG r=-.62, p<0.01 and PPG r=-.33, p<0.01) and positive correlation with HOMA-IR (HbA1c r=.22, p<0.01, FPG r=.42, p<0.01 and PPG r=.25, p<0.01). After 6 months follow-up there was a significant reduction of HbA1c, FPG and PPG (all p<0.01), a significant decrease in fasting insulin level (p=0.006), while CgA and gastrin level increased (p=0.003 and p<0.001 respectively). In the stepwise regression analysis, only two independent predictors of gastrin and CgA levels emerged PPG (p=0.009) and BMI (p=0.016). Conclusion: At the time of DMT2 onset there was no association between baseline gastrin levels and parameters of glucoregulation however after 6 months of follow-up increase in gastrin and CgA levels was observed along with the improvement of glycemic control indicating a possible relationship of gastrin levels and amelioration of beta cell function followed by metformin initiation as well as life style changes. Disclosure M. Cigrovski Berkovic: None. D. Herman Mahecic: None. I. Bilic-Curcic: None.
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