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Abstract
BackgroundGlucagon-like peptide-1 (GLP-1) treatment has been shown to reduce stroke incidence in diabetes and also to be neuroprotective in experimental stroke models. The prognostic value of endogenous levels of GLP-1 in the recovery phase after stroke remains to be elucidated. The aim of the study was to investigate the potential association between GLP-1 levels and functional outcome after stroke and to determine whether GLP-1 is altered in the acute phase of stroke compared to 3 months post stroke and to healthy controls.MethodsFasting GLP-1 was measured on hospital day 2–4 in patients without previously known diabetes (n = 59) that received recombinant tissue plasminogen activator (rtPA) for ischemic stroke. Fasting GLP-1 was measured again after 3 months and neurologic outcome was measured as modified Rankin Scale (mRS). mRS ≥ 2 was considered as unfavorable outcome. A control group of healthy individuals (n = 27) was recruited and their fasting GLP-1 was measured.ResultsFasting GLP-1 was higher in the patients that suffered a stroke compared to healthy controls (25.1 vs. 18.0 pmol/L; p = 0.004). The GLP-1 levels did not change significantly at the 3-month follow up OGTT (25.8 vs. 25.6; p = 0.80). There was no significant association between GLP-1 levels and unfavorable mRS (OR 1.03, 95% CI 0.95–1.12, p = 0.50).ConclusionsEndogenous GLP-1 levels in patients that recently suffered an ischemic stroke are higher than in healthy controls and remained unchanged at the 3 months follow-up, possibly indicating an elevation of the levels of GLP-1 already pre-stroke. However, no association between endogenous GLP-1 and functional outcome of stroke 3 months post stroke was found.
Highlights
Glucagon-like peptide-1 (GLP-1) treatment has been shown to reduce stroke incidence in diabetes and to be neuroprotective in experimental stroke models
Of the 379 patients treated with recombinant tissue plasminogen activator (rtPA) at the hospital Södersjukhuset from January 2014 to January 2017, 59 patients were included in the present study. 51 completed double Oral Glucose Tolerance Test (OGTT), 1 died during the follow up period and 7 declined a second OGTT
Principal findings This study aimed at describing the secretion of GLP-1 in acute stroke and to determine if endogenous levels of this peptide was associated with functional outcome after rtPA treated ischemic stroke
Summary
Glucagon-like peptide-1 (GLP-1) treatment has been shown to reduce stroke incidence in diabetes and to be neuroprotective in experimental stroke models. GLP-1 receptors have been found in neurons, and in the brain [11]. Both experimental studies and large randomized trials have indicated that the treatment with stable GLP-1 analogues, both before and after onset of ischemic stroke, may be neuroprotective and may reduce the risk of ischemic stroke [12,13,14,15,16,17,18]. Human studies evaluating effects of both exogenous and endogenous GLP-1 on functional outcome after stroke are utterly scarce and highly needed [20]. Previous data on the relationship between endogenous GLP-1 levels and cardiovascular disease are ambiguous [21, 22]
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