Endocrine Abstracts

Aims: To estimate the nonglycaemic effects of incretins in patients with long history of type 1 diabetes (T1D) and chronic kidney disease (CKD).

Materials and methods: We examined 75 patients with a long history T1D (more than 20 years) and CKD on the different stages: 32 patients with CKD at the stages 1–4, 17 patients on haemodialysis, 11 with kidney transplantation, and 15 patients without CKD. In addition to routine methods of investigation we have estimated mineral and bone disorders (MBD) factors (phosphorus (P), phosphorus and calcium product (PxCa) parathormone (PTH), 25(OH)vitamin D (vitamin D), and fibroblast growth factor 23 (FGF 23)), made a multispiral computed tomography of heart with Agatston index definition. Markers of proinflammatory (monocyte chemoattractant protein-1 (MCP-1) and C-reactive protein (CRP)), fibrosis (transforming growth factor-beta (TGFβ)), and cardiovascular collapse (atrial natriuretic peptide (NTpro-BNP)) were defined. Determining the level of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

Results: The study showed no difference on the level of GLP-1 and GIP in patients with a long history of T1D, regardless of the presence and stage of CKD and the degree of compensation of diabetes. Received confirmation inverse relationship between GLP-1 and the level of total cholesterol (r=−0.320; P<0.05), Agatston index (r=−0.317; P<0.05), as well as the GYP and fibrinogen level (r=−0.285; P<0.05), CRP (r=−0.626; P<0.05), FGF-23 (r=−0.341; P<0.05), and MCP-1 (r=0.277; P<0.05).

Conclusions: In patients with T1D is defined inhibitory role of incretins in the progression of atherosclerosis and MBD, actively involved in the development of cardiovascular disease, irrespective of the stage of CKD. The obtained data require further study from the standpoint of application nonglycaemic effects of drugs of incretins in the treatment of patients with T1D.