Postprandial increase in glucagon-like peptide-1 is blunted in severe heart failure

Daniel F. Arruda-Junior, Flavia L. Martins, Thiago Almeida Salles, Leonardo Jensen, Rafael Dariolli, Ednei L. Antonio, Leonardo Dos Santos, Renato O. Crajoinas, Paulo J.F. Tucci, Luis Henrique W. Gowdak, Jose Eduardo Krieger, Alexandre C. Pereira, Adriana C. Girardi

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The relationship between disturbances in glucose homeostasis and heart failure (HF) progression is bidirectional. However, the mechanisms by which HF intrinsically impairs glucose homeostasis remain unknown. The present study tested the hypothesis that the bioavailability of intact glucagon-like peptide-1 (GLP-1) is affected in HF, possibly contributing to disturbed glucose homeostasis. Serum concentrations of total and intact GLP-1 and insulin were measured after an overnight fast and 15 min after the ingestion of a mixed breakfast meal in 49 non-diabetic patients with severe HF and 40 healthy control subjects. Similarly, fasting and postprandial serum concentrations of these hormones were determined in sham-operated rats, and rats with HF treated with an inhibitor of the GLP-1-degrading enzyme dipeptidyl peptidase-4 (DPP4), vildagliptin, or vehicle for 4 weeks.We found that HF patients displayed a much lower increase in postprandial intact and total GLP-1 levels than controls. The increase in postprandial intact GLP-1 in HF patients correlated negatively with serum brain natriuretic peptide levels and DPP4 activity and positively with the glomerular filtration rate. Likewise, the postprandial increases in both intact and total GLP-1 were blunted in HF rats and were restored by DPP4 inhibition. Additionally, vehicle-treated HF rats displayed glucose intolerance and hyperinsulinemia, whereas normal glucose homeostasis was observed in vildagliptin-treated HF rats. We conclude that the postprandial increase in GLP-1 is blunted in non-diabetic HF. Impaired GLP-1 bioavailability after meal intake correlates with poor prognostic factors and may contribute to the establishment of a vicious cycle between glucose disturbance and HF development and progression.

Original languageEnglish
Pages (from-to)1081-1094
Number of pages14
JournalClinical Science
Issue number9
StatePublished - 1 May 2020
Externally publishedYes


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