Postprandial glucagon-like peptide 1 secretion is associated with urinary albumin excretion in newly diagnosed type 2 diabetes patients

Table 1 Baseline characteristics

Variable	Newly diagnosed type 2 diabetes			P value
	Total	UACR < 30 mg/g	UACR ≥ 30 mg/g
Number	760	595	165
Age, yr	50.5 ± 9.1	50.3 ± 9.1	51.1 ± 9.6	0.306
Sex, %				0.234
Female	306 (40.1)	232 (38.8)	74 (44.3)	0.212
BMI, kg/m2	25.5 ± 2.6	25.4 ± 2.6	25.7 ± 2.7	0.281
Waist circumference, cm	89.4 ± 8.4	89.2 ± 8.4	90.1 ± 8.2	0.226
SBP, mmHg	123.7 ± 13.1	122.7 ± 12.8	127.2 ± 13.4	< 0.001
DBP, mmHg	79.1 ± 8.5	78.4 ± 8.4	81.3 ± 8.7	< 0.001
eGFR, mL/min	105.6 ± 54.8	103.5 ± 31.9	112.6 ± 98.3	0.052
HbA1c, %	7.5 ± 1.1	7.5 ± 1.2	7.6 ± 1.3	0.804
TG, mmol/L	2.4 ± 2.4	2.3 ± 2.2	2.7 ± 2.9	0.058
HDL-C, mmol/L	1.2 ± 0.3	1.2 ± 0.3	1.2 ± 0.3	0.812
LDL-C, mmol/L	3.1 ± 0.9	3.0 ± 0.9	3.1 ± 1.0	0.508
HOMA-IR	4.0 (2.5-6.3)	3.8 (2.5-6.1)	4.9 (3.1-7.4)	< 0.001
HOMA-β	49.2 (29.0-76.2)	48.1 (28.1-74.4)	53.0 (32.9-81.4)	0.086
LnUACR	2.34 ± 1.51	1.82 ± 1.26	4.16 ± 0.65	< 0.001
RAS inhibitor/RASR blocker use	34 (4.4)	25 (4.2)	9 (5.4)	0.431

Values are expressed as means ± SD, median (interquartile range) or n (%). BMI: Body mass index; DBP: Diastolic blood pressure; eGFR: Evaluated glomerular filtration rate; HbA1c: Hemoglobin A1c; HOMA-IR: Homeostasis model assessment-insulin resistance; HOMA-β: Homeostasis model assessment-β; HDL-c: High density lipoprotein cholesterol; LDL-c: Low density lipoprotein; LnUACR: Natural logarithm of urinary albumin-to-creatinine ratio; SBP: Systolic blood pressure; TG: Triglyceride; RAS: Renin angiotensin system; RASR: Renin angiotensin system receptor; UACR: Urinary albumin-to-creatinine ratio.

Table 2 Mean differences [B (95% confidence interval)] in urinary albumin-to-creatinine ratio among the quartiles of plasma glucagon-like peptide 1 levels in all type 2 diabetes mellitus patients

Variable	Q1	Q2	Q3	Q4	P value
30 min GLP-1	0.24-7.8	7.81-14.3	14.33-27.24	27.31-89.48
Number	191	196	187	186	-
LnUACR	2.58 ± 1.37	2.62 ± 1.30	2.34 ± 1.47	1.85 ± 1.75	-
Model 0	0-reference	-0.036 (-0.333 to 0.261)	-0.214 (-0.516 to 0.088)	-0.746 (-1.046 to -0.445)a	< 0.001
Model 1	0-reference	-0.022 (-0.314 to 0.271)	-0.213 (-0.510 to 0.084)	-0.772 (-1.069 to -0.476)a	< 0.001
Model 2	0-reference	0.086 (-0.223 to 0.395)	-0.152 (-0.460 to 0.155)	-0.708 (-1.017 to -0.399)a	< 0.001
120 min GLP-1	0.03-7.13	7.18-13.6	13.61-25.97	26.0-98.36
Number	194	190	193	183	-
LnUACR	2.57 ± 1.54	2.59 ± 1.22	2.23 ± 1.52	2.01 ± 1.65	-
Model 0	0-reference	-0.030 (-0.272 to 0.331)	-0.330 (-0.632 to -0.028)a	-0.517 (-0.822 to -0.213)a	0.001
Model 1	0-reference	-0.051 (-0.247 to 0.350)	-0.270 (-0.567 to 0.028)	-0.456 (-0/758 to -0.155)a	< 0.001
Model 2	0-reference	0.169 (-0.142 to 0.480)	-0.332 (-0.639 to -0.025)a	-0.431 (-0.744 to -0.119)a	< 0.001
AUCGLP-1	175.1-734.2	313.7-1736.3	2817.0-4454.6	4510.2-11877.2
Number	193	192	189	186	-
LnUACR	2.80 ± 1.24	2.49 ± 138	2.25 ± 1.51	1.86 ± 1.72	-
Model 0	0-reference	-0.331 (-0.630 to -0.033)	-0.528 (-0.827 to -0.229)	-0.920 (-1.220 to -0.619)a	< 0.001
Model 1	0-reference	-0.251 (-0.547 to 0.045)	-0.496 (-0.794 to -0.198)a	-0.869 (-1.168 to -0.569)a	< 0.001
Model 2	0-reference	-0.231 (-0.539 to 0.077)	-0.446 (-0.757 to -0.135)a	-0.860 (-1.169 to -0.552)a	< 0.001

^aP < 0.05.

Values are presented as range, number, means ± SD, or mean difference (95% confidence interval). Model 0: Crude; Model 1: Adjusted for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, statins medication, evaluated glomerular filtration rate and glycosylated hemoglobin; Model 2: Additionally adjusted for homeostasis model assessment of insulin resistance, area under the glucose curve and area under the glucagon curve. GLP-1: Glucagon-like peptide 1; UACR: Urinary albumin-creatinine ratio; LnUACR: Natural logarithm of urinary albumin-to-creatinine ratio; AUCGLP-1: Area under the curve for active glucagon-like peptide 1.

Table 3 The association between glucagon-like peptide 1 levels during a standard meal test and the urinary albumin-creatinine ratio

Variable	Q1	Q2	Q3	Q4	P value
30 min GLP-1
Microalbuminuria	48 (25.4)	47 (24.6)	42 (23.2)	29 (15.3)
Model 0	1-reference	0.959 (0.603-0.525)	0.828 (0.516-1.330)	0.529 (0.317-0.884)a	0.014
Model 1	1-reference	0.962 (0.599-1.543)	0.817 (0.505-1.322)	0.517 (0.307-0.873)a	0.012
Model 2	1-reference	0.967 (0.600-1.557)	0.826 (0.507-1.346)	0.534 (0.315-0.905)a	0.018
120 min GLP-1
Microalbuminuria	51 (26.8)	42 (22.2)	41 (21.4)	32 (16.8)
Model 0	1-reference	0.779 (0.487-1.245)	0.740 (0.642-1.186)	0.552 (0.336-0.908)a	0.022
Model 1	1-reference	0.798 (0.495-1.286)	0.775 (0.480-1.251)	0.585 (0.353-0.969)a	0.044
Model 2	1-reference	0.826 (0.508-1.343)	0.819 (0.504-1.331)	0.592 (0.355-0.988)a	0.056
AUCGLP-1
Microalbuminuria	52 (27.4)	51 (25.3)	37 (18.9)	32 (15.8)
Model 0	1-reference	0.891 (0.568-1.417)	0.620 (0.383-1.006)	0.498 (0.301-0.823)a	0.002
Model 1	1-reference	0.973 (0.610-1.552)	0.640 (0.391-1.048)	0.528 (0.316-0.883)a	0.005
Model 2	1-reference	1.015 (0.632-1.630)	0.704 (0.426-1.161)	0.547 (0.325-0.920)a	0.010

^aP < 0.05.

Values are presented as range, number, means ± SD, or mean difference (95% confidence interval). Model 0: Crude; Model 1: Adjusted for age, sex, body mass index, systolic blood pressure, diastolic blood pressure, statins medication, evaluated glomerular filtration rate and glycosylated hemoglobin; Model 2: Additionally adjusted for homeostasis model assessment of insulin resistance, area under the glucose curve and area under the glucagon curve. GLP-1: Glucagon-like peptide 1; AUCGLP-1: Area under the curve for active glucagon-like peptide 1.