Background: Glucagon-like peptide-1 (GLP-1) is a gut derived incretin hormone that stimulates insulin secretion, cellular glucose uptake and has immune-regulatory functions. GLP-1 is markedly altered following trauma and sepsis, but the implications remain unclear.
Study design:We performed an analysis of a prospective, longitudinal cohort study of critically-ill surgical patients with sepsis. Patient characteristics, and clinical data were collected, as well as peripheral blood sampling for biomarker analysis, out to 28 days after sepsis onset. We prospectively adjudicated sepsis diagnosis, severity, clinical outcomes and 6-month follow-up.
Results:The cohort included 157 septic surgical patients with significant physiologic derangement (Max. SOFA score 8, IQR 4-11), a high rate of multiple organ failure (50.3%) and septic shock (24.2%). Despite high disease severity, both early death (<14 days; n=4, 2.9%) and overall inpatient mortality was low (n=12, 7.6%). However, post-discharge 6-month mortality was nearly 3-fold higher (19.7%). Both GLP-1 and IL-6 levels were significantly elevated for 21 days (p≤0.01) in patients that developed CCI compared to patients with a rapid recovery. Elevated GLP-1 at 24 hours was a significant independent predictor for the development of CCI after controlling for IL-6 and glucose levels (p=0.027), and at day 14 for death or severe functional disability at 6 months (WHO/Zubrod score 4-5, p=0.014).
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