Role of endogenous GLP‐1 on arterial stiffness and renal haemodynamics following bariatric surgery

Abstract

BackgroundCardiovascular trials have revealed the positive impact of GLP‐1 receptor agonists (GLP‐1 RAs) on cardiovascular outcomes in type 2 diabetes (T2D). However, the specific effects of endogenous GLP‐1 on arterial stiffness and renal function remain understudied. This study aimed to explore the influence of endogenous GLP‐1 response post‐bariatric surgery on arterial stiffness and renal haemodynamic.MethodsThirty individuals with morbid obesity and without T2D, scheduled for Roux‐en‐Y Gastric Bypass (RYGB), were included. Clinical parameters, 3‐hour oral glucose tolerance test (OGTT) with serial sampling for glycaemia, GLP‐1 and insulin, carotid‐femoral pulse wave velocity (cf‐PWV), carotid distensibility coefficient (carotid‐DC) and renal resistive index (RRI) measurements were conducted pre‐surgery and 1‐year post‐surgery. Participants were categorized into high‐response and low‐response groups based on their post‐surgery increase in GLP‐1 (median increase of 104% and 1%, respectively, pre‐ vs. post‐surgery).ResultsPost‐surgery, high‐response group demonstrated a greater reduction in cf‐PWV (p = .033) and a greater increase (p = .043) in carotid DC compared to low‐response group. These enhancements were observed independently of weight loss or blood pressure changes. High‐response group exhibited a reduction in RRI (p = .034), although this association was influenced by improvement in pulse pressure. Finally, a multivariate stepwise regression analysis indicated that the percentage increase of GLP1, Δ‐GLP1(AUC)%, was the best predictor of percentage decrease in cf‐PWV (p = .014).ConclusionsElevated endogenous GLP‐1 response following RYGB was associated with improved arterial stiffness and renal resistances, suggesting potential cardio‐renal benefits. The findings underscore the potential role of endogenous GLP‐1 in influencing vascular and renal haemodynamics independent of traditional weight loss.