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

D Moriconi; R M Bruno; E Rebelos; S Armenia; S Baldi; L Bonvicini; S Taddei; M Nannipieri

doi:10.1111/eci.14256

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

Eur J Clin Invest. 2024 May 22:e14256. doi: 10.1111/eci.14256. Online ahead of print.

Authors

D Moriconi¹, R M Bruno², E Rebelos¹, S Armenia¹, S Baldi¹, L Bonvicini¹, S Taddei¹, M Nannipieri¹

Affiliations

¹ Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
² INSERM U970 Team 7, Paris Cardiovascular Research Centre - PARCC, Universitè Paris-Cité, Paris, France.

PMID: 38774979
DOI: 10.1111/eci.14256

Abstract

Background: Cardiovascular 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.

Methods: Thirty 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).

Results: Post-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).

Conclusions: Elevated 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.

Keywords: carotid distensibility; endogenous GLP‐1; pulse wave velocity; renal resistive index.