Frontiers in Endocrinology (Jun 2022)

Postprandial Dynamics of Proglucagon Cleavage Products and Their Relation to Metabolic Health

  • Robert Wagner,
  • Robert Wagner,
  • Robert Wagner,
  • Robert Wagner,
  • Robert Wagner,
  • Sabine S. Eckstein,
  • Sabine S. Eckstein,
  • Louise Fritsche,
  • Louise Fritsche,
  • Katsiaryna Prystupa,
  • Katsiaryna Prystupa,
  • Katsiaryna Prystupa,
  • Sebastian Hörber,
  • Sebastian Hörber,
  • Sebastian Hörber,
  • Hans-Ulrich Häring,
  • Hans-Ulrich Häring,
  • Hans-Ulrich Häring,
  • Andreas L. Birkenfeld,
  • Andreas L. Birkenfeld,
  • Andreas L. Birkenfeld,
  • Andreas Peter,
  • Andreas Peter,
  • Andreas Peter,
  • Andreas Fritsche,
  • Andreas Fritsche,
  • Andreas Fritsche,
  • Martin Heni,
  • Martin Heni,
  • Martin Heni,
  • Martin Heni,
  • Martin Heni

DOI
https://doi.org/10.3389/fendo.2022.892677
Journal volume & issue
Vol. 13

Abstract

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IntroductionWhile oral glucose ingestion typically leads to a decrease in circulating glucagon levels, a substantial number of persons display stable or rising glucagon concentrations when assessed by radioimmunoassay (RIA). However, these assays show cross-reactivity to other proglucagon cleavage products. Recently, more specific assays became available, therefore we systematically assessed glucagon and other proglucagon cleavage products and their relation to metabolic health.Research Design and MethodsWe used samples from 52 oral glucose tolerance tests (OGTT) that were randomly selected from persons with different categories of glucose tolerance in an extensively phenotyped study cohort.ResultsGlucagon concentrations quantified with RIA were non-suppressed at 2 hours of the OGTT in 36% of the samples. Non-suppressors showed lower fasting glucagon levels compared to suppressors (p=0.011). Similar to RIA measurements, ELISA-derived fasting glucagon was lower in non-suppressors (p<0.001). Glucagon 1-61 as well as glicentin and GLP-1 kinetics were significantly different between suppressors and non-suppressors (p=0.004, p=0.002, p=0.008 respectively) with higher concentrations of all three hormones in non-suppressors. Levels of insulin, C-peptide, and free fatty acids were comparable between groups. Non-suppressors were leaner and had lower plasma glucose concentrations (p=0.03 and p=0.047, respectively). Despite comparable liver fat content and insulin sensitivity (p≥0.3), they had lower 2-hour post-challenge glucose (p=0.01).ConclusionsGlucagon 1-61, glicentin and GLP-1 partially account for RIA-derived glucagon measurements due to cross-reactivity of the assay. However, this contribution is small, since the investigated proglucagon cleavage products contribute less than 10% to the variation in RIA measured glucagon. Altered glucagon levels and higher post-challenge incretins are associated with a healthier metabolic phenotype.

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