Abstract: SA-PO934
GLP-1 Analogue Ameliorates Progression of Not Only Left Ventricular Hypertrophy But Also Atrial Volume in Patients with Type 2 Diabetes Mellitus on Peritoneal Dialysis
Session Information
- Peritoneal Dialysis: Inflammation, Peritoneal Transport
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Author
- Hiramatsu, Takeyuki, Konan Kosei Hospital, Konan Aichi, Japan
Background
Diabetes mellitus (DM) is a progressive multifactorial disease associated with cardiovascular complications. Patients undergoing peritoneal dialysis also experience an increased incidence of cardiovascular disease. To prevent progression of systemic cardiovascular complications in DM patients, glycemic control is important. Moreover, left ventricular mass index (LVMI) or left atrial volume index (LAVI) were known to be the predictive factors for mortality in dialysis patients. In this study, we examined the efficacy and safety of the glucagon-like peptide analogue (GLP-1) to treat type 2 diabetes patients undergoing peritoneal dialysis.
Methods
Thirty-four type 2 diabetes patients who underwent peritoneal dialysis were enrolled. Participants were divided in two groups (Group A; n=24, liraglutide 0.9mg daily, Group B; n=10, duraglutide 0.75mg once a week). Prior to GLP-1 therapy, 16 patients used insulin, 8 used oral antidiabetic agents, and 3 used diet therapy. After liraglutide initiation, biochemical examination and echocardiography was examined at baseline and every 12 months for 36 months.
Results
In Group A, there were no differences in glycemic control before and after initiation of liraglutide. Nevertheless, medical adherence was improved after liraglutide use. After liraglutide use, brain natriuretic peptide (BNP) and human atrial natriuretic peptide (HANP) were significantly decreased. Moreover, echocardiographic finding showed LVMI and LAVI were significantly ameliorated instead of unchanged left ventricular ejection fraction or E/e’. Similar findings were shown after duraglutide use in Group B. (Table)
Conclusion
These findings suggest that GLP-1 analogue for type 2 diabetes patients undergoing peritoneal dialysis improved medical adherence and was effective for ameliorating left ventricular function. Moreover, it may ameliorate progression of diastolic function including E/e’ and LVAI.
Table. Clinical data change
| Liraglutide 0.9mg / day (n = 24) | Duraglutide 0.75mg / once a week (n = 10) | |||||||
| at baseline | after 12 months | after 24 months | after 36 months | at baseline | after 12 months | after 24 months | after 36 months | |
| daily oral tablets (n) | 17.4 ± 5.2 | 14.1 ± 4.4* | 14.5 ± 4.3* | 14.8 ± 4.8* | 15.7 ± 5.1 | 12.2 ± 5.4* | 11.0 ± 6.4* | 11.9 ± 5.5* |
| HbA 1c (%) | 6.27 ± 0.80 | 6.01 ± 0.68 | 5.91 ± 0.70 | 5.96 ± 0.57 | 6.28 ± 0.66 | 6.06 ± 0.57 | 6.02 ± 0.59 | 6.10 ± 0.35 |
| Ejection Fraction (%) | 59.1 ± 12.9 | 64.9 ± 9.6** | 63.4 ± 7.9** | 61.8 ± 11.6 | 60.7 ± 7.8 | 69.4 ± 8.8** | 70.1 ± 4.9** | 66.4 ± 9.8 |
| E/e’ | 17.1 ± 4.9 | 15.3 ± 5.3 | 14.2 ± 5.6 | 14.5 ± 5.5 | 16.4 ± 3.5 | 15.0 ± 1.9 | 15.0 ± 1.9 | 17.3 ± 6.0 |
| LVMI (g/m2) | 171.2 ± 23.4 | 146.6 ± 21.2* | 150.9 ± 24.7* | 143.1 ± 20.1* | 164.3 ± 13.8 | 132.2 ± 16.9* | 140.8 ± 25.8** | 148.1 ± 42.0 |
| LAVI(mL/m2) | 44.0 ± 10.2 | 37.2 ± 9.8 | 35.8 ± 8.6** | 34.6 ± 9.2** | 38.2 ± 9.7 | 33.3 ± 9.8 | 34.7 ± 8.3 | 35.4 ± 9.5 |
*:p<0.01,**:p<0.05 vs at baseline
Funding
- NIDDK Support