الفهرس 
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Abstract
GLP-1 hormone is secreted from enteroendocrine L cells that are present throughout the small and large intestine. Together with GIP they fully account for the incretin effect which is well-known to be defective in patients with T2DM.
The main functions of GLP-1 are: stimulation of insulin secretion in a glucose- dependent manner, reduction of glucagon levels, inhibition of gastric emptying and reduction of weight through suppression of appetite and food intake.
Besides its main effects on glucose homeostasis, GLP-1 has non-glycemic effects in multiple tissues. Some animal and in vitro studies reported that GLP-1 has as anti-oxidant, anti-inflammatory and anti-atherosclerotic effects and some of these effects are also noted with the use of GLP-1 receptor agonists in T2DM patients.
The aim of this study was to estimate the fasting level of GLP-1 in T2DM patients and to study its association with oxidative stress, atherosclerotic vascular changes and cardiometabolic risk factors (including inflammation).
This study included 60 T2DM male patients with age ≥ 40 and 30 normal male subjects matched for age as a control group. Patient with history of acute infection, malignancy, metabolic or endocrinal disease other than T2DM, severe renal impairment, hepatic impairment, cardiac failure and those who use incretin mimitics, incretin enhancers or metformin were excluded at the start of the study.
After taking their informed consent, all the participants were subjected to history taking (including duration of diabetes, history of hypertension and dyslipidemia and family history of CVD), physical examination (including vital signs and anthropometric measurements) and measurement of FPG, HbA1c, ALT, UACR and lipid profile.
They are also subjected to ELISA for determination levels of fasting total GLP-1, insulin, 8-iso PGF2α (as a marker of oxidative stress) and IL-6 (as a marker of inflammation), measuring of insulin resistance with (HOMA-2), measurement of CIMT with carotid Doppler and assessment of ABPI (both are markers of atherosclerotic vascular changes).
The patients were recruited from the Outpatient Diabetes Clinic and Diabetes and Metabolism Unit at Alexandria University Hospital during the period from January 2016 to August 2016.
The study showed that there was no statistically significant difference between the two groups as regards fasting total GLP-1 level, ALT and prevalence of PAD.
FPG, HbA1c, total cholesterol, TG, LDL, UACR, insulin, insulin resistance, IL-6, 8-iso PGF2α and CIMT were significantly higher in T2DM patient group than the control group.
HDL level was significantly lower in T2DM patient group than the control group.
Regarding the correlations between fasting total GLP-1 and the different studied parameters in both the total sample and T2DM patient subgroup, there were significantly negative correlations between GLP-1 and diastolic BP, FPG, HbA1c, UACR, 8-iso PGF2α and CIMT.
There were no statistically significant correlations between fasting total GLP-1 and age, BMI, waist circumference, systolic BP, ALT, total cholesterol, TG, LDL, HDL, insulin, insulin resistance and IL-6 in both the total sample and T2DM patient subgroup.