New Biomarkers of Acute Intestinal Ischemia: A Prospective Study Validating the Interest of Glucagon-Like Peptide-1 and -2.

Abstract

Acute intestinal ischemia (AII) remains a major diagnostic challenge, associated with high morbidity and mortality. Current biomarkers lack sufficient sensitivity and specificity. Proglucagon-derived peptides constitute a family of hormones involved in the regulation of intestinal mucosal physiology. Alterations in circulating levels of these peptides may occur during intestinal ischemia, suggesting their potential as diagnostic biomarkers. The aim of our study was to assess whether circulating levels of proglucagon-derived peptides differ between patients with AII and a control group. This was a prospective, single-center study including patients diagnosed with AII and a control group of patients presenting with acute abdominal pain. Clinical and biochemical parameters, as well as management strategies, were recorded. Circulating levels of proglucagon-derived peptides were measured in serum. A total of 23 patients were included in the ischemia group and 23 in the control group. Univariate analysis revealed statistically significant differences between groups: glucagon-like peptide (GLP) 1 levels were significantly higher in the ischemia group compared with controls (5.3 vs 2.3 pmol/L, p = 0.01), as were GLP-2 levels (2.8 vs 0.9 pmol/L, p = 0.023) and venous lactate (3.3 vs 1.6 mmol/L, p = 0.034). Other biomarkers, including glicentin, intestinal fatty acid-binding protein, and citrulline, showed borderline or nonsignificant differences. Serum levels of GLP-1 and GLP-2 were significantly increased in patients with AII compared with controls. These findings suggest that GLP-1 and GLP-2 may serve as promising biomarkers for the early diagnosis of AII in the emergency setting.