INTRODUCTION Cardiac surgery with cardiopulmonary bypass (CPB) is associated with gut barrier dysfunction. Gut barrier dysfunction might be estimated non-invasively by lipopolysaccharide (LPS) plasma concentration. Glucagon-like peptide-1 (GLP-1) is a gut secreted hormone that is a potential marker of mucosal integrity. Our objective was to evaluate GLP-1 as a peri-operative marker of gut barrier dysfunction in patients undergoing cardiac surgery with CPB. METHODS GLP-1, intestinal fatty acid binding protein (I-FABP) and lipopolysaccharide were assayed: at induction, after CPB and 24 h after admission in the intensive care unit. The primary end-point was peri-operative lipopolysaccharide concentration (LPS concentration at those 3 time points). RESULTS Seventy-two patients were included in the present analysis. The highest measured post-operative GLP-1 concentration was in the sample taken 24 h after admission to intensive care, which was associated with peri-operative lipopolysaccharide plasma concentration. Patients who had the highest GLP-1 concentrations at 24 h experienced more severe inflammation and worse clinical outcomes. CONCLUSION Our study supports that GLP-1 is not only a hormone of glucose metabolism but is also secreted when gut barrier is impaired in cardiac surgery with CPB. The GLP-1 levels measured 24 h after admission to the intensive care unit were associated with LPS concentration, inflammation and clinical outcomes.

中文翻译：

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胰高血糖素样肽-1 与接受体外循环心脏手术的患者的不良临床结果、脂多糖易位和炎症相关

引言 体外循环 (CPB) 心脏手术与肠道屏障功能障碍有关。肠道屏障功能障碍可以通过脂多糖 (LPS) 血浆浓度非侵入性地进行评估。胰高血糖素样肽-1 (GLP-1) 是一种肠道分泌的激素，是粘膜完整性的潜在标志物。我们的目标是评估 GLP-1 作为 CPB 心脏手术患者围手术期肠道屏障功能障碍的标志物。方法 检测 GLP-1、肠道脂肪酸结合蛋白 (I-FABP) 和脂多糖：诱导时、CPB 后和重症监护病房入院后 24 小时。主要终点是围手术期脂多糖浓度（这 3 个时间点的 LPS 浓度）。结果 本次分析包括 72 名患者。最高测量的术后 GLP-1 浓度出现在进入重症监护室后 24 小时采集的样本中，这与围手术期脂多糖血浆浓度有关。在 24 小时时 GLP-1 浓度最高的患者经历了更严重的炎症和更差的临床结果。结论 我们的研究支持 GLP-1 不仅是葡萄糖代谢的激素，而且在 CPB 心脏手术中肠道屏障受损时也会分泌。入住重症监护病房后 24 小时测量的 GLP-1 水平与 LPS 浓度、炎症和临床结果相关。在 24 小时时 GLP-1 浓度最高的患者经历了更严重的炎症和更差的临床结果。结论 我们的研究支持 GLP-1 不仅是葡萄糖代谢的激素，而且在 CPB 心脏手术中肠道屏障受损时也会分泌。入住重症监护病房后 24 小时测量的 GLP-1 水平与 LPS 浓度、炎症和临床结果相关。在 24 小时时 GLP-1 浓度最高的患者经历了更严重的炎症和更差的临床结果。结论 我们的研究支持 GLP-1 不仅是葡萄糖代谢的激素，而且在 CPB 心脏手术中肠道屏障受损时也会分泌。入住重症监护病房后 24 小时测量的 GLP-1 水平与 LPS 浓度、炎症和临床结果相关。