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

Background: 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.

Objective: The aim of our study was to assess whether circulating levels of proglucagon-derived peptides differ between patients with acute intestinal ischemia and a control group.

Study design: This was a prospective, single-center study including patients diagnosed with acute intestinal ischemia (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.

Results: 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 : GLP-1 (glucagon-like peptide 1) levels were significantly higher in the ischemia group compared to controls (5.3 pmol/L vs. 2.3 pmol/L, p = 0.01), as were GLP-2 (glucagon-like peptide 2) levels (2.8 pmol/L vs. 0.9 pmol/L, p = 0.023)and venous lactate (3.3 mmol/L vs. 1.6 mmol/L, p = 0.034). Other biomarkers, including glicentin, intestinal fatty acid-binding protein (I-FABP), and citrulline, showed borderline or non-significant differences.

Conclusion: Serum levels of GLP-1 and GLP-2 were significantly increased in patients with acute intestinal ischemia compared to 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.