[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-405470-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-405470-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","impaired-incretin-homeostasis-in-nondiabetic-moderate-to-severe-ckd","Impaired Incretin Homeostasis in Nondiabetic Moderate-to-Severe CKD","","Background examines how incretins—regulators of insulin secretion and glucose homeostasis processed by DPP-4—may be altered by CKD. Methods used standardized 2-hour oral glucose tolerance testing in 59 people with nondiabetic CKD and 39 matched controls, measuring GLP-1 and GIP total and incremental areas under the curve, plus fasting DPP-4 levels/activity, with regression adjustment. Results showed higher GLP-1 total area and GIP iAUC in CKD, with glucagon elevation at 30 and 120 minutes but no insulin or DPP-4 differences.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/impaired-incretin-homeostasis-in-nondiabetic-moderate-to-severe-ckd/405470/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/impaired-incretin-homeostasis-in-nondiabetic-moderate-to-severe-ckd/405470.png","ImageObject",300,407,{"name":42,"@type":43},"Himbo","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-04","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the main purpose of the study on CKD and incretins?","Question",{"text":63,"@type":64},"To evaluate how nondiabetic moderate-to-severe CKD affects postprandial incretin hormone levels and their determinants during a standardized oral glucose tolerance test.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What testing and measurements were used to assess incretin response?",{"text":68,"@type":64},"A 2-hour oral glucose tolerance test measured total and incremental areas under the curve for GLP-1 and GIP, along with fasting DPP-4 levels and activity; linear regression adjusted for demographic, body composition, and lifestyle factors.",{"name":70,"@type":61,"acceptedAnswer":71},"Did CKD change insulin levels or DPP-4 activity compared with controls?",{"text":72,"@type":64},"No. There were no differences between groups in insulin levels or in plasma DPP-4 activity or levels.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},405470,1790717486,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":145,"read_time":146,"preview_page_count":4},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","Clinical Research  \nImpaired Incretin Homeostasis in Nondiabetic Moderate-to-Severe CKD  \nArmin Ahmadi  , 1 Jorge Gamboa  ,2 Jennifer E. Norman  ,3 Bamba Enkhmaa  ,4 Madelynn Tucker,5 Brian J. Bennett ,6 Leila R. Zelnick ,7 Sili Fan,8 Lars F. Berglund ,9 Talat Alp Ikizler , [10](10 Ian H. de)[ Ian H. de](10 Ian H. de) Boer ,7 Bethany P. Cummings,5, 11 and Baback Roshanravan  1  \nKey Points  \nc Total incretin levels and incretin response during oral glucose tolerance testing were significantly higher among patients with moderate-to-severe nondiabetic patients with CKD compared with healthy people.  \nc Unlike in healthy individuals, increased incretin response was not correlated with insulin response and coincided with persistently greater glucagon levels to oral glucose tolerance testing in CKD.  \nc Disruption in the incretin system and glucagon dynamics may contribute to metabolic complications in moderateto-severe CKD.  \nAbstract  \nBackground Incretins are regulators of insulin secretion and glucose homeostasis metabolized by dipeptidyl peptidase-4 (DPP-4) . CKD may modify incretin release, metabolism, or response.  \nMethods We performed 2-hour oral glucose tolerance testing in 59 people with nondiabetic CKD (eGFR ,60 ml/min per 1.73 m2) and 39 matched controls. We measured total area under the curve and incremental area under the curve (iAUC) of plasma total glucagon-like peptide-1 (GLP-1) and total glucose-dependent insulinotropic polypeptide (GIP) . Fasting DPP-4 levels and activity were measured. Linear regression was used to adjust for demographic, body composition, and lifestyle factors.  \nResults Mean (SD) eGFR was 38613 and 89617 ml/min per 1.73 m2 in patients with CKD and controls, respectively. GLP-1 total area under the curve and GIP iAUC were higher in patients with CKD than controls with a mean of 153161452 versus 136461484 pM3min and 62,370633,453 versus 42,365625,061 pg3min/ml, respectively. After adjustment, CKD was associated with 15,271 pM3min/ml greater GIP iAUC (95% confidence intervals [CIs],  \n387 to 30,154) compared with controls. Adjustment for covariates attenuated associations of CKD with higher GLP-1 iAUC (adjusted difference, 122; 95% CI, 2619 to 864) . Plasma glucagon levels were higher at 30 minutes (mean difference, 1.6; 95% CI, 0.3 to 2.8 mg/dl) and 120 minutes (mean difference, 0.84; 95% CI, 0.2 to 1.5 mg/dl) inpatients with CKD compared with controls. There were no differences in insulin levels or plasma DPP-4 activity or levels between groups.  \nConclusions Overall, incretin response to oral glucose is preserved or augmented in moderate-to-severe CKD, without apparent differences in circulating DPP-4 concentration or activity. However, neither insulin secretion nor glucagon suppression is enhanced.  \nCJASN 20: 12–22, 2025. doi: [https://doi.org/10.2215/CJN.0000000000000566](https://doi.org/10.2215/CJN.0000000000000566)  \nThis is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nDue to the number of contributing authors, the affiliations are listed at the end of this article.  \nReceived: February 15, 2024 Accepted: October 3, 2024  \nPublished Online Ahead of Print: October 9, 2024  \nA.A., J.G., B.P.C., and B.R. contributed equally to this work.  \nCorrespondence: Dr. Armin Ahmadi, email: [arahmadi@ucdavis.edu](arahmadi@ucdavis.edu)  \n[Copyright](Copyright) © [2024 The Author](2024 The Author)([s](s)) . Published by Wolters Kluwer Health, Inc.  \n12 on behalf of the American Society of Nephrology CJASN 20: 12–22, January, 2025  \nIntroduction  \nCKD even in a nondiabetic setting is associated with metabolic dysregulation, including disrupted insulin and glucose homeostasis.1–3 Factors contributing to CKDassociated glucometabolic","cbCaicQpj12KjpIJ","https://ap.wps.com/l/cbCaicQpj12KjpIJ","pdf",552270,11,"English","# Key Points\n# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What was the main purpose of the study on CKD and incretins?\",\"answer\":\"To evaluate how nondiabetic moderate-to-severe CKD affects postprandial incretin hormone levels and their determinants during a standardized oral glucose tolerance test.\"},{\"question\":\"What testing and measurements were used to assess incretin response?\",\"answer\":\"A 2-hour oral glucose tolerance test measured total and incremental areas under the curve for GLP-1 and GIP, along with fasting DPP-4 levels and activity; linear regression adjusted for demographic, body composition, and lifestyle factors.\"},{\"question\":\"Did CKD change insulin levels or DPP-4 activity compared with controls?\",\"answer\":\"No. There were no differences between groups in insulin levels or in plasma DPP-4 activity or levels.\"}]","Impaired Incretin Homeostasis in Nondiabetic Moderate-to-Severe CKD | PDF",1790560196,28]