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Gut hormones in POTS and their relation to hemodynamic parameters and gastrointestinal symptoms

Tufvesson, Hanna LU orcid ; Roth, Bodil LU ; Johansson, Madeleine LU orcid ; Hamrefors, Viktor LU orcid ; Fedorowski, Artur LU orcid ; Lindholm, Eero LU and Ohlsson, Bodil LU (2026) In Scientific Reports 16. p.1-12
Abstract

Postural orthostatic tachycardia syndrome (POTS) is associated with multiple autonomic symptoms, including gastrointestinal (GI) complaints, and has been linked to insulin resistance. We aimed to explore HbA1c, circulating metabolic hormones (insulin, C-peptide, GIP, GLP-1, glucagon, leptin, and peptide YY) and cortisol, and their associations with hemodynamic parameters and GI symptoms in POTS. Two POTS cohorts were studied and compared with matched controls. In the fasting cohort, blood samples were drawn in 42 patients and 41 controls, followed by active standing tests with measurement of pulse and blood pressure (BP) in supine and standing positions. In the non-fasting cohort, questionnaires assessed GI symptoms and HbA1c was... (More)

Postural orthostatic tachycardia syndrome (POTS) is associated with multiple autonomic symptoms, including gastrointestinal (GI) complaints, and has been linked to insulin resistance. We aimed to explore HbA1c, circulating metabolic hormones (insulin, C-peptide, GIP, GLP-1, glucagon, leptin, and peptide YY) and cortisol, and their associations with hemodynamic parameters and GI symptoms in POTS. Two POTS cohorts were studied and compared with matched controls. In the fasting cohort, blood samples were drawn in 42 patients and 41 controls, followed by active standing tests with measurement of pulse and blood pressure (BP) in supine and standing positions. In the non-fasting cohort, questionnaires assessed GI symptoms and HbA1c was measured in 43 patients and 52 controls. Fasting C-peptide and insulin levels correlated with BP in POTS (q = 0.002) but not in controls. Fasting insulin tended to be higher in POTS but was not statistically significant after adjustment for BMI (β = 6.85; 95% CI: -1.04-14.74; p = 0.085). Morning cortisol was comparable between groups. In the non-fasting cohort, HbA1c and metabolic hormones were comparable between groups, with no associations with GI symptoms. Together, these findings suggest a potential link between insulin-related pathways and BP regulation in POTS. Future studies are warranted to further investigate insulin dynamics in POTS.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Female, Male, Adult, Gastrointestinal Hormones/blood, Hemodynamics, Postural Orthostatic Tachycardia Syndrome/blood, Insulin/blood, Blood Pressure, Hydrocortisone/blood, Glycated Hemoglobin/metabolism, Middle Aged, Gastrointestinal Diseases/blood, Case-Control Studies, Young Adult, Leptin/blood, C-Peptide/blood
in
Scientific Reports
volume
16
article number
15514
pages
1 - 12
publisher
Nature Publishing Group
external identifiers
  • pmid:42156945
ISSN
2045-2322
DOI
10.1038/s41598-026-52963-0
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
4a4b1417-f0a6-4f43-b189-8eeb70a54e71
date added to LUP
2026-05-25 17:50:56
date last changed
2026-05-26 07:44:02
@article{4a4b1417-f0a6-4f43-b189-8eeb70a54e71,
  abstract     = {{<p>Postural orthostatic tachycardia syndrome (POTS) is associated with multiple autonomic symptoms, including gastrointestinal (GI) complaints, and has been linked to insulin resistance. We aimed to explore HbA1c, circulating metabolic hormones (insulin, C-peptide, GIP, GLP-1, glucagon, leptin, and peptide YY) and cortisol, and their associations with hemodynamic parameters and GI symptoms in POTS. Two POTS cohorts were studied and compared with matched controls. In the fasting cohort, blood samples were drawn in 42 patients and 41 controls, followed by active standing tests with measurement of pulse and blood pressure (BP) in supine and standing positions. In the non-fasting cohort, questionnaires assessed GI symptoms and HbA1c was measured in 43 patients and 52 controls. Fasting C-peptide and insulin levels correlated with BP in POTS (q = 0.002) but not in controls. Fasting insulin tended to be higher in POTS but was not statistically significant after adjustment for BMI (β = 6.85; 95% CI: -1.04-14.74; p = 0.085). Morning cortisol was comparable between groups. In the non-fasting cohort, HbA1c and metabolic hormones were comparable between groups, with no associations with GI symptoms. Together, these findings suggest a potential link between insulin-related pathways and BP regulation in POTS. Future studies are warranted to further investigate insulin dynamics in POTS.</p>}},
  author       = {{Tufvesson, Hanna and Roth, Bodil and Johansson, Madeleine and Hamrefors, Viktor and Fedorowski, Artur and Lindholm, Eero and Ohlsson, Bodil}},
  issn         = {{2045-2322}},
  keywords     = {{Humans; Female; Male; Adult; Gastrointestinal Hormones/blood; Hemodynamics; Postural Orthostatic Tachycardia Syndrome/blood; Insulin/blood; Blood Pressure; Hydrocortisone/blood; Glycated Hemoglobin/metabolism; Middle Aged; Gastrointestinal Diseases/blood; Case-Control Studies; Young Adult; Leptin/blood; C-Peptide/blood}},
  language     = {{eng}},
  month        = {{05}},
  pages        = {{1--12}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Gut hormones in POTS and their relation to hemodynamic parameters and gastrointestinal symptoms}},
  url          = {{http://dx.doi.org/10.1038/s41598-026-52963-0}},
  doi          = {{10.1038/s41598-026-52963-0}},
  volume       = {{16}},
  year         = {{2026}},
}