Tianpeng Zheng1, Linyuan Qin2, Bo Chen3, Xueping Hu4, Xiaoxi Zhang5, Yihong Liu6, Hongbo Liu7, Shenghua Qin8, Gang Li9, Qinghua Li10. 1. Department of Endocrinology and Metabolism, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China Center of Diabetic Systems Medicine, Guilin Medical University, Guilin, Guangxi, China w19831120@126.com. 2. Department of Epidemiology and Health Statistics, Guilin Medical University, Guilin, Guangxi, China. 3. Research Center of Combine Traditional Chinese and Western Medicine, Affiliated Traditional Medicine Hospital of Sichuan Medical University, Luzhou, Sichuan, China. 4. Department of Endocrinology and Metabolism, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China. 5. Center of Diabetic Systems Medicine, Guilin Medical University, Guilin, Guangxi, China. 6. Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan, China. 7. Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China. 8. Medical Examination Center, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China. 9. Department of Psychiatry, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China. 10. Department of Psychiatry, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
Abstract
OBJECTIVE: Hyperglycemia, inflammation, and oxidative stress are thought to be involved in the pathogenesis of cognitive decline. Dipeptidyl peptidase-4 (DPP4) is a newly identified adipokine related to these risk factors. Hence, we aimed to investigate the association between plasma DPP4 activities and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We evaluated plasma DPP4 activity, inflammatory markers, and oxidative stress parameters in a cross-sectional sample of 1,160 patients with type 2 diabetes aged 60 years or older in China. MCI was diagnosed based on criteria established by the National Institute on Aging-Alzheimer's Association workgroups RESULTS: Patients in the highest quartile of DPP4 activity had higher HbA1c, interleukin 6 (IL-6), CRP, nitrotyrosine, 8-iso-PGF2a, and lower Montreal Cognitive Assessment (MoCA) scores compared with subjects in the lowest quartile (P < 0.001). In the highest DPP4 quartile, MCI risk was higher (odds ratio 3.49; 95% CI 1.97-4.57) than in the lowest quartile after adjustment for potential confounders. The risk for MCI increased more with higher levels of DPP4 activity, IL-6, CRP, nitrotyrosine, and 8-iso-PGF2a (P < 0.05), but not with higher levels of HbA1c. CONCLUSIONS: This study shows that increased DPP4 activities are independently associated with MCI in elderly patients with type 2 diabetes. The mechanisms might be partly explained by the effect of DPP4 on inflammation and oxidative stress. These observations raise further interest in DPP4 activity for its potential effect on these MCI-related risk factors as a biological marker or even a possible therapeutic target for MCI.
OBJECTIVE:Hyperglycemia, inflammation, and oxidative stress are thought to be involved in the pathogenesis of cognitive decline. Dipeptidyl peptidase-4 (DPP4) is a newly identified adipokine related to these risk factors. Hence, we aimed to investigate the association between plasma DPP4 activities and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We evaluated plasma DPP4 activity, inflammatory markers, and oxidative stress parameters in a cross-sectional sample of 1,160 patients with type 2 diabetes aged 60 years or older in China. MCI was diagnosed based on criteria established by the National Institute on Aging-Alzheimer's Association workgroups RESULTS:Patients in the highest quartile of DPP4 activity had higher HbA1c, interleukin 6 (IL-6), CRP, nitrotyrosine, 8-iso-PGF2a, and lower Montreal Cognitive Assessment (MoCA) scores compared with subjects in the lowest quartile (P < 0.001). In the highest DPP4 quartile, MCI risk was higher (odds ratio 3.49; 95% CI 1.97-4.57) than in the lowest quartile after adjustment for potential confounders. The risk for MCI increased more with higher levels of DPP4 activity, IL-6, CRP, nitrotyrosine, and 8-iso-PGF2a (P < 0.05), but not with higher levels of HbA1c. CONCLUSIONS: This study shows that increased DPP4 activities are independently associated with MCI in elderly patients with type 2 diabetes. The mechanisms might be partly explained by the effect of DPP4 on inflammation and oxidative stress. These observations raise further interest in DPP4 activity for its potential effect on these MCI-related risk factors as a biological marker or even a possible therapeutic target for MCI.
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