title: Increased plasma DPP4 activity is predictive of prediabetes and type 2 diabetes onset in Chinese over a four-year period: result from the China National Diabetes and Metabolic Disorders Study.
abstract: BACKGROUND
  The significance of associations between prediabetes, type 2 diabetes, and dipeptidyl peptidase-4 (DPP4) activity in a Chinese population is not clear.
  
  
  OBJECTIVE
  The objective of the study was to determine whether DPP4 activity and active glucagon-like peptide-1 (GLP-1) were predictive of the onset of prediabetes and type 2 diabetes.
  
  
  METHODS
  This was a 4-year follow-up study conducted in Sichuan, China. A total of 474 Chinese women and men aged 18-70 years were studied.
  
  
  METHODS
  All subjects were divided into 3 groups (normal glucose tolerance, prediabetes, and type 2 diabetes) on the basis of their glucose metabolism status after 4 years. The DPP4 activity, active GLP-1, and glucagon were measured at baseline and 4 years later.
  
  
  RESULTS
  The baseline DPP4 activity was significantly higher in subjects who had progressed to prediabetes or type 2 diabetes compared with subjects who remained normoglycemic (P < .01). In a multiple linear regression analysis, baseline DPP4 activity and active GLP-1 were independent predictors of an increase in insulin resistance over a 4-year period (P < .05). Cox proportional hazards models revealed that DPP4 activity independently predicted the risk of developing prediabetes [relative risk 2.77 (95% confidence interval 1.38-5.55), P < .01] and type 2 diabetes [5.10 (95% confidence interval 1.48-17.61), P < .05] after adjustment for confounding risk factors.
  
  
  CONCLUSIONS
  DPP4 activity is an important predictor of the onset of insulin resistance, prediabetes, and type 2 diabetes in apparently healthy Chinese individuals. This finding may have important implications for understanding the etiology of diabetes.
authors.affiliation: Department of Endocrinology and Metabolism (T.Z., Y.G., A.B., T.C., X.R., H.T.), West China Hospital of Sichuan University, Sichuan 610041, People's Republic of China; and Department of Endocrinology and Metabolism (T.Z.), Affiliated Hospital of Guilin Medical University, Guangxi 541001, People's Republic of China.
authors.forename: Tianpeng
authors.initials: T
authors.lastname: Zheng
authors.forename: Yun
authors.initials: Y
authors.lastname: Gao
authors.forename: Attit
authors.initials: A
authors.lastname: Baskota
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.forename: Xingwu
authors.initials: X
authors.lastname: Ran
authors.forename: Haoming
authors.initials: H
authors.lastname: Tian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D018819:Dipeptidyl Peptidase 4 / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D005951:Glucose Tolerance Test; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis*; D012306:Risk; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D052216:Glucagon-Like Peptide 1; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4