title: Increased plasma dipeptidyl peptidase-4 activities are associated with high prevalence of subclinical atherosclerosis in Chinese patients with newly diagnosed type 2 diabetes: a cross-sectional study.
abstract: OBJECTIVE
  Hyperglycemia, insulin resistance, dislipidemia, oxidative stress and inflammation are well-documented risk factors for subclinical atherosclerosis. 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 subclinical atherosclerosis in type 2 diabetes.
  
  
  METHODS
  A total of 985 newly diagnosed type 2 diabetic subjects were studied. Plasma DPP4 activity, mannose 6-phosphate receptor (M6P-R), oxidative stress parameters, inflammatory markers and common carotid artery Intima-Media Thickness (c-IMT) were measured in all participants.
  
  
  RESULTS
  Participants in the highest quartile of DPP4 activity had higher HbA1c, homeostatic model assessment of insulin resistance(HOMA-IR), triglyceride, low-density lipoprotein cholesterol(LDL-C), oxidized LDL, nitrotyrosine, 8-iso-PGF2a, interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), M6P-R, c-IMT compared with participants in the lowest quartile (all P < 0.001). DPP4 activities were associated positively with HbA1c, HOMA-IR, triglyceride, LDL-C, oxidized LDL, nitrotyrosine, 8-iso-PGF2a, IL-6, hs-CRP, M6P-R and c-IMT (all P < 0.05). The ORs for insulin resistance, dislipidemia, oxidative stress and inflammation were higher with increasing DPP4 quartiles (P < 0.001 for trend). In the highest DPP4 quartile, subclinical atherosclerosis risk was significantly higher (OR 4.97; 95% CI 3.03-8.17) than in the lowest quartile. This association remained strong (2.17; 1.21-3.89) after further controlling for HbA1c, HOMA-IR, triglyceride, oxidized LDL, nitrotyrosine, and IL-6.
  
  
  CONCLUSIONS
  This study shows that increased DPP4 activities are positively and independently associated with subclinical atherosclerosis in type 2 diabetes. Our findings suggest of potential role of DPP4 in the pathogenesis of subclinical atherosclerosis and in the prevention and management of this disease.
authors: Department of Endocrinology and Metabolism, Affiliated Hospital of Guilin Medical University, Guangxi, PR China; Center of Diabetic Systems Medicine, Guilin Medical University, Guangxi, PR China. Electronic address: w19831120@126.com.
authors: T P
authors: TP
authors: Zheng
authors: Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Sichuan, PR China.
authors: Y H
authors: YH
authors: Liu
authors: Department of Endocrinology and Metabolism, Affiliated Hospital of Guilin Medical University, Guangxi, PR China.
authors: L X
authors: LX
authors: Yang
authors: Medical Examination Center, Affiliated Hospital of Guilin Medical University, Guangxi, PR China.
authors: S H
authors: SH
authors: Qin
authors: Department of Laboratory Medicine, Affiliated Hospital of Guilin Medical University, Guangxi, PR China.
authors: H B
authors: HB
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness; D002681:China; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D018819:Dipeptidyl Peptidase 4 / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018384:Oxidative Stress; D015995:Prevalence; D017527:Receptor, IGF Type 2 / Q000097:blood; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D017527:Receptor, IGF Type 2; C034304:cation-dependent mannose-6-phosphate receptor; C042807:DPP4 protein, human; D018819:Dipeptidyl Peptidase 4
keywords: Atherosclerosis; DPP4 activity; Dislipidemia; Inflammation; Insulin resistance; Oxidative stress