title: Association of Plasma DPP4 Activity With Mild Cognitive Impairment in Elderly Patients With Type 2 Diabetes: Results From the GDMD Study in China.
abstract: 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.
  
  
  
  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
  
  
  
  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.
  
  
  
  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.
authors.affiliation: 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.
authors.forename: Tianpeng
authors.initials: T
authors.lastname: Zheng
authors.affiliation: Department of Epidemiology and Health Statistics, Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Linyuan
authors.initials: L
authors.lastname: Qin
authors.affiliation: Research Center of Combine Traditional Chinese and Western Medicine, Affiliated Traditional Medicine Hospital of Sichuan Medical University, Luzhou, Sichuan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Endocrinology and Metabolism, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Xueping
authors.initials: X
authors.lastname: Hu
authors.affiliation: Center of Diabetic Systems Medicine, Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Diabetic Centre of Control and Prevention, The People's Liberation Army 520 Hospital, Mianyang, Sichuan, China.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Liu
authors.affiliation: Medical Examination Center, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Shenghua
authors.initials: S
authors.lastname: Qin
authors.affiliation: Department of Psychiatry, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Psychiatry, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China Department of Neurology, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Li
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002681:China; D060825:Cognitive Dysfunction / Q000097:blood* / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D018819:Dipeptidyl Peptidase 4 / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018384:Oxidative Stress; D012307:Risk Factors; D014443:Tyrosine / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D015237:Dinoprost; D018819:Dipeptidyl Peptidase 4; D006442:Glycated Hemoglobin; D015850:Interleukin-6; D014443:Tyrosine; C508600:IL6 protein, human; C517652:hemoglobin A1c protein, human; C075750:8-epi-prostaglandin F2alpha; C002744:3-nitrotyrosine; C042807:DPP4 protein, human