Naslov
Relationship between serum DPP-4 activity, insulin resistance and microvascular complications in type 1 diabetic patients

Autori
Duvnjak, Lea ; Blaslov, Kristina ; Bulum, Tomislav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Skup
First EASD INCRETIN study group

Mjesto i datum
Kopenhagen, Danska, 15.01.2015. - 17.01.2015

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
dipeptidyl peptidase-4; insulin resistance; alanine aminotransferaze; microvascular complications; type 1 diabetes

Sažetak
Relationship between serum DPP-4 activity, insulin resistance and microvascular complications in type 1 diabetic patients Background: Dipeptidyl peptidase-4 (DPP4) is an ubiquitous serine protease recently proposed as a novel adipokine linked to insulin resistance (IR). We investigated the relationship between fasting serum DPP4 activity, IR and hepatic markers of IR, estimated glomerular filtration rate (eGFR) and retinopathy in type 1 diabetic (T1DM) patients. Methods: A cross-sectional study comprised 44 T1DM patients aged >18 and <65 years. Insulin sensitivity was calculated using the equation derived from euglycemic- hyperinsulinemic clamp studies-estimated glucose disposal rate (eGDR). DPP4 serum activity was determined spectrophotometrically as a rate of cleavage of 7-Amino-4-Methyl Coumarin (AMC) from H-Gly-Pro-AMC. Results: Patients were divided according to mean DPP4 serum activity (31.42 U/L). The group with higher compared to the group with lower mean fasting serum DPP4 activity showed lower eGDR (p=0.003), higher alanine aminotransferase (ALT) (p=0.001) and aspartate aminotransferase (AST) level (p=0.002), lower estimated glomerular filtration rate (eGFR) and higher prevalence of retinopathy (p<0.005). The linear regression analysis showed that eGDR decreases for 0.155 mgkg-1min-1 ; eGFR decreases for 1, 371 ml/min/1, 73m2 while ALT increases for 1.216 U/L by each increase of serum DPP4 activity of 1 U/L ((p=0.007, p=0, 014, p=0.025 respectively) after adjustment for possible confounders: age, gender, disease duration, HbA1c, use of antihypertensives and statins. Multivariate multinominal regression analysis found that fasting serum DPP4 activity was positively associated with the prevalence of proliferative (OR 1.571 (1.159-2.131)) and non- proliferative (OR 1.338 (1.090-1.643)) retinopathy after adjustment for age, gender, disease duration and HbA1c level. Conclusion: Serum DPP4 activity is associated with IR , its hepatic markers , eGFR as well as with the prevalence of retinopathy in T1DM patients. The possible role of DPP-4 enzime in the pathophysiology of insulin resistance and its relation with the development of microvascular complications merits to be further investigated

Izvorni jezik
Engleski

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