2142-PUB: Major Limb Amputation Decreased Plasma DPP-1 Activity in Diabetes Patients

Abstract

Metabolic syndrome and diabetes mellitus (DM) are associated with increasing DPP-4 level. In recent researches, DPP-4 inhibitor, besides from glycemic control, was found to have benefit in inflammation and cardiovascular disease. The changes of DPP-4 level in metabolic syndrome or DM patients with peripheral arterial occlusive disease (PAOD) have not been clarified. We collected 30 patients with metabolic syndrome and 30 patients without metabolic syndrome, who were scheduled to receive operation. The patients in acute disease status, in pregnancy or breast-feeding, with coagulopathy were excluded. Smoking, BMI (body mass index), underlying disease were extracted from medical record. The blood sample and the fat tissue near the surgical wound were collected. Serum DPP-4, GLP-1, HbA1c, TG, LDL level, and cytokines in fat tissue (TNF-⍺, IL-1β, IL6) were examined. This research has been approved by IRB of VGHKS. The serum DPP-4 level was significantly higher in overweight (BMI≧24) patients, and slightly higher in patient with metabolic syndrome, DM or PAOD. Among patients with metabolic syndrome, the DPP-4 level was significant lower in patients who received amputation for DM foot and/PAOD. However, this condition was not observed in traumatic amputation patients. The DPP-4 inhibitor only lower serum DPP-4 level in patients with metabolic syndrome. Serum DPP-4 level decreased after amputation for severe infection with poor peripheral perfusion, but not in traumatic amputation. This finding supports that DPP-4 was associated with inflammation and vascular disease.