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Related Concept Videos

Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

348
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
348
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

576
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
576
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

103
Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
103
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

407
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
407
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

444
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
444
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

78
Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
78

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Decrease of dipeptidyl peptidase 4 activity is associated with weight loss after bariatric surgery.

Carsten T Herz1,2,3, Johanna M Brix2,4, Bernhard Ludvik2,4

  • 1Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria.

Obesity Surgery
|February 4, 2021
PubMed
Summary
This summary is machine-generated.

Weight loss from bariatric surgery significantly reduces Dipeptidyl peptidase 4 (DPP4) activity. This decrease in DPP4 is linked to improved metabolic health markers and reduced liver injury.

Keywords:
dipeptidyl peptidase 4lipidslivermorbid obesity

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Area of Science:

  • Metabolic Dysfunction
  • Obesity Research
  • Bariatric Surgery Outcomes

Background:

  • Dipeptidyl peptidase 4 (DPP4) is secreted by adipocytes and linked to insulin resistance.
  • DPP4 may directly contribute to metabolic dysfunction in morbid obesity, independent of GLP-1.
  • Investigating DPP4's role in metabolic dysfunction is crucial for understanding obesity complications.

Purpose of the Study:

  • To assess the impact of bariatric surgery-induced weight loss on serum DPP4 activity.
  • To determine if changes in DPP4 activity correlate with improvements in metabolic dysfunction markers.
  • To explore the association between reduced DPP4 activity and fatty liver disease markers post-surgery.

Main Methods:

  • Study included 68 non-diabetic patients undergoing bariatric surgery.
  • Serum DPP4 activity was measured using a fluorogenic substrate before and after surgery.
  • Correlations between DPP4 activity changes and metabolic markers were analyzed.

Main Results:

  • Median serum DPP4 activity decreased significantly post-surgery (p=0.012).
  • Reduced DPP4 activity correlated with lower BMI, improved cholesterol, and better insulin sensitivity (Matsuda index).
  • Decreased DPP4 activity was associated with reduced hepatic injury markers like gamma-glutamyltransferase.

Conclusions:

  • Bariatric surgery leads to sustained reduction in circulating DPP4 activity.
  • DPP4 inhibition may offer therapeutic benefits beyond glucose metabolism.
  • Further research is needed to explore DPP4's pleiotropic effects in metabolic health.