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    Home > Active Ingredient News > Study of Nervous System > Brain: DPP4 inhibitors provide long-term benefits for patients with diabetic Parkinson's disease

    Brain: DPP4 inhibitors provide long-term benefits for patients with diabetic Parkinson's disease

    • Last Update: 2021-06-10
    • Source: Internet
    • Author: User
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    Dipeptidyl peptidase-4 inhibitors, or DPP-4 inhibitors or gliptin drugs, are oral antidiabetic drugs that inhibit dipeptidyl peptidase-4 and are mainly used to treat type 2 diabetes (T2DM).
    The first is a DPP-4 inhibitor sitagliptin in 2006 by the US Food and Drug
    Administration Administration (US the FDA approval) of.

    Diabetes Management FDA

    Glucagon raise blood sugar levels, DPP-4 inhibitors may reduce glucagon and reducing hypoglycemic levels.
    The principle of DPP-4 inhibitors is to increase the level of incretin hormone (GLP-1) and GIP that can inhibit the release of glucagon, increase insulin secretion, slow down gastric emptying, and lower blood sugar levels.

    The principle of hypoglycemic DPP-4 inhibitors is to increase the level of incretin hormone (GLP-1) and GIP that can inhibit the release of glucagon, increase insulin secretion, slow down gastric emptying, and lower blood sugar levels.
    The principle of DPP-4 inhibitors is to increase the level of incretin hormone (GLP-1) and GIP that can inhibit the release of glucagon, increase insulin secretion, slow down gastric emptying, and lower blood sugar levels.

    For most patients with T2DM, DPP-4 inhibitors should not be used as the initial treatment, but should start with dietary adjustments, weight loss, exercise, and the use of metformin (if there are no contraindications).
    DPP-4 inhibitors can be used as monotherapy for patients who cannot tolerate or ban metformin, such as patients with chronic kidney disease, especially those with a particularly high risk of hypoglycemia.

    Metformin

    Parkinson's disease (PD) is the second largest neurodegenerative disease in the world and is characterized by motor retardation, limb stiffness, and tremor.
    PD patients may also have cognitive and behavioral problems.
    For example, dementia is quite common in severely ill patients, and major depressive disorder and anxiety disorders also occur in more than one-third of cases.
    Other possible symptoms include sensory, sleep, and emotional problems.

    Parkinson's disease (PD) is the second largest neurodegenerative disease in the world and is characterized by motor retardation, limb stiffness, and tremor.
    Parkinson's disease (PD) is the second largest neurodegenerative disease in the world and is characterized by motor retardation, limb stiffness, and tremor.

    Studies have shown that those with T2DM have a 32% increased risk of developing a progressively debilitating neurological disease in the later stages.
    More data suggest that Parkinson's disease may have a common pathogenesis with T2DM.
    So, does the treatment of DPP4 inhibitors have a beneficial effect on the substantia nigra dopamine and longitudinal exercise performance of diabetic patients with PD? To this end, experts from the Department of Neurology, Yonsei University School of Medicine in South Korea conducted related research, and the results were published in the Brain magazine.

    Studies have shown that those with T2DM have a 32% increased risk of developing a progressively debilitating neurological disease in the later stages.
    More data suggest that Parkinson's disease may share a common pathogenesis with T2DM.
    Studies have shown that those with T2DM have a 32% increased risk of developing a progressively debilitating neurological disease in the later stages.
    More data suggest that Parkinson's disease may have a common pathogenesis with T2DM.

    Researchers divided 697 new-onset PD patients who received dopamine transporter imaging into three groups based on their previous diagnosis of diabetes and the use of DPP4 inhibitors: PD diabetes patients who were being treated with DPP4 inhibitors (group 1, n = 54 ) Or Parkinson’s disease patients who did not use DPP4 inhibitors (group 2, n = 85), and non-diabetic Parkinson’s disease patients (group 3, n = 558).

    diagnosis

    In PD diabetic patients treated with DPP4 inhibitors in the anterior putamen (2.
    56±0.
    74 vs 2.
    10±0.
    50; P=0.
    016), posterior (1.
    83±0.
    69 vs 1.
    40±0.
    50; P<0.
    001) and ventral (1.
    72) ±0.
    58 vs 1.
    35±0.
    37; P=0.
    001) The basic dopamine level was higher than that of non-DPP4 inhibitor-treated PD diabetes patients.
    In addition, PD diabetic patients receiving DPP4 inhibitors had higher dopamine transporter availability in the posterior putamen than non-diabetic Parkinson's disease patients (1.
    83 ± 0.
    69 vs 1.
    43 ± 0.
    59; P <0.
    001).

    In PD diabetic patients treated with DPP4 inhibitors in the anterior putamen (2.
    56±0.
    74 vs 2.
    10±0.
    50; P=0.
    016), posterior (1.
    83±0.
    69 vs 1.
    40±0.
    50; P<0.
    001) and ventral (1.
    72) ±0.
    58 vs 1.
    35±0.
    37; P=0.
    001) The basic dopamine level was higher than that of non-DPP4 inhibitor-treated PD diabetes patients.
    In PD diabetic patients treated with DPP4 inhibitors in the anterior putamen (2.
    56±0.
    74 vs 2.
    10±0.
    50; P=0.
    016), posterior (1.
    83±0.
    69 vs 1.
    40±0.
    50; P<0.
    001) and ventral (1.
    72) ±0.
    58 vs 1.
    35±0.
    37; P=0.
    001) The basic dopamine level was higher than that of non-DPP4 inhibitor-treated PD diabetes patients.

    After adjusting for age, sex, course of disease, and vascular risk factors, the linear regression model showed that the previous DPP4 inhibitor treatment was still consistent with the anterior putamen (β = -0.
    186, P = 0.
    012) and posterior (β =- 0.
    336, P <0.
    001) and ventral (β = -0.
    204, P = 0.
    005) dopamine transporter availability has an independent and significant relationship.

    The previous DPP4 inhibitor treatment of blood vessels was still related to the anterior putamen (β = -0.
    186, P = 0.
    012), posterior (β = -0.
    336, P <0.
    001) and ventral (β = -0.
    204, P = 0.
    005).
    ) The availability of dopamine transporters has an independent and significant relationship.
    The previous DPP4 inhibitor treatment is still related to the anterior putamen (β = -0.
    186, P = 0.
    012), posterior (β = -0.
    336, P <0.
    001) and ventral (β = -0.
    204, P = 0.
    005) The availability of dopamine transporters has an independent and significant relationship.

    The linear mixed model showed that the longitudinal increase of levodopa equivalent in the Parkinson's disease diabetes group being treated with a DPP4 inhibitor was slower than the other groups.
    Survival analysis showed that
    the rate of levodopa-induced dyskinesia in the diabetic group previously treated with DPP4 inhibitors was significantly lower than that in the diabetic group without DPP4 inhibitors.

    The rate of levodopa-induced dyskinesia in the diabetic group previously treated with a DPP4 inhibitor was significantly lower than that in the diabetic group without a DPP4 inhibitor.
    The rate of levodopa-induced dyskinesia in the diabetic group previously treated with a DPP4 inhibitor was significantly lower than that in the diabetic group without a DPP4 inhibitor.

    These findings indicate that DPP4 inhibitors may have a beneficial effect on the baseline dopamine degeneration of the substantia nigra and long-term exercise results in diabetic Parkinson's disease patients, and may extend its effect to non-diabetic Parkinson's disease patients.

    These findings indicate that DPP4 inhibitors may have a beneficial effect on the baseline dopamine degeneration of the substantia nigra and long-term exercise results in diabetic Parkinson's disease patients, and may extend its effect to non-diabetic Parkinson's disease patients.
    These findings indicate that DPP4 inhibitors may have a beneficial effect on the baseline dopamine degeneration of the substantia nigra and long-term exercise results in diabetic Parkinson's disease patients, and may extend its effect to non-diabetic Parkinson's disease patients.

     

    references:

    Beneficial effects of dipeptidyl peptidase-4 inhibitors in diabetic Parkinson's disease, Brain, Volume 144, Issue 4, April 2021, Pages 1127–1137, https://doi.
    org/10.
    1093/brain/awab015



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