Clinical Trials Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2021; 9(33): 10161-10171
Published online Nov 26, 2021. doi: 10.12998/wjcc.v9.i33.10161
Association between plasma dipeptidyl peptidase-4 levels and cognitive function in perinatal pregnant women with gestational diabetes mellitus
Si-Ri-Gu-Leng Sana, En-You Li, Xi-Jin Deng, Lei Guo
Si-Ri-Gu-Leng Sana, En-You Li, Lei Guo, Department of Anesthesiology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Xi-Jin Deng, Department of Anesthesiology, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
Author contributions: Li EY designed the study; Sana SRGL designed the study, collected data, and wrote and revised the manuscript; Deng XJ interpreted and analyzed the data; Guo L collected the data.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University, No. IRB-AF/SC-04/01.0.
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry, No. ChiCTR2000038703.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: En-You Li, PhD, Doctor, Professor, Department of Anesthesiology, the First Affiliated Hospital of Harbin Medical University, No. 23 Youzheng Street, Nangang District, Harbin 150001, Heilongjiang Province, China. lienyou_1111@163.com
Received: April 2, 2021
Peer-review started: April 2, 2021
First decision: July 3, 2021
Revised: July 13, 2021
Accepted: September 6, 2021
Article in press: September 6, 2021
Published online: November 26, 2021
Abstract
BACKGROUND

Dipeptidyl peptidase-4 (DPP4) is associated with cognitive dysfunction in patients with type 2 diabetes.

AIM

To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus (GDM).

METHODS

The study subjects were divided into three groups: GDM group (n = 81), healthy pregnant (HP) group (n = 85), and control group (n = 51). The Montreal Cognitive Assessment (MoCA) was used to assess the cognitive status of each group. Venous blood samples were collected to measure blood lipids, glycated hemoglobin, and glucose levels. For each participant, a 3-mL blood sample was collected and centrifuged, and the serum was collected. Blood samples were stored at -80 ℃, and DPP4, interleukin-6 (IL-6), and 8-iso-prostaglandin F2α (8-iso-PGF2α), and brain-derived neurotrophic factor (BDNF) were detected using ELISA.

RESULTS

The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention (P < 0.05); however, the scores were not significantly different between the GDM and HP groups (P > 0.05). In terms of language, the GDM group had significantly different scores from those in the other two groups (P < 0.05). In terms of memory, a significant difference was found between the HP and control groups (P < 0.05), as well as between the GDM and HP groups. The levels of DPP4, IL-6, and 8-iso-PGF2α in the GDM group were significantly higher than those in the HP and control groups (P < 0.05); however, the differences between these levels in the HP and control groups were not significant (P > 0.05). The level of BDNF in the GDM group was significantly lower than that in the HP and control groups (P < 0.05), although the difference in this level between the HP and control groups was not significant (P > 0.05).

CONCLUSION

Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss, which might be associated with elevated DPP4 levels.

Keywords: Gestational diabetes mellitus, Dipeptidyl peptidase-4, Cognitive function, Oxidative stress, Perinatal pregnant women, Montreal cognitive assessment

Core Tip: It is generally believed that diabetes can cause cognitive impairment, and even is an important cause of Alzheimer’s disease. This study investigated whether gestational diabetes mellitus (GDM) induced cognitive decline in perinatal pregnant women and assessed a possible relationship between serum dipeptidyl peptidase-4 (DPP4) levels and maternal cognitive function in perinatal pregnant women with GDM, and detected DPP4 levels in cord blood. DPP4 may cause cognitive impairment by aggravating inflammatory response and oxidative stress response.