Non-linear association and benchmark dose of blood pressure on carotid artery intima-media thickening in a general population of southern China.

Background and aims: This study aimed to evaluate whether there is a J-curve association between blood pressure (BP) and carotid artery intima-media thickening (CAIT) and estimate the effect of the turning point of BP on CAIT. Methods and results: Data from 111,494 regular physical examinations conducted on workers and retirees (aged 18 years or older) between January 2011 and December 2016, exported from the hospital information system, were analyzed. Restricted cubic splines (RCS) logistic regression was employed to access the association of BP with CAIT, and Bayesian benchmark dose methods were used to estimate the benchmark dose as the departure point of BP measurements. All the pnon-linear values of BP measurements were less than 0.05 in the RCS logistic regression models. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) had J-curve associations with the risk of CAIT at a turning point around 120/70 mmHg in the RCS. The benchmark dose for a 1% change in CAIT risk was estimated to be 120.64 mmHg for SBP and 72.46 mmHg for DBP. Conclusion: The J-curve associations between SBP and DBP and the risk of CAIT were observed in the general population in southern China, and the turning point of blood pressure for significantly reducing the risk of CAIT was estimated to be 120.64/72.46 mmHg for SBP/DBP.

Constructing eRNA-mediated gene regulatory networks to explore the genetic basis of muscle and fat-relevant traits in pigs.

BACKGROUND: Enhancer RNAs (eRNAs) play a crucial role in transcriptional regulation. While significant progress has been made in understanding epigenetic regulation mediated by eRNAs, research on the construction of eRNA-mediated gene regulatory networks (eGRN) and the identification of critical network components that influence complex traits is lacking. RESULTS: Here, employing the pig as a model, we conducted a comprehensive study using H3K27ac histone ChIP-seq and RNA-seq data to construct eRNA expression profiles from multiple tissues of two distinct pig breeds, namely Enshi Black (ES) and Duroc. In addition to revealing the regulatory landscape of eRNAs at the tissue level, we developed an innovative network construction and refinement method by integrating RNA-seq, ChIP-seq, genome-wide association study (GWAS) signals and enhancer-modulating effects of single nucleotide polymorphisms (SNPs) measured by self-transcribing active regulatory region sequencing (STARR-seq) experiments. Using this approach, we unraveled eGRN that significantly influence the growth and development of muscle and fat tissues, and identified several novel genes that affect adipocyte differentiation in a cell line model. CONCLUSIONS: Our work not only provides novel insights into the genetic basis of economic pig traits, but also offers a generalizable approach to elucidate the eRNA-mediated transcriptional regulation underlying a wide spectrum of complex traits for diverse organisms.

Machine learning classifiers for screening nonalcoholic fatty liver disease in general adults.

Nonalcoholic fatty liver disease (NAFLD) is one of major causes of end-stage liver disease in the coming decades, but it shows few symptoms until it develops into cirrhosis. We aim to develop classification models with machine learning to screen NAFLD patients among general adults. This study included 14,439 adults who took health examination. We developed classification models to classify subjects with or without NAFLD using decision tree, random forest (RF), extreme gradient boosting (XGBoost) and support vector machine (SVM). The classifier with SVM was showed the best performance with the highest accuracy (0.801), positive predictive value (PPV) (0.795), F1 score (0.795), Kappa score (0.508) and area under the precision-recall curve (AUPRC) (0.712), and the second top of area under receiver operating characteristic curve (AUROC) (0.850). The second-best classifier was RF model, which was showed the highest AUROC (0.852) and the second top of accuracy (0.789), PPV (0.782), F1 score (0.782), Kappa score (0.478) and AUPRC (0.708). In conclusion, the classifier with SVM is the best one to screen NAFLD in general population based on the results from physical examination and blood testing, followed by the classifier with RF. Those classifiers have a potential to screen NAFLD in general population for physician and primary care doctors, which could benefit to NAFLD patients from early diagnosis.

Oxidative stress-mediated influence of plasma DPP4 activity to BDNF ratio on mild cognitive impairment in elderly type 2 diabetic patients: results from the GDMD study in China.

OBJECTIVE: Increased dipeptidyl peptidase-4 (DPP4) activity and reduced brain-derived neurotrophic factor (BDNF) in peripheral circulation are both associated with a high risk of mild cognitive impairment (MCI) in the elderly. Hence, we aimed to investigate the association between plasma DPP4 activity to BDNF ratio (DBR) and MCI in elderly patients with type 2 diabetes. DESIGN AND METHODS: We measured plasma DPP4 activity, BDNF levels, oxidative stress parameters, inflammatory markers and calculated DBR in 1833 elderly type 2 diabetic patients aged 60 years or older. MCI was diagnosed according to the National Institute on Aging-Alzheimer's Association workgroups criteria. Further, mediation analysis was performed to estimate the mediator role of oxidative stress on the relationship between DPP4 activity and BDNF. RESULTS: DPP4 activity was negatively associated with BDNF (r = -0.408, P < 0.001). Oxidative stress, particularly in male participants, acted as a partial mediator in the relationship between DPP4 activity and BDNF. Participants in the highest quartile of DBR had higher nitrotyrosine, 8-isoPGF2a, interleukin-6, C-reactive protein and lower Montreal Cognitive Assessment score compared with those in the lowest quartile. The odds ratio (5.15, 95% CI 3.64-7.30) for MCI in the highest DBR quartile was significantly higher than in the lowest quartile. The risk for MCI increased with higher levels of DPP4 activity and lower levels of BDNF. CONCLUSIONS: Oxidative stress partially mediates the inverse relationship between DPP4 and BDNF. Our data provide evidence for a strong link between DBR and MCI, suggesting DBR to be a new biomarker for MCI in type 2 diabetic patients.

Strong Association between Plasma Dipeptidyl Peptidase-4 Activity and Impaired Cognitive Function in Elderly Population with Normal Glucose Tolerance.

Objective: Inflammation, oxidative stress, and decreased glucagon-like peptide-1 (GLP-1) are risk factors for cognitive impairment. Dipeptidyl peptidase-4 (DPP4) was identified as a novel adipokine capable of enhancing these risk factors. Hence, we investigated the relationship between plasma DPP4 activity and impaired cognitive function in elderly Chinese population with normal glucose tolerance (NGT). Methods: We performed a cross-sectional study using data from 1229 elderly participants (60 years or older) in Guilin. Plasma DPP4 activity, oxidative stress parameters, fasting active GLP-1, and inflammatory markers were measured in all participants. Impaired cognitive function was diagnosed according to the National Institute on Aging-Alzheimer's Association workgroups criteria. Results: Participants in the upper quartile of plasma DPP4 activity had higher C-reactive protein (CRP), interleukin-6 (IL-6), 8-iso-PGF2a, nitrotyrosine, and lower GLP-1 and Montreal Cognitive Assessment (MoCA) scores compared with those in the lowest quartile (P < 0.001). The odds ratios (ORs) for increased CRP, IL-6, 8-iso-PGF2a, nitrotyrosine, and decreased active GLP-1 were higher with increasing DPP4 quartiles after adjustment for confounders (all P < 0.001). In the highest DPP4 quartile, impaired cognitive function risk was higher (OR, 2.26; 95% confidence interval, 1.36-3.76) than in the lowest quartile after adjustment for potential confounders. The risk for impaired cognitive function increased more with higher levels of DPP4 activity, nitrotyrosine and 8-iso-PGF2a (P < 0.05), but not with higher IL-6, CRP or lower GLP-1. Conclusion: Plasma DPP4 activity is significantly and independently associated with impaired cognitive function, mainly executive, in elderly Chinese population with NGT. The underlying mechanisms for this association may be partly attributed to the effect of DPP4 on oxidative stress. Plasma DPP4 activity might serve as a risk biomarker or therapeutic target for the prevention and treatment of impaired cognitive function.

Increased Dipeptidyl Peptidase-4 Activity Is Associated With High Prevalence of Depression in Middle-Aged and Older Adults: A Cross-Sectional Study.

OBJECTIVE: Obesity, inflammation, and decreased neuropeptide Y (NPY) are risk factors for depression. Dipeptidyl peptidase-4 (DPP4), a newly identified adipokine, has been proved to promote inflammation and NPY degradation. Hence, we aimed to investigate the association between plasma DPP4 activity and depression symptoms in middle-aged and older adults. METHODS: We cross-sectionally assessed 1,335 Chinese adults aged 45-76 years recruited from the Medical Examination Center, Guilin, China, between 2013 and 2014. The main outcome measures were plasma DPP4 activity, inflammatory markers, and NPY. Depression symptoms were determined by the score on the 9-item Patient Health Questionnaire (PHQ-9). Each of the 9 depression items of the PHQ-9 correspond to 1 of the DSM-IV diagnostic criteria for symptoms of major depressive disorder. RESULTS: Subjects in the highest quartile of DPP4 activity had higher body mass index (BMI), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and PHQ-9 score compared with subjects in the lowest quartile (P < .05). Compared to patients without depression symptoms, patients with depression symptoms had higher BMI, waist-to-hip ratio, IL-6, hs-CRP, and DPP4 activity (P < .05). DPP4 activity was associated positively with IL-6, hs-CRP, and PHQ-9 score and negatively with NPY after adjustment for potential confounders (P < .05). The risk for depression symptoms increased with higher levels of DPP4 activity and inflammation and lower levels of NPY. CONCLUSIONS: Increased DPP4 activity is independently associated with depression symptoms in middle-aged and older adults. The mechanisms might be partly explained by mutual influence among inflammation, NPY, and DPP4. These observations raise further interest in DPP4 activity for the potential effect on inflammation and NPY metabolism, as a risk biomarker, or even a possible therapeutic target for depression. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR-EPC-14005273).

Association of Plasma DPP4 Activity With Mild Cognitive Impairment in Elderly Patients With Type 2 Diabetes: Results From the GDMD Study in China.

OBJECTIVE: Hyperglycemia, inflammation, and oxidative stress are thought to be involved in the pathogenesis of cognitive decline. Dipeptidyl peptidase-4 (DPP4) is a newly identified adipokine related to these risk factors. Hence, we aimed to investigate the association between plasma DPP4 activities and mild cognitive impairment (MCI) in elderly patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: We evaluated plasma DPP4 activity, inflammatory markers, and oxidative stress parameters in a cross-sectional sample of 1,160 patients with type 2 diabetes aged 60 years or older in China. MCI was diagnosed based on criteria established by the National Institute on Aging-Alzheimer's Association workgroups RESULTS: Patients in the highest quartile of DPP4 activity had higher HbA1c, interleukin 6 (IL-6), CRP, nitrotyrosine, 8-iso-PGF2a, and lower Montreal Cognitive Assessment (MoCA) scores compared with subjects in the lowest quartile (P < 0.001). In the highest DPP4 quartile, MCI risk was higher (odds ratio 3.49; 95% CI 1.97-4.57) than in the lowest quartile after adjustment for potential confounders. The risk for MCI increased more with higher levels of DPP4 activity, IL-6, CRP, nitrotyrosine, and 8-iso-PGF2a (P < 0.05), but not with higher levels of HbA1c. CONCLUSIONS: This study shows that increased DPP4 activities are independently associated with MCI in elderly patients with type 2 diabetes. The mechanisms might be partly explained by the effect of DPP4 on inflammation and oxidative stress. These observations raise further interest in DPP4 activity for its potential effect on these MCI-related risk factors as a biological marker or even a possible therapeutic target for MCI.

Increased plasma dipeptidyl peptidase-4 activities are associated with high prevalence of diabetic nephropathy in Chinese patients with newly diagnosed type 2 diabetes: A cross-sectional study.

OBJECTIVE: To investigate the association between plasma Dipeptidyl peptidase-4 (DPP4) activities and diabetic nephropathy in type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 1193 newly diagnosed type 2 diabetic subjects were studied. Plasma DPP4 activity, mannose 6-phosphate receptor, inflammatory markers and oxidative stress parameters were measured in all participants. Diabetic nephropathy was defined as the presence of albuminuria or an estimated glomerular filtration rate < 60 mL/min/1.73 m(2). RESULTS: Participants in the highest quartile of DPP4 activity had higher HbA1c, homeostatic model assessment of insulin resistance, nitrotyrosine, 8-iso-PGF2a, interleukin-6, high-sensitivity C-reactive protein, mannose 6-phosphate receptor, urinary albumin-to-creatinine ratio and lower estimated glomerular filtration rate compared with participants in the lowest quartile (all p < 0.001). DPP4 activities were associated positively with HbA1c, homeostatic model assessment of insulin resistance, nitrotyrosine, 8-iso-PGF2a, interleukin-6, high-sensitivity C-reactive protein, mannose 6-phosphate receptor, urinary albumin-to-creatinine ratio and negatively with estimated glomerular filtration rate (all p < 0.001). In the highest DPP4 quartile, diabetic nephropathy risk was significantly higher (odds ratio: 3.77; 95% confidence interval: 2.34-6.07) than in the lowest quartile after adjustment for potential confounders. This association remained strong (2.85; 1.74-4.68) after further controlling for HbA1c, homeostatic model assessment of insulin resistance, nitrotyrosine and high-sensitivity C-reactive protein. CONCLUSION: This study shows that increased DPP4 activities are strongly and independently associated with diabetic nephropathy in type 2 diabetes. The associations between DPP4 and diabetic nephropathy, although strong, do not imply causality. There are however plausible mechanisms which could explain such a link.

Plasma DPP4 Activities Are Associated With Osteoporosis in Postmenopausal Women With Normal Glucose Tolerance.

CONTEXT: Inflammation, insulin resistance, dyslipidemia, and glucagon-like peptide-1 (GLP-1) are risk factors for osteoporosis. Dipeptidyl peptidase-4 (DPP4) is a newly identified adipokine related to these risk factors. OBJECTIVE: To investigate the association between plasma DPP4 activities and osteoporosis. DESIGN, SETTING, AND PATIENTS: This was a cross-sectional study conducted in Guilin, China. A total of 744 postmenopausal women with normal glucose tolerance were studied. MAIN OUTCOME MEASURES: Plasma DPP4 activity, inflammatory markers, blood lipids, homeostatic model assessment of insulin resistance (HOMA-IR), active GLP-1, bone turnover markers, and bone mineral density (BMD) were measured in all participants. RESULTS: Participants in the highest quartile of DPP4 activity had higher triglyceride, total cholesterol, HOMA-IR, IL-6, high-sensitivity C-reactive protein (hs-CRP), C-terminal telopeptide of type I collagen, and osteocalcin and lower BMD (lumbar spine and femoral neck) and active GLP-1 compared with participants in the lowest quartile (P < .05). DPP4 activities were associated positively with triglyceride, total cholesterol, HOMA-IR, IL-6, hs-CRP, C-terminal telopeptide of type I collagen, and osteocalcin and negatively with active GLP-1 and BMD (P < .05). In the highest DPP4 quartile, osteoporosis risk was significantly higher (odds ratio, 3.01; 95% confidence interval, 1.66-5.43) than in the lowest quartile after adjustment for potential confounders. The risk for osteoporosis increased more with higher levels of DPP4 activity, HOMA-IR, IL-6, and hs-CRP (P < .05), but not with higher levels of triglyceride and total cholesterol or lower levels of active GLP-1. CONCLUSIONS: This study shows that increased DPP4 activities are independently associated with osteoporosis. The mechanisms may be partly explained by the effect of DPP4 on inflammation and insulin resistance.