DPP-4 as a Possible Biomarker of Inflammation Before Abdominal Surgery for Chronic Pathology: Our Experience with Elective Cholecystectomy

Medicina (Kaunas). 2019 May 16;55(5):148. doi: 10.3390/medicina55050148.

Abstract

Background and objectives: Dipeptidyl-Peptidase 4 (DPP-4) is a protein expressed in numerous cells and tissues. Recently it has shown its involvement as a catalyst in the inflammatory response in various pulmonary, autoimmune, intestinal and other pathologies. The objective of this study was to compare the preoperative serum levels of DPP-4 in patients with and without surgical finding of perivesicular inflammation. Materials and methods: a cross-sectional analytical study nested in a prospective cohort, including patients scheduled for elective cholecystectomy, without surgical complications, that were 18-70 years of age, with low cardiovascular risk, without a history of peritonitis, pancreatitis, or jaundice and underwent ERCP protocol, type 2 diabetes mellitus, acute inflammatory (Protein C Reactive < 3 mg/L, leucocytes < 10 1000/mm3), neoplastic, nephrologic or liver disease, the use of anti-inflammatory drugs, steroids and/or antibiotics, the use of pacemakers or metallic implants and without major amputations and whom agreed to participate by providing their informed consent. Ethical and Research register: 45-16. Prior to surgery we compiled anthropometric data and a blood sample to determine the serum levels of DPP-4. The presence of perivesicular inflammation was determined in the surgery. The data was analyzed using the statistical program Rstudio. Results: High BMI values were observed (27.8 ± 6.4); waist circumference (94.7 ± 15.1) and percentage of fat mass (34.7 ± 11.7), showing a cumulative frequency of 65.9% for overweight/obesity. In 27.3% of the interventions, intraoperative perivesicular inflammation findings were reported. The serum levels of DPP-4 were lower in the group of patients with perivesicular inflammation (3947.6 ± 1659.5 vs. 3053.2 ± 1469.6, LC95% of the difference: 160.4-1628.3), being statistically significant (P = 0.018). Conclusions: In the subacute or chronic phases of cholecystitis, there appears to be a constant consumption of DPP-4, which would modulate a better immune response that could be related to the reduction of postoperative complications, so the use of Serum levels of DPP-4 as an early biomarker could improve the diagnostic accuracy of this pathology and the surgical approach.

Keywords: biomarker; cholecystectomy; dipeptidyl peptidase-4; pathology; perivesicular inflammation; surgical.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers / analysis
  • Biomarkers / blood
  • Cholecystectomy / methods*
  • Cholecystectomy / trends
  • Chronic Disease
  • Cohort Studies
  • Cross-Sectional Studies
  • Digestive System Surgical Procedures / methods
  • Dipeptidyl Peptidase 4 / analysis*
  • Dipeptidyl Peptidase 4 / blood
  • Female
  • Humans
  • Inflammation / blood*
  • Inflammation / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Biomarkers
  • DPP4 protein, human
  • Dipeptidyl Peptidase 4