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    Assessment of serum glucagon-like peptide-1 and dipeptidyl peptidase-4 levels in patients with migraine
    (Springer Heidelberg, 2025) Gultekin, Melis; Davran, Fatih; Yuksel, Nehir; Beyazcicek, Ozge; Demir, Serif
    Background Migraine is a prevalent neurovascular disorder affecting over one billion people globally, imposing significant daily life limitations. Migraine headaches are linked to the activation of trigeminal nerve endings. Glucagon-like peptide-1 (GLP-1) is a hormone involved in insulin regulation and plays neuroprotective roles in the central nervous system (CNS). Dipeptidyl peptidase-4 (DPP-4) is a protease enzyme that degrades GLP-1, rendering it inactive, and modulates metabolic and neurological pathways. This study investigates the association between serum GLP-1 and DPP-4 levels and migraine pathophysiology to propose a novel therapeutic approach for migraine. Methods The study included 42 migraine patients and 42 healthy controls. After fasting for at least 8 h, blood samples were collected. Serum GLP-1 and DPP-4 levels were measured using ELISA, and statistical analyses were conducted with SPSS 24.0. Results Serum GLP-1 and DPP-4 levels were significantly lower in migraine patients compared to controls (p < 0.001). Patients with migraine with aura had significantly lower GLP-1 levels compared to those with migraine without aura (p = 0.016). A significant decrease in GLP-1 levels was observed in patients experiencing pain localized in the occipital lobe (p = 0.01). Conclusions Serum GLP-1 and DPP-4 levels were lower in migraine patients. Given the role of GLP-1 in the central nervous system, reduced GLP-1 may contribute to migraine pain. Similarly, low DPP-4, which metabolizes GLP-1, may be linked to these findings and could trigger attacks by increasing blood CGRP levels.