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Chen J, Huang Y, Liu C, Chi J, Wang Y, Xu L. The role of C-peptide in diabetes and its complications: an updated review. Front Endocrinol (Lausanne) 2023; 14:1256093. [PMID: 37745697 PMCID: PMC10512826 DOI: 10.3389/fendo.2023.1256093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Worldwide, diabetes and its complications have seriously affected people's quality of life and become a serious public health problem. C-peptide is not only an indicator of pancreatic β-cell function, but also a biologically active peptide that can bind to cell membrane surface signaling molecules and activate downstream signaling pathways to play antioxidant, anti-apoptotic and inflammatory roles, or regulate cellular transcription through internalization. It is complex how C-peptide is related to diabetic complications. Both deficiencies and overproduction can lead to complications, but their mechanisms of action may be different. C-peptide replacement therapy has shown beneficial effects on diabetic complications in animal models when C-peptide is deficient, but results from clinical trials have been unsatisfactory. The complex pattern of the relationship between C-peptide and diabetic chronic complications has not yet been fully understood. Future basic and clinical studies of C-peptide replacement therapies will need to focus on baseline levels of C-peptide in addition to more attention also needs to be paid to post-treatment C-peptide levels to explore the optimal range of fasting C-peptide and postprandial C-peptide maintenance.
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Affiliation(s)
| | | | | | | | - Yangang Wang
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Xu
- Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Ahmadirad H, Teymoori F, Mokhtari E, Jahromi MK, Norouzzadeh M, Tavakkoli S, Shahrokhtabar T, Farhadnejad H, Mirmiran P. Serum C-peptide level and the risk of cardiovascular diseases mortality and all-cause mortality: a meta-analysis and systematic review. Front Cardiovasc Med 2023; 10:1205481. [PMID: 37485272 PMCID: PMC10360119 DOI: 10.3389/fcvm.2023.1205481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Aims and background Recently, the serum of C-peptide has been the focus of researchers as a possible predictor of mortality. However, the possible association of serum C-peptide with cardiovascular diseases (CVDs) mortality and all-cause mortality has not been clearly identified. This meta-analysis aimed to assess the relationship between serum C-peptide and the risk of CVDs mortality and all-cause mortality. Methods A comprehensive and systematic search was performed in various important databases, including the PubMed, Web of Science, and Scopus to find relevant studies up to November 2022. The reported hazard ratio (HR) [95% confidence interval (CI)] for all studies was converted into log HR, and their SD was calculated. Then to compute the pooled HR, the random-effects model with inverse variance weighting method was performed. Results Twenty-three studies were included in the meta-analysis. Fourteen studies reported HR for all-cause mortality, and nine studies for CVDs-related mortality. The pooled results indicate a significant association between serum C-peptide and the risk of all-cause mortality (HR: 1.22; 95% CI: 1.12-1.32, I2 = 76.8%; P-value < 0.001). Also, higher serum C-peptide was related to the increased risk of CVDs mortality (HR: 1.38; 95% CI: 1.08-1.77, I2 = 81.8%; P-value = 0.012). Conclusions Our investigation suggested that an increased level of serum C-peptide is associated with a higher risk of both CVDs and all-cause mortality. Further, large-scale studies and sufficient samples are recommended to present a convincing link between C-peptide and the risk of CVDs and all-cause mortality. Systematic Review Registration identifier, CRD42022364842.
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Affiliation(s)
- Hamid Ahmadirad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Mokhtari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mitra Kazemi Jahromi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, BandarAbbas, Iran
| | - Mostafa Norouzzadeh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Tavakkoli
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Tahere Shahrokhtabar
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Farhadnejad
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zhou J, Yuan Y, Li X. The association between C-peptide and atrial cardiomyopathy in nondiabetic adults: results from NHANES III. Heart Vessels 2023:10.1007/s00380-023-02259-4. [PMID: 36928669 DOI: 10.1007/s00380-023-02259-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
Serum C-peptide exhibits various biological activities. The relationship between C-peptide and atrial cardiomyopathy remains unknown. We aimed to investigate the association between C-peptide level and atrial cardiomyopathy in nondiabetic adults. Our study enrolled 4578 participants without diagnosed diabetes from the Third National Health and Nutrition Examination Survey (NHANES III). Atrial cardiomyopathy was defined as a deep terminal negative P wave in V1 below - 100 µV (more negative), according to the electrocardiogram. The participants were categorized into low C-peptide (≤ 1.46 nmol/L) and high C-peptide (> 1.46 nmol/L) groups, according to the receiver operating characteristic analysis. Odds ratio (OR) and 95% confidence interval (CI) for the association between C-peptide level and atrial cardiomyopathy were generated using multivariate logistic regression analysis. The prevalence of atrial cardiomyopathy was higher in the high C-peptide group than in the low C-peptide group (5.62% vs. 2.31%, P < 0.001, respectively). Multivariate logistic regression analysis showed that participants in the high C-peptide group had a 3.60-fold (95% CI 1.81-6.99) higher risk of atrial cardiomyopathy than those in the low C-peptide group. Per standard deviation increase in C-peptide was linked to a 1.20-fold (95% CI 1.00-1.41) higher risk in atrial cardiomyopathy. High C-peptide level might be an independent risk factor for atrial cardiomyopathy in nondiabetic adults.
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Affiliation(s)
- Jingliang Zhou
- Department of Cardiology, Peking University People's Hospital, 11Th South Street, Xicheng District, Beijing, 100044, China
| | - Yanping Yuan
- Department of Endocrinology, Peking University People's Hospital, Beijing, 100044, China
| | - Xuebin Li
- Department of Cardiology, Peking University People's Hospital, 11Th South Street, Xicheng District, Beijing, 100044, China.
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Zhao E, Chen S. Association of serum C-peptide with all-cause and cardiovascular disease mortality in ultrasound-defined nonalcoholic fatty liver disease. Clin Res Hepatol Gastroenterol 2022; 46:102002. [PMID: 35973558 DOI: 10.1016/j.clinre.2022.102002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/25/2022] [Accepted: 08/09/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine the prognostic value of C-peptide in long-term nonalcoholic fatty liver disease (NAFLD) mortality. METHODS A total of 4670 participants with NAFLD were enrolled in this study. Multivariable Cox regression models evaluated the links between C-peptide levels and all-cause and cardiovascular disease (CVD) mortality risk using adjusted hazard ratios (aHR). In addition, a two‑piecewise Cox model with penalized splines was adapted to investigate the nonlinear relationships between C-peptide and mortality. RESULTS After a mean follow‑up period of 20 years, 1714 deaths from all causes were recorded. In an adjusted Cox regression analysis, using the low C-peptide group as the reference (quartile 1), higher C-peptide (quartile 4) was notably associated with increased all-cause mortality (aHR =1.39; 95% CI: 1.18-1.65) and CVD death (aHR = 1.97; 95% CI: 1.41-2.76). Spline analyses demonstrated that the association between C-peptide levels and all-cause mortality was U-shaped, with a threshold value of 0.41 nmol/L. Below the threshold, every one-unit increment in C-peptide had a 70% reduced risk of all-cause death (aHR = 0.30, 95% CI: 0.1-0.7). Above the threshold, the C-peptide levels were associated with a higher probability of all-cause death (aHR = 1. 3, 95% CI:1.2-1.4). CONCLUSIONS In the US NAFLD population defined by ultrasound, a U-shaped association was detected between baseline serum C-peptide level and all-cause mortality.
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Affiliation(s)
- Enfa Zhao
- Department of Ultrasound, the First Affiliated Hospital of Anhui Medical University, Shushan District, Hefei, Anhui, China
| | - Shimin Chen
- Department of Gastroenterology, Traditional Chinese Medical Hospital of Taihe Country, No 59, Tuanjie West Road, Taihe County, Fuyang 236600, Anhui Province, China.
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Maddaloni E, Bolli GB, Frier BM, Little RR, Leslie RD, Pozzilli P, Buzzetti R. C-peptide determination in the diagnosis of type of diabetes and its management: A clinical perspective. Diabetes Obes Metab 2022; 24:1912-1926. [PMID: 35676794 PMCID: PMC9543865 DOI: 10.1111/dom.14785] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/21/2022] [Accepted: 06/01/2022] [Indexed: 12/19/2022]
Abstract
Impaired beta-cell function is a recognized cornerstone of diabetes pathophysiology. Estimates of insulin secretory capacity are useful to inform clinical practice, helping to classify types of diabetes, complication risk stratification and to guide treatment decisions. Because C-peptide secretion mirrors beta-cell function, it has emerged as a valuable clinical biomarker, mainly in autoimmune diabetes and especially in adult-onset diabetes. Nonetheless, the lack of robust evidence about the clinical utility of C-peptide measurement in type 2 diabetes, where insulin resistance is a major confounder, limits its use in such cases. Furthermore, problems remain in the standardization of the assay for C-peptide, raising concerns about comparability of measurements between different laboratories. To approach the heterogeneity and complexity of diabetes, reliable, simple and inexpensive clinical markers are required that can inform clinicians about probable pathophysiology and disease progression, and so enable personalization of management and therapy. This review summarizes the current evidence base about the potential value of C-peptide in the management of the two most prevalent forms of diabetes (type 2 diabetes and autoimmune diabetes) to address how its measurement may assist daily clinical practice and to highlight current limitations and areas of uncertainties to be covered by future research.
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Affiliation(s)
- Ernesto Maddaloni
- Experimental Medicine DepartmentSapienza University of RomeRomeItaly
| | - Geremia B. Bolli
- Department of Medicine and Surgery, Section of Endocrinology and MetabolismUniversity of PerugiaPerugiaItaly
| | - Brian M. Frier
- The Queen's Medical Research InstituteUniversity of EdinburghEdinburghScotlandUK
| | - Randie R. Little
- Department of Pathology and Anatomical SciencesUniversity of MissouriColumbiaMissouriUSA
| | - Richard D. Leslie
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Paolo Pozzilli
- Centre for Immunobiology, Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
- Department of MedicineUnit of Endocrinology and Diabetes, Campus Bio‐Medico University of RomeRomeItaly
| | - Raffaela Buzzetti
- Experimental Medicine DepartmentSapienza University of RomeRomeItaly
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Mahmoodi MR, Najafipour H. Association of C-peptide and lipoprotein(a) as two predictors with cardiometabolic biomarkers in patients with type 2 diabetes in KERCADR population-based study. PLoS One 2022; 17:e0268927. [PMID: 35609059 PMCID: PMC9128999 DOI: 10.1371/journal.pone.0268927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
We sought association between serum Lipoprotein(a) and C-Peptide levels as two predictors with cardiometabolic biomarkers in patients with type 2 diabetes mellitus. This nested case-control study was conducted on 253 participants with type 2 diabetes mellitus and control from the second phase of the KERCADR cohort study. The participants were randomly allocated into case and control groups. The quantitative levels of Lipoprotein(a) and C-Peptide were measured by ELISA. Atherogenic indices of plasma were measured. The plasma Atherogenic Index of Plasma significantly decreased (P = 0.002) in case-male participants, and plasma Castelli Risk Index II level significantly increased (P = 0.008) in control-male participants with the highest dichotomy of Lipoprotein(a). The plasma Atherogenic Index of Plasma level in case-female participants significantly increased (P = 0.023) with the highest dichotomy of C-Peptide. Serum C-Peptide level significantly increased (P = 0.010 and P = 0.002, respectively) in control-male participants with the highest dichotomies of Atherogenic Index of Plasma and Castelli Risk Index I. There was a significant association between the highest quartile of C-Peptide and higher anthropometric values in case participants; and higher atherogenic indices of plasma and anthropometric values in control participants. Raised serum C-peptide than raised Lipoprotein(a) can be a prior predictor for cardiometabolic disease risk in healthy participants and patients with type 2 diabetes mellitus with increased cardiometabolic biomarkers. Case and control males with general and visceral obesity and case and control females with visceral obesity are exposure to increased C-peptide, respectively. Lipoprotein(a) may be risk independent biomarker for type 2 diabetes mellitus. Reducing raised Lipoprotein(a) levels to less than 30ng/ml with strict control of low density lipoprotein cholesterol would be the best approach to prevent coronary artery disease consequences. It is suggested that a screening system be set up to measure the Lp(a) levels in the community for seemingly healthy people or individuals with one or more cardiometabolic biomarkers.
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Affiliation(s)
- Mohammad Reza Mahmoodi
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
- * E-mail:
| | - Hamid Najafipour
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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Association of low fasting C-peptide levels with cardiovascular risk, visit-to-visit glucose variation and severe hypoglycemia in the Veterans Affairs Diabetes Trial (VADT). Cardiovasc Diabetol 2021; 20:232. [PMID: 34879878 PMCID: PMC8656002 DOI: 10.1186/s12933-021-01418-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/06/2021] [Indexed: 01/01/2023] Open
Abstract
Aims Low C-peptide levels, indicating beta-cell dysfunction, are associated with increased within-day glucose variation and hypoglycemia. In advanced type 2 diabetes, severe hypoglycemia and increased glucose variation predict cardiovascular (CVD) risk. The present study examined the association between C-peptide levels and CVD risk and whether it can be explained by visit-to-visit glucose variation and severe hypoglycemia. Materials and methods Fasting C-peptide levels at baseline, composite CVD outcome, severe hypoglycemia, and visit-to-visit fasting glucose coefficient of variation (CV) and average real variability (ARV) were assessed in 1565 Veterans Affairs Diabetes Trial participants. Results There was a U-shaped relationship between C-peptide and CVD risk with increased risk with declining levels in the low range (< 0.50 nmol/l, HR 1.30 [95%CI 1.05–1.60], p = 0.02) and with rising levels in the high range (> 1.23 nmol/l, 1.27 [1.00–1.63], p = 0.05). C-peptide levels were inversely associated with the risk of severe hypoglycemia (OR 0.68 [0.60–0.77]) and visit-to-visit glucose variation (CV, standardized beta-estimate − 0.12 [SE 0.01]; ARV, − 0.10 [0.01]) (p < 0.0001 all). The association of low C-peptide levels with CVD risk was independent of cardiometabolic risk factors (1.48 [1.17–1.87, p = 0.001) and remained associated with CVD when tested in the same model with severe hypoglycemia and glucose CV. Conclusions Low C-peptide levels were associated with increased CVD risk in advanced type 2 diabetes. The association was independent of increases in glucose variation or severe hypoglycemia. C-peptide levels may predict future glucose control patterns and CVD risk, and identify phenotypes influencing clinical decision making in advanced type 2 diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01418-z.
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Cui P, Chen Y, Waili N, Li Y, Ma C, Li Y. Associations of serum C-peptide and insulin-like growth factor binding proteins-3 with breast cancer deaths. PLoS One 2020; 15:e0242310. [PMID: 33180852 PMCID: PMC7660502 DOI: 10.1371/journal.pone.0242310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/31/2020] [Indexed: 12/22/2022] Open
Abstract
C-peptide is usually considered as a marker of insulin secretion and has no physiological function. This study aimed to assess the association between serum C-peptide level as independent risk factor and breast cancer and explored the possible underlying mechanisms. This was a population-based cohort study. All the data was collected according to a standard protocol. The C-peptide and insulin-like growth factor binding proteins-3(IGFBP-3) concentrations were measured in blood. The breast cancer deaths were confirmed by National Death Index records. Cox proportional hazard regression analysis was conducted to determine the hazard ratio of serum C-peptide level for breast cancer deaths. Analysis of covariance was used to assess the association between serum C-peptide and IGFBP-3 level, and the linear trend was tested by using a linear model. A total of 8,373 women 17 years of age or older were included in the study, and 57 breast cancer deaths were observed over the study period. The result of survival analysis showed that breast cancer deaths increased with increasing levels of serum C-peptide. The hazard ratio was 1.69 (95% confidence interval, 1.17–2.45). The levels of circulating IGFBP-3 were positively associated with changes in serum C-peptide levels and showed a strong linear trend in the covariance analysis. Serum C-peptide level was associated with increased risk of breast cancer death. Our results suggest that the increased risk of breast cancer death can be via a pathway that serum C-peptide level positive associated with the change in serum IGFBP-3 level.
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Affiliation(s)
- PinYu Cui
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuan Chen
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Nuremaguli Waili
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - YaXing Li
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - CuiLing Ma
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Li
- Department of Public Health, School of Medicine, Zhejiang University, Hangzhou, China
- * E-mail:
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Erendor F, Eksi YE, Sahin EO, Balci MK, Griffith TS, Sanlioglu S. Lentivirus Mediated Pancreatic Beta-Cell-Specific Insulin Gene Therapy for STZ-Induced Diabetes. Mol Ther 2020; 29:149-161. [PMID: 33130311 DOI: 10.1016/j.ymthe.2020.10.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/31/2020] [Accepted: 10/23/2020] [Indexed: 02/07/2023] Open
Abstract
Autoimmune destruction of pancreatic beta cells is the characteristic feature of type 1 diabetes mellitus. Consequently, both short- and intermediate-acting insulin analogs are under development to compensate for the lack of endogenous insulin gene expression. Basal insulin is continuously released at low levels in response to hepatic glucose output, while post-prandial insulin is secreted in response to hyperglycemia following a meal. As an alternative to multiple daily injections of insulin, glucose-regulated insulin gene expression by gene therapy is under development to better endure postprandial glucose excursions. Controlled transcription and translation of proinsulin, presence of glucose-sensing machinery, prohormone convertase expression, and a regulated secretory pathway are the key features unique to pancreatic beta cells. To take advantage of these hallmarks, we generated a new lentiviral vector (LentiINS) with an insulin promoter driving expression of the proinsulin encoding cDNA to sustain pancreatic beta-cell-specific insulin gene expression. Intraperitoneal delivery of HIV-based LentiINS resulted in the lowering of fasting plasma glucose, improved glucose tolerance and prevented weight loss in streptozoticin (STZ)-induced diabetic Wistar rats. However, the combinatorial use of LentiINS and anti-inflammatory lentiviral vector (LentiVIP) gene therapy was required to increase serum insulin to a level sufficient to suppress non-fasting plasma glucose and diabetes-related inflammation.
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Affiliation(s)
- Fulya Erendor
- Department of Gene and Cell Therapy, Faculty of Medicine, Akdeniz University, Antalya 07058, Turkey
| | - Yunus Emre Eksi
- Department of Gene and Cell Therapy, Faculty of Medicine, Akdeniz University, Antalya 07058, Turkey
| | - Elif Ozgecan Sahin
- Department of Gene and Cell Therapy, Faculty of Medicine, Akdeniz University, Antalya 07058, Turkey
| | - Mustafa Kemal Balci
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Akdeniz University, Antalya 07058, Turkey
| | - Thomas S Griffith
- Department of Urology, School of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Salih Sanlioglu
- Department of Gene and Cell Therapy, Faculty of Medicine, Akdeniz University, Antalya 07058, Turkey.
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Mazidi M, Katsiki N, Mikhailidis DP, Banach M. Effect of Dietary Insulinemia on All-Cause and Cause-Specific Mortality: Results From a Cohort Study. J Am Coll Nutr 2019; 39:407-413. [PMID: 31763961 DOI: 10.1080/07315724.2019.1646167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Insulin response to diet might predict the risk of mortality; however, the evidence is limited. We prospectively evaluated the link between the dietary hyperinsulinemia index (DHI) and dietary insulin resistance index (DIRI) with all-cause and cause-specific (cardiovascular disease [CVD] and cancer) mortality.Methods: The National Health and Nutrition Examination Survey (1999-2010) database was used. Vital status through December 31, 2011, was ascertained. Stepwise linear regression models consisted of 39 macro/micronutrients applied, and fasting plasma C-peptide for the DHI and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) for the DIRI were used. Adjusted Cox regression (followed by propensity score matching) was performed to determine the hazard ratios (HRs) and 95% confidence interval (95% CIs).Results: Overall, 22,246 participants were included (mean age = 47.8 years; 48.9% men). There was a significant increasing risk of mortality across the quartiles of DHI, i.e., participants with a highest score of DHI (Q4) had a greater risk of all-cause (HR: 1.21, 95% CI: 1.17-1.26), CVD (HR: 1.17, 95% CI: 1.07-1.29), and cancer (HR: 1.15, 95% CI: 1.08-1.23) mortality compared with the first quartile (Q1; p < 0.001 for all comparisons). Similarly, participants in the highest DIRI quartile (Q4) had 23% and 31% higher risk of all-cause and CVD mortality, respectively, compared with Q1, while the association between cancer mortality and DIRI was non-significant (HR: 0.88, 95% CI: 0.35-2.61).Conclusions: These findings highlight, for the first time, the detrimental role (association) of insulinemia and insulin resistance potential of diet on all-cause and cause-specific mortality. Our findings support the role of C-peptide and TG/HDL-C ratio as cost-effective and practical biomarkers in clinical settings. These results need to be confirmed to establish their implications.
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Affiliation(s)
- Mohsen Mazidi
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.,Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.,Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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Rashad NM, Samir GM, Sabry HM, Mohy NM, El Shabrawy SM. Serum C peptide and carotid intima-medial thickness are independent markers of glucose intolerance among patients with ischemic cerebrovascular stroke. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_97_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pikkemaat M, Andersson T, Melander O, Chalmers J, Rådholm K, Bengtsson Boström K. C-peptide predicts all-cause and cardiovascular death in a cohort of individuals with newly diagnosed type 2 diabetes. The Skaraborg diabetes register. Diabetes Res Clin Pract 2019; 150:174-183. [PMID: 30878389 DOI: 10.1016/j.diabres.2019.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/30/2019] [Accepted: 03/07/2019] [Indexed: 02/02/2023]
Abstract
AIMS To study the association between baseline level of C-peptide and all-cause death, cardiovascular death and cardiovascular complications among persons with newly diagnosed type 2 diabetes. METHODS The Skaraborg Diabetes Register contains data on baseline C-peptide concentrations among 398 persons <65 years with newly diagnosed type 2 diabetes 1996-1998. National registries were used to determine all-cause death, cardiovascular death and incidence of myocardial infarction and ischemic stroke until 31 December 2014. The association between baseline C-peptide and outcomes were evaluated with adjustment for multiple confounders by Cox regression analysis. Missing data were handled by multiple imputation. RESULTS In the imputed and fully adjusted model there was a significant association between 1 nmol/l increase in C-peptide concentration and all-cause death (HR 2.20, 95% CI 1.49-3.25, p < 0.001, number of events = 104), underlying cardiovascular death (HR 2.69, 1.49-4.85, p = 0.001, n = 35) and the composite outcome of underlying cardiovascular death, myocardial infarction or ischemic stroke (HR 1.61, 1.06-2.45, p = 0.027, n = 90). CONCLUSIONS Elevated C-peptide levels at baseline in persons with newly diagnosed type 2 diabetes are associated with increased risk of all-cause and cardiovascular mortality. C-peptide might be used to identify persons at high risk of cardiovascular complications and premature death.
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Affiliation(s)
- Miriam Pikkemaat
- Husensjö Health Care Center, Helsingborg, Sweden; Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Sweden.
| | - Tobias Andersson
- Närhälsan Norrmalm Health Centre, Skövde, Sweden; Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Olle Melander
- Department of Medicine, Malmö University Hospital, Lund University, Sweden
| | - John Chalmers
- The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Australia
| | - Karin Rådholm
- The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Australia; Division of Community Medicine, Primary Care, Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Department of Local Care West, County Council of Östergötland, Linköping, Sweden
| | - Kristina Bengtsson Boström
- Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; R&D Center Skaraborg Primary Care, Skövde, Sweden
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Xu J, Wang X, Xu P, Liu S, Teng F, Liu X, Zhu Q, Hua X, Gong Z, Jia X. Mass spectrometry-based peptidome profiling of human serous ovarian cancer tissues. Int J Biochem Cell Biol 2018; 107:53-61. [PMID: 30543932 DOI: 10.1016/j.biocel.2018.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/23/2018] [Accepted: 12/07/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Bioactive peptides existing in vivo have been considered as an important class of natural medicines for the treatment of diseases. Peptidome analysis of tissues and biofluids had provided important information about the differentially expressed bioactive peptides in vivo. METHODS Here, we analyzed the peptidome of serous ovarian cancer tissue samples and normal ovarian epithelial tissue samples by mass spectrometry and further investigated the possible bioactive peptides that were differentially expressed. RESULTS We identified 634 differentially expressed peptides, 508 of these peptides were highly abundant in serous ovarian cancer tissues, a result consistent with higher protease activity in ovarian cancer patients. The difference in preferred cleavage sites between the serous ovarian cancer tissues and normal ovarian epithelium indicated the characteristic peptidome of ovarian cancer and the nature of cancer-associated protease activity. Interestingly, KEGG pathway analysis of the peptide precursors indicated that the differentially regulated pathways in ovarian cancer are highly consistent with the pathways discovered in other cancers. Besides, we found that a proportion of the differentially expressed peptides are similar to the known immune-regulatory peptides and anti-bacterial peptides. Then we further investigated the function of the two down-regulated peptides in ovarian cancer cells and found that peptide P1DS significantly inhibited the invasion and migration of OVCAR3 and SKOV3 ovarian cancer cells. CONCLUSIONS Our results are the first to identify the differentially expressed peptides between the serous ovarian cancer tissue and the normal ovarian epithelium. Our results indicate that bioactive peptides involved in tumorigenesis are existed in vivo.
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Affiliation(s)
- Juan Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Xusu Wang
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Pengfei Xu
- Nanjing Maternal and Child Health Institute, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Siyu Liu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Fang Teng
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Xiaoguang Liu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Qiaoying Zhu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Xiangdong Hua
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Zhen Gong
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China
| | - Xuemei Jia
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, 210004, China.
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Andrade RLM, Gigante DP, de Oliveira IO, Horta BL. C-Peptide and cardiovascular risk factors among young adults in a southern Brazilian cohort. BMC Endocr Disord 2018; 18:80. [PMID: 30400868 PMCID: PMC6218973 DOI: 10.1186/s12902-018-0308-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 10/17/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Proinsulin connecting peptide (C-Peptide) is a marker of the beta-cell function and has been considered a marker of insulin resistance whose evidence suggests were associated with cardiovascular mortality. Our study aims to evaluate the association of C-Peptide with metabolic cardiovascular risk factors among young adults followed since birth in southern Brazil. METHODS In 1982, maternity hospital in Pelotas, a southern Brazilian city, were visited daily and all births were identified. Live births whose family lived in the urban area of the city were identified, their mothers interviewed, and these subjects have been prospectively followed. Casual hyperglycemia patients were excluded from analysis. C-Peptide was assessed at 23 years, when transversely analyzed its association with cardiometabolic and hemodynamic risk factors, and longitudinally 30 years of age. RESULTS At age 23, 4297 individuals were evaluated, and C-Peptide was measured in 3.807. In a cross-sectional analysis at 23 years of age, C-Peptide was positively associated with waist circumference, body mass index, glycaemia, triglycerides, and C-reactive protein. The association with HDL cholesterol was negative. In the longitudinal analysis at 30 years, C-Peptide remained associated with BMI, waist circumference, glycated hemoglobin, triglycerides, and C-reactive protein, whereas the association was negative for HDL. CONCLUSION In the Pelotas birth cohort, the C-Peptide was associated with obesity indicators (waist circumference and BMI) cross-sectional (23 years) and longitudinal (30 years). We also observed cross-sectional and longitudinal associations of C-Peptide with cardiometabolic and inflammatory risk factors.
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Affiliation(s)
- Romildo Luiz Monteiro Andrade
- University Hospital Cassiano Antônio de Moraes (HUCAM) of the Federal, University of Espírito Santo (UFES), Vitória-ES, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas-RS, Brazil
- Vitória, Brazil
| | - Denise P. Gigante
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas-RS, Brazil
| | | | - Bernardo Lessa Horta
- Post-Graduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas-RS, Brazil
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Wahab N, Chen R, Curb JD, Willcox BJ, Rodriguez BL. The Association of Fasting Glucose, Insulin, and C-Peptide, with 19-Year Incidence of Coronary Heart Disease in Older Japanese-American Men; the Honolulu Heart Program. Geriatrics (Basel) 2018; 3. [PMID: 30555835 PMCID: PMC6290673 DOI: 10.3390/geriatrics3020022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The role of fasting glucose, insulin levels, and C-peptide in coronary heart disease (CHD) in non-diabetic individuals remains uncertain. We examined the association between fasting glucose, insulin and C-peptide with the long-term incidence of CHD in Japanese-American men. In 1980–1982, from a random sample of the Honolulu Heart Program men (n = 1378), aged 61–81 years, data on several CHD and metabolic risk factors were obtained to examine the relation of fasting glucose, insulin and C-peptide to 19-year CHD incidence. Age-adjusted incidence of CHD increased with increasing quintiles of glucose, insulin and C-peptide. Age-adjusted CHD rates in the glucose quintiles were 11.9, 11.6, 14.4, 18.1 and 24.1 per 1000 person-years (trend p < 0.001). In individual Cox models (lowest quintiles of glucose, insulin and C-peptide as reference) the relative risks (95% confidence interval) of CHD incidence for the glucose quintiles adjusting for age, smoking, hypertension, cholesterol, physical activity, and body mass index, were 0.9 (0.6–1.4), 1.2 (0.8–1.8), 1.4 (0.9–2.2), and 1.7 (1.1–2.6), respectively (trend p = 0.004). Insulin and C-peptide were not significantly associated with CHD on multivariate analysis. Fasting glucose remained the only significant predictor of increased CHD risk (p = 0.003) in a model combining all 3 metabolic variables. In this cohort, only fasting glucose independently predicts long-term incidence of CHD. Age-adjusted insulin and C-peptide levels were associated with CHD incidence, but after adjustment for other risk factors, do not independently predict CHD.
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Affiliation(s)
- Nazneem Wahab
- CK Hui Heart Centre, Division of Cardiology, Royal Alexandra Hospital, University of Alberta, Rm 6S132A Robbins Pavillion, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada
- Correspondence: ; Tel.: +1-780-428-3246
| | - Randi Chen
- Department of Research, Kuakini Medical Center, 347 N. Kuakini St, Honolulu, Hawaii, 96817, USA; (R.C.); (B.J.W.)
| | - Jess David Curb
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Hale Pulama Mau, 9th Floor, 347 N. Kuakini St, Honolulu, Hawaii, 96817, USA;
- Escuela deMedicina, Tecnologico deMonterrey, AvenidaMorones Prieto 3000, Monterrey, NL, 64710, Mexico
| | - Bradley J. Willcox
- CK Hui Heart Centre, Division of Cardiology, Royal Alexandra Hospital, University of Alberta, Rm 6S132A Robbins Pavillion, 10240 Kingsway Avenue, Edmonton, AB T5H 3V9, Canada
- Escuela deMedicina, Tecnologico deMonterrey, AvenidaMorones Prieto 3000, Monterrey, NL, 64710, Mexico
| | - Beatriz L. Rodriguez
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, Hale Pulama Mau, 9th Floor, 347 N. Kuakini St, Honolulu, Hawaii, 96817, USA;
- Escuela deMedicina, Tecnologico deMonterrey, AvenidaMorones Prieto 3000, Monterrey, NL, 64710, Mexico
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梁 倩, 汪 新, 胡 豪, 赖 嘉, 姚 伟, 陈 妙, 饶 茜. [Correlation between fasting C-peptide and serum uric acid in patients with type 2 diabetes mellitus]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:490-495. [PMID: 29735453 PMCID: PMC6765660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To explore the relationship between fasting C-peptide (F-CP) and serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 347 hospitalized patients with T2DM were stratified according to F-CP level to analyze the impact of increased F-CP levels on SUA level and the incidence of hyperuricemia (HUA). The patients with an elevated SUA level (>420 µmol/L) and a normal SUA level (≤420 µmol/L) were compared for general data, fasting C-peptide and other clinical indexes. Pearson or Spearman correlation analysis was used to analyze the correlation of SUA level with F-CP levels and other parameters. The risk factors of elevated SUA were analyzed by binary logistic regression, multiple regression analysis and hierarchical interaction analysis. The ROC curve was used to analyze the independent risk factors of elevated SUA and determine the corresponding cut-off values. RESULTS Compared with those with a normal SUA level, patients with elevated SUA had higher body mass index (BMI), waist-to-hip ratio, F-CP, postprandial 2hC peptide (2hP-CP), triglyceride (TG), homocysteine (HCY), serum creatinine (SCr) level (P<0.05), and a greater percentage of drinking (44.8% vs 32.6%, P=0.006), but had significantly lowered levels of HbA1c, high-density lipoprotein (HDL), and estimated glomerular filtration rate (eGFR) (P<0.05). SUA was found to be positively correlated with F-CP, 2hP-CP, BMI, waist-to-hip ratio, diastolic blood pressure, TG, HCY, SCr, smoking and drinking (P<0.05), and was negatively correlated with gender, age, age of disease onset, HbA1c, HDL and eGFR (P<0.05). SUA level and the incidence of hyperuricemia increasea significantly with F-CP level (P<0.05). F-CP was identified as an independent risk factor for elevated SUA, and gender did not affect the relationship between F-CP and SUA. ROC curve analysis showed that a F-CP level >1.260 ng/mL was associated with a significantly increased risk of hyperuricemia in T2DM patients. CONCLUSION F-CP is closely related with SUA and may be an independent risk factor of elevated SUA in patients with T2DM.
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Affiliation(s)
- 倩 梁
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 新宇 汪
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 豪飞 胡
- 深圳市第二人民医院内分泌科肾内科,广东 深圳 518037Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen 518037, China
| | - 嘉宝 赖
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
| | - 伟力 姚
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 妙玲 陈
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 茜 饶
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
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梁 倩, 汪 新, 胡 豪, 赖 嘉, 姚 伟, 陈 妙, 饶 茜. [Correlation between fasting C-peptide and serum uric acid in patients with type 2 diabetes mellitus]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:490-495. [PMID: 29735453 PMCID: PMC6765660 DOI: 10.3969/j.issn.1673-4254.2018.04.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the relationship between fasting C-peptide (F-CP) and serum uric acid (SUA) in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 347 hospitalized patients with T2DM were stratified according to F-CP level to analyze the impact of increased F-CP levels on SUA level and the incidence of hyperuricemia (HUA). The patients with an elevated SUA level (>420 µmol/L) and a normal SUA level (≤420 µmol/L) were compared for general data, fasting C-peptide and other clinical indexes. Pearson or Spearman correlation analysis was used to analyze the correlation of SUA level with F-CP levels and other parameters. The risk factors of elevated SUA were analyzed by binary logistic regression, multiple regression analysis and hierarchical interaction analysis. The ROC curve was used to analyze the independent risk factors of elevated SUA and determine the corresponding cut-off values. RESULTS Compared with those with a normal SUA level, patients with elevated SUA had higher body mass index (BMI), waist-to-hip ratio, F-CP, postprandial 2hC peptide (2hP-CP), triglyceride (TG), homocysteine (HCY), serum creatinine (SCr) level (P<0.05), and a greater percentage of drinking (44.8% vs 32.6%, P=0.006), but had significantly lowered levels of HbA1c, high-density lipoprotein (HDL), and estimated glomerular filtration rate (eGFR) (P<0.05). SUA was found to be positively correlated with F-CP, 2hP-CP, BMI, waist-to-hip ratio, diastolic blood pressure, TG, HCY, SCr, smoking and drinking (P<0.05), and was negatively correlated with gender, age, age of disease onset, HbA1c, HDL and eGFR (P<0.05). SUA level and the incidence of hyperuricemia increasea significantly with F-CP level (P<0.05). F-CP was identified as an independent risk factor for elevated SUA, and gender did not affect the relationship between F-CP and SUA. ROC curve analysis showed that a F-CP level >1.260 ng/mL was associated with a significantly increased risk of hyperuricemia in T2DM patients. CONCLUSION F-CP is closely related with SUA and may be an independent risk factor of elevated SUA in patients with T2DM.
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Affiliation(s)
- 倩 梁
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 新宇 汪
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 豪飞 胡
- 深圳市第二人民医院内分泌科肾内科,广东 深圳 518037Department of Nephrology, Shenzhen Second People's Hospital, Shenzhen 518037, China
| | - 嘉宝 赖
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
| | - 伟力 姚
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 妙玲 陈
- 深圳市第二人民医院内分泌科, 广东 深圳 518037Department of Endocrinology, Shenzhen Second People's Hospital, Shenzhen 518037, China
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
| | - 茜 饶
- 深圳大学医学部,广东 深圳 518060Shenzhen University Health Science Center, Shenzhen 518060, China
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Andrade RLM, Callo G, Horta BL. Peptídeo C e mortalidade cardiovascular: revisão sistemática e metanálise. Rev Panam Salud Publica 2018; 43:e23. [PMID: 31093247 PMCID: PMC6459372 DOI: 10.26633/rpsp.2019.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 10/25/2018] [Indexed: 11/24/2022] Open
Abstract
Objetivo Analisar as evidências de associação entre peptídeo C e mortalidade cardiovascular e geral disponíveis na literatura. Métodos Foi realizada uma revisão sistemática das bases de dados MEDLINE e EMBASE. Foram incluídos artigos publicados em inglês, português ou espanhol relatando estudos observacionais que investigaram a associação entre o peptídeo C e a mortalidade cardiovascular e geral. Buscou-se ainda avaliar a associação entre peptídeo C e fatores de risco cardiometabólicos, fatores hemodinâmicos e medidas antropométricas. A qualidade metodológica dos estudos foi avaliada de acordo com os critérios da escala Newcastle-Ottawa. Resultados Foram identificados 107 estudos relacionados ao tema. Ao final do processo de triagem, foram incluídos 18 artigos que apresentavam dados sobre a associação entre peptídeo C e risco cardiovascular. Cinco estudos forneceram dados sobre a relação entre peptídeo C e mortalidade cardiovascular e geral. O peptídeo C esteve associado positivamente ao IMC em chineses, e inversamente ao HDL colesterol em amostras populacionais na Ásia, Oriente Médio e Estados Unidos. Todavia, não foi possível realizar metanálise para os componentes de risco cardiovascular. Por outro lado, o peptídeo C esteve associado com a mortalidade cardiovascular (RR = 1,62; IC95%: 0,99 a 2,66) e geral (RR = 1,39; IC95%: 1,04 a 1,84). Conclusão Na revisão sistemática e metanálise realizadas, os níveis séricos de peptídeo C estiveram associados positivamente com a mortalidade geral em todos os indivíduos e com a mortalidade cardiovascular em pessoas sem comorbidades. Com base nesses resultados, é possível recomendar o emprego do peptídeo C na prática clínica como proxy da condição de resistência à insulina associada a mortalidade cardiovascular.
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Affiliation(s)
| | - Gabriela Callo
- Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Epidemiologia, Pelotas (RS), Brasil
| | - Bernardo Lessa Horta
- Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Epidemiologia, Pelotas (RS), Brasil
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de Medeiros SF, Angelo LCA, de Medeiros MAS, Banhara CR, Barbosa BB, Yamamoto MMW. The Role of C-Peptide as Marker of Cardiometabolic Risk in Women With Polycystic Ovary Syndrome: A Controlled Study. J Clin Med Res 2018; 10:260-267. [PMID: 29416587 PMCID: PMC5798275 DOI: 10.14740/jocmr3325w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/12/2018] [Indexed: 12/20/2022] Open
Abstract
Background The aim of this study was to examine the role of C-peptide as a biological marker of cardiometabolic risk in polycystic ovary syndrome (PCOS). Methods This case-control study enrolled 385 PCOS patients and 240 normal cycling women. Anthropometric and clinical variables were taken at first visit. Fasting C-peptide, glucose, lipids, and hormone measurements were performed. Simple and multiple correlations between C-peptide and other variables associated with dysmetabolism and cardiovascular disease were examined. Results C-peptide was well correlated with several anthropometric, metabolic, and endocrine parameters. In PCOS patients, stepwise multiple regression including C-peptide as the criterion variable and other predictors of cardiovascular disease risk provided a significant model in which the fasting C-peptide/glucose ratio, glucose, body weight, and free estrogen index (FEI) were retained (adjusted R2 = 0.988, F = 7.161, P = 0.008). Conclusion C-peptide levels alone or combined with C-peptide/glucose ratio, glucose, body weight, and FEI provided a significant model to identify PCOS patients with higher risk of future cardiometabolic diseases.
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Affiliation(s)
- Sebastiao Freitas de Medeiros
- Department of Gynecology and Obstetrics, Medical School, Federal University of Mato Grosso, Cuiaba, MT, Brazil.,Tropical Institute of Reproductive Medicine, Cuiaba, MT, Brazil
| | - Laura Camila Antunes Angelo
- Department of Gynecology and Obstetrics, Medical School, Federal University of Mato Grosso, Cuiaba, MT, Brazil
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Little RR, Wielgosz RI, Josephs R, Kinumi T, Takatsu A, Li H, Stein D, Burns C. Implementing a Reference Measurement System for C-Peptide: Successes and Lessons Learned. Clin Chem 2017; 63:1447-1456. [PMID: 28646033 PMCID: PMC5575958 DOI: 10.1373/clinchem.2016.269274] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/25/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Assessment of endogenous insulin secretion by measuring C-peptide concentrations is widely accepted. Recent studies have shown that preservation of even small amounts of endogenous C-peptide production in patients with type 1 diabetes reduces risks for diabetic complications. Harmonization of C-peptide results will facilitate comparison of data from different research studies and later among clinical laboratory results at different sites using different assay methods. CONTENT This review provides an overview of the general process of harmonization and standardization and the challenges encountered with implementing a reference measurement system for C-peptide. SUMMARY Efforts to harmonize C-peptide results are described, including those by the National Institute of Diabetes and Digestive and Kidney Diseases-led C-peptide Standardization Committee in the US, activities in Japan, efforts by the National Institute for Biological Standards and Control in the UK, as well as activities led by the Bureau International des Poids et Mesures and the National Metrology Institute in China. A traceability scheme is proposed along with the next steps for implementation. Suggestions are made for better collaboration to optimize the harmonization process for other measurands.
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Affiliation(s)
- Randie R Little
- Department of Pathology and Anatomical Sciences, University of Missouri School of Medicine, Columbia, MO;
| | | | - Ralf Josephs
- Bureau International des Poids et Mesures, Sèvres Cedex, France
| | - Tomoya Kinumi
- Bio-Medical Standards Group, National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan
| | - Akiko Takatsu
- Bio-Medical Standards Group, National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, Ibaraki, Japan
| | - Hongmei Li
- National Institute of Metrology, Beijing, China
| | - Daniel Stein
- Division of Endocrinology and Metabolism, Diabetes Research and Training Center, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
| | - Chris Burns
- National Institute for Biological Standards and Control, South Mimms, UK
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Cardellini M, Farcomeni A, Ballanti M, Morelli M, Davato F, Cardolini I, Grappasonni G, Rizza S, Guglielmi V, Porzio O, Pecchioli C, Menghini R, Ippoliti A, Federici M. C-peptide: A predictor of cardiovascular mortality in subjects with established atherosclerotic disease. Diab Vasc Dis Res 2017; 14:395-399. [PMID: 28565926 DOI: 10.1177/1479164117710446] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
AIM Insulin resistance and type 2 diabetes are independent risk factors for cardiovascular diseases. Levels of C-peptide are increased in these patients and its role in the atherosclerosis progression was studied in vitro and in vivo over the past years. To evaluate the possible use of C-peptide as cardiovascular biomarkers, we designed an observational study in which we enrolled patients with mono- or poly-vascular atherosclerotic disease. METHODS We recruited 431 patients with stable atherosclerosis and performed a yearly follow-up to estimate the cardiovascular and total mortality and cardiovascular events. RESULTS We performed a mean follow-up of 56 months on 268 patients. A multivariate Cox analysis showed that C-peptide significantly increased the risk of cardiovascular mortality [Hazard Ratio: 1.29 (95% confidence interval: 1.02-1.65, p < 0.03513)] after adjustment for age, sex, diabetes treatment, estimated glomerular filtration rate and known diabetes status. Furthermore, levels of C-peptide were significantly correlated with metabolic parameters and atherogenic factors. CONCLUSION C-peptide was associated with cardiovascular mortality independently of known diabetes status in a cohort of patients with chronic atherosclerotic disease. Future studies using C-peptide into a reclassification approach might be undertaken to consider its potential as a cardiovascular disease biomarker.
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Affiliation(s)
- Marina Cardellini
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- 2 Center for Atherosclerosis, Policlinico Tor Vergata, Rome, Italy
| | - Alessio Farcomeni
- 3 Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy
| | - Marta Ballanti
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Monica Morelli
- 4 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Davato
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Iris Cardolini
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Grappasonni
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Stefano Rizza
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- 2 Center for Atherosclerosis, Policlinico Tor Vergata, Rome, Italy
| | - Valeria Guglielmi
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ottavia Porzio
- 4 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
- 5 Medical Laboratory Unit, Bambino Gesù Children's Hospital and Research Institute, IRCCS, Rome, Italy
| | - Chiara Pecchioli
- 2 Center for Atherosclerosis, Policlinico Tor Vergata, Rome, Italy
| | - Rossella Menghini
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Arnaldo Ippoliti
- 4 Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Federici
- 1 Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- 2 Center for Atherosclerosis, Policlinico Tor Vergata, Rome, Italy
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Shpakov AO. Mechanisms of action and therapeutic potential of proinsulin C-peptide. J EVOL BIOCHEM PHYS+ 2017. [DOI: 10.1134/s0022093017030024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Li Y, Zhao D, Li Y, Meng L, Enwer G. Serum C-peptide as a key contributor to lipid-related residual cardiovascular risk in the elderly. Arch Gerontol Geriatr 2017; 73:263-268. [PMID: 28869884 DOI: 10.1016/j.archger.2017.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 05/10/2017] [Accepted: 05/27/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The serum levels of C-peptide, an important risk factor for cardiovascular disease (CVD), increase with age. This study aimed to investigate the association between serum C-peptide and increased risk for CVD with altered lipid metabolism in the elderly. METHODS This was a population-based cross-sectional study that included 3091 elderly participants aged ≥65 years. Serum C-peptide and lipid levels were measured according to standard protocols. Sampling weights were used to estimate the characteristics of study participants. Stratified analysis of covariance was used to evaluate the changes in the serum lipid levels according to quartiles of serum C-peptide levels, and the linear trend was assessed using a linear model. The logistic regression model was carried out to determine the association between the serum C-peptide levels and serum lipid levels. RESULTS The results of the analysis of covariance stratified by sex and serum insulin level showed that the serum triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with changes in the serum C-peptide levels, independent of the serum insulin level. The logistic regression analyses indicated that the serum C-peptide levels were positively associated with the serum TG levels, and negatively associated with the serum HDL-C levels. A significant dose-response association was obtained in both men and women. CONCLUSIONS Serum C-peptide levels were strongly associated with increased serum TG and reduced HDL-C levels in the elderly. Our results suggest that serum C-peptide increases the risk of CVD via a pathway that increases TG or decreases HDL-C levels.
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Affiliation(s)
- Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, China.
| | - DuoDuo Zhao
- School of Basic Medical Sciences, Zhejiang University, China
| | - Yue Li
- School of Basic Medical Sciences, Zhejiang University, China
| | - Lu Meng
- Department of Social Medicine, School of Public Health, Zhejiang University, China
| | - Gulmire Enwer
- Department of Social Medicine, School of Public Health, Zhejiang University, China
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Abstract
C-peptide is a widely used measure of pancreatic beta cell function. It is produced in equimolar amounts to endogenous insulin but is excreted at a more constant rate over a longer time. Methods of estimation include urinary and unstimulated and stimulated serum sampling. Modern assays detect levels of c-peptide which can be used to guide diabetes diagnosis and management. We explore the evidence behind the various tests available. We recommend the glucagon stimulation c-peptide testing owing to its balance of sensitivity and practicality. C-peptide levels are associated with diabetes type and duration of disease. Specifically a c-peptide level of less than 0.2 nmol/l is associated with a diagnosis of type 1 diabetes mellitus (T1DM). C-peptide level may correlate with microvascular and macrovascular complications and future use of insulin therapy, as well as likely response to other individual therapies. We explore the potential uses of c-peptide measurement in clinical practice.
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Affiliation(s)
- Emma Leighton
- Diabetes Department, Gartnavel General Hospital, Glasgow, UK
| | | | - Gregory C Jones
- Diabetes Department, Gartnavel General Hospital, Glasgow, UK.
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Pikkemaat M, Melander O, Hjerpe P, Bengtsson Boström K. Prediction of treatment response in patients with newly diagnosed type 2 diabetes: the Skaraborg diabetes register. J Diabetes Complications 2017; 31:854-858. [PMID: 28319005 DOI: 10.1016/j.jdiacomp.2017.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/22/2017] [Accepted: 02/25/2017] [Indexed: 12/21/2022]
Abstract
AIMS Type 2 diabetes is associated with cardiovascular complications. It is largely unknown which patients have poor treatment response and high complication risk; biomarkers are studied for this purpose. The aim of the study was to investigate the association between clinical factors such as HbA1c, level of biomarkers (C-peptide, copeptin) at diagnosis and changes in HbA1c, blood pressure or body mass index (BMI) after five years. METHODS Clinical data and blood samples from 460 newly diagnosed type 2 diabetes patients from the Skaraborg diabetes register (SDR) at diagnosis and after 5years and were analyzed with linear and logistic regressions. RESULTS High BMI at diagnosis and smoking were associated with less reduction of HbA1c i.e. poorer treatment outcome after 5years. A high HbA1c at baseline predicted a greater reduction of HbA1c and need for insulin treatment. High systolic blood pressure and BMI at baseline were associated with greater reduction. The biomarkers were not associated with increase of blood pressure, HbA1c, BMI or need for insulin treatment. CONCLUSIONS Smokers and patients with high HbA1c at diagnosis respond poorer to treatment over 5years. This highlights the importance of advice for non-smoking and weight reduction and more intensive treatment over time.
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Affiliation(s)
- Miriam Pikkemaat
- Husensjö Health Care Centre, Skaragatan 102, 25363 Helsingborg, Sweden; Center for Primary Health Care Research, Department of Clinical Sciences, Jan Waldenströms gata 35, 205 02 Malmö, Lund University, Sweden.
| | - Olle Melander
- Department of Medicine, Malmö University Hospital, Södra Förstadsgatan 101, 21428 Malmö, Lund University, Sweden
| | - Per Hjerpe
- R&D Centre Skaraborg Primary Care, Långgatan 18, 541 30, Skövde, Sweden
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Marcelino Rodríguez I, Oliva García J, Alemán Sánchez JJ, Almeida González D, Domínguez Coello S, Brito Díaz B, Gannar F, Rodríguez Pérez MDC, Elosua R, Cabrera de León A. Lipid and inflammatory biomarker profiles in early insulin resistance. Acta Diabetol 2016; 53:905-913. [PMID: 27432443 DOI: 10.1007/s00592-016-0885-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 07/02/2016] [Indexed: 12/25/2022]
Abstract
AIMS To analyze the serum lipid and inflammatory biomarker profile in the early insulin resistance (e-IR). METHODS Cross-sectional study of 5943 adults without diabetes, stratified into no IR group (C-peptide <third tertile and glucose <100 mg/dL), e-IR group (C-peptide ≥third tertile and glucose <100 mg/dL) and advanced IR group (glucose ≥100 mg/dL). RESULTS E-IR showed significant differences with no IR in the serum concentration of triglycerides (P < 0.001), HDL cholesterol (P < 0.001), LDL cholesterol (P < 0.001), sCD40L (P < 0.001), C-reactive protein (P < 0.004), leptin (P < 0.001) and adiponectin (P < 0.001). Adjusting for age, gender and abdominal obesity, corroborated the association of e-IR with highest quintile of triglycerides (OR 3.88 [3.07-4.89]), HDL cholesterol (OR 0.35 [0.28-0.44]), sCD40L (OR 0.47 [0.24-0.94]), C-reactive protein (OR 2.31 [1.29-4.12]), adiponectin (OR 0.11 [0.04-0.32]), PAI-1 (OR 3.29 [1.29-8.40]) and resistin (OR 1.25 [1.01-1.54]); the same biomarkers were associated with advanced IR although resistin was a protective factor (OR 0.73 [0.58-0.93]). CONCLUSIONS Euglycemic patients with e-IR present an unfavorable serum lipid and inflammatory biomarker profile. Measuring C-peptide in euglycemic patients with elevated triglycerides identifies e-IR.
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Affiliation(s)
- Itahisa Marcelino Rodríguez
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
| | - José Oliva García
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - José Juan Alemán Sánchez
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Delia Almeida González
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Immunology Unit, University Hospital Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain
| | - Santiago Domínguez Coello
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Buenaventura Brito Díaz
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Fadoua Gannar
- Faculty of Sciences of Bizerte, Carthage University, Tunis, Tunisia
| | - María Del Cristo Rodríguez Pérez
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain
- Primary Care Authority, Santa Cruz de Tenerife, Spain
| | - Roberto Elosua
- Cardiovascular Research Network of the Carlos III Institute of Health, Santa Cruz de Tenerife, Spain
- Cardiovascular Epidemiology and Genetics, IMIM, Barcelona, Spain
| | - Antonio Cabrera de León
- Research Unit, University Hospital Nuestra Señora de la Candelaria, Carretera de El Rosario 145, 38010, Santa Cruz de Tenerife, Canary Islands, Spain.
- Área de medicina preventiva y salud pública, Universidad de La Laguna, La Laguna, Spain.
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Janowska J, Chudek J, Olszanecka-Glinianowicz M, Semik-Grabarczyk E, Zahorska-Markiewicz B. Interdependencies among Selected Pro-Inflammatory Markers of Endothelial Dysfunction, C-Peptide, Anti-Inflammatory Interleukin-10 and Glucose Metabolism Disturbance in Obese Women. Int J Med Sci 2016; 13:490-9. [PMID: 27429585 PMCID: PMC4946119 DOI: 10.7150/ijms.14110] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 04/02/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Currently increasing importance is attributed to the inflammatory process as a crucial factor responsible for the progressive damage to vascular walls and progression of atherosclerosis in obese people. We have studied the relationship between clinical and biochemical parameters and C-peptide and anti-inflammatory IL-10, as well as selected markers of inflammation and endothelial dysfunction such as: CCL2, CRP, sICAM-1, sVCAM-1 and E-selectin in obese women with various degree of glucose metabolism disturbance. MATERIAL AND METHODS The studied group consisted of 61 obese women, and 20 normal weight, healthy volunteers. Obese patients were spited in subgroups based on the degree of glucose metabolism disorder. Serum samples were analyzed using ELISA kits. RESULTS Increased concentrations of sICAM-1, sVCAM-1, E-selectin, CCL2 and CRP were found in all obese groups compared to the normal weight subjects. In patients with Type 2 diabetes mellitus (T2DM) parameters characterizing the degree of obesity significantly positively correlated with levels of CRP and CCL2. Significant relationships were found between levels of glucose and sICAM-1and also E-selectin and HOMA-IR. C-peptide levels are positively associated with CCL2, E-selectin, triglycerides levels, and inversely with IL-10 levels in newly diagnosed T2DM group (p<0.05). Concentrations of IL-10 correlated negatively with E-selectin, CCL2, C-peptide levels, and HOMA-IR in T2DM group (p<0.05). CONCLUSION Disturbed lipid and carbohydrate metabolism are manifested by enhanced inflammation and endothelial dysfunction in patients with simply obesity. These disturbances are associates with an increase of adhesion molecules. The results suggest the probable active participation of higher concentrations of C-peptide in the intensification of inflammatory and atherogenic processes in obese patients with type 2 diabetes. In patients with obesity and type 2 diabetes, altered serum concentrations of Il-10 seems to be dependent on the degree of insulin resistance and proinflammatory status.
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Affiliation(s)
- Joanna Janowska
- 1. Department of Pathophysiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
| | - Jerzy Chudek
- 1. Department of Pathophysiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- 2. Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
| | - Elżbieta Semik-Grabarczyk
- 3. Department of Internal, Autoimmune and Metabolic Diseases, Faculty of Medicine, Medical University of Silesia, Poland
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C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study. PLoS One 2015; 10:e0127112. [PMID: 26098780 PMCID: PMC4476669 DOI: 10.1371/journal.pone.0127112] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 04/10/2015] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE C-peptide has been reported to be a marker of subclinical atherosclerosis in type 2 diabetes mellitus (T2DM) patients, whereas its role in coronary artery disease (CAD) has not been clarified, especially in diabetics with differing body mass indices (BMIs). DESIGN AND METHODS This cross-sectional study included 501 patients with T2DM. First, all subjects were divided into the following two groups: CAD and non-CAD. Then, binary logistic regression was used to determine the risk factors for CAD for all patients. To clarify the role of obesity, we re-divided all subjects into two additional groups (obese and non-obese) based on BMI. Finally, binary logistic regression was used to determine the risk factors for CAD for each weight group. RESULTS The patients with CAD showed a higher BMI and fasting C-peptide level in addition to an increased prevalence of traditional risk factors for CAD, such as hypertension, insulin resistance, higher cholesterol, cysteine-C (Cys-C) and lower estimated glomerular filtration rate (eGFR). Logistic regression analysis showed that fasting C-peptide (OR=1.513, p=0.005), insulin treatment (OR=1.832, p=0.027) hypertension (OR=1.987, p=0.016) and hyperlipidemia (OR=4.159, p<0.001) significantly increased the risk of clinical CAD in the T2DM patients independent of age, gender, diabetes duration, smoking and alcohol statuses, fasting insulin and glucose, hypoglycemic episodes, UA and eGFR. Additionally, in both of the obese (OR=1.488, p=0.049) and non-obese (OR=1.686, p=0.037) DM groups, C-peptide was associated with an increased risk of CAD after multiple adjustments. CONCLUSIONS C-peptide is associated with an increased CAD risk in T2DM patients, no matter whether they are obese or not.
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Cabrera de León A, Oliva García JG, Marcelino Rodríguez I, Almeida González D, Alemán Sánchez JJ, Brito Díaz B, Domínguez Coello S, Bertomeu Martínez V, Aguirre Jaime A, Rodríguez Pérez MDC. C-peptide as a risk factor of coronary artery disease in the general population. Diab Vasc Dis Res 2015; 12:199-207. [PMID: 25696117 DOI: 10.1177/1479164114564900] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To analyse the association between serum C-peptide and coronary artery disease in the general population. METHODS Follow-up study of 6630 adults from the general population. They were stratified into group 1 (no insulin resistance: C-peptide < third tercile and glycaemia < 100 mg/dL), group 2 (initial insulin resistance: C-peptide ⩾ third tercile and glycaemia < 100 mg/dL) and group 3 (advanced insulin resistance: glycaemia ⩾ 100 mg/dL). RESULTS After 3.5 years of follow-up, group 2 had a higher incidence of myocardial infarction (relative risk (RR) = 4.2, 95% confidence interval (CI) = 1.7-10.6) and coronary artery disease (RR = 3.5, 95% CI = 1.9-6.6) than group 1. Group 3 also had increased incidences of both diseases. In multivariable analysis of the entire population, groups 2 and 3 showed significant risks of myocardial infarction and coronary artery disease (RR > 3 and RR > 2, respectively). However, when people with diabetes were excluded, the increased risks were corroborated only in group 2 for myocardial infarction (RR = 2.8, 95% CI = 1.1-6.9; p = 0.025) and coronary artery disease (RR = 2.4, 95% CI = 1.3-4.6; p = 0.007). CONCLUSION Elevated C-peptide is associated with the incidence of myocardial infarction and coronary artery disease in the general population. It can be an earlier predictor of coronary events than impaired fasting glucose.
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Affiliation(s)
- Antonio Cabrera de León
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain University of La Laguna, La Laguna, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain
| | - José Gregorio Oliva García
- Endocrine Diseases Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Itahisa Marcelino Rodríguez
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain
| | - Delia Almeida González
- Cardiovascular Research Network of the Carlos III Institute of Health, Spain Immunology Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - José Juan Alemán Sánchez
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain
| | - Buenaventura Brito Díaz
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain
| | - Santiago Domínguez Coello
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain
| | - Vicente Bertomeu Martínez
- Cardiovascular Research Network of the Carlos III Institute of Health, Spain Servicio de Cardiología, Hospital San Juan, Universidad Miguel Hernández, Alicante, Spain
| | - Armando Aguirre Jaime
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - María del Cristo Rodríguez Pérez
- Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain
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Burgmaier M, Hoppe S, Krüger T, Mahnken AH, Ketteler M, Reith S, Mühlenbruch G, Marx N, Brandenburg V. Serum levels of C-peptide are associated with coronary artery calcification in patients with rheumatoid arthritis. Rheumatol Int 2015; 35:1541-7. [PMID: 25782584 DOI: 10.1007/s00296-015-3244-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/03/2015] [Indexed: 11/25/2022]
Abstract
C-peptide has pro-atherogenic effects in animal models, and elevated C-peptide levels are associated with cardiovascular and all-cause mortality in patients undergoing coronary angiography. This cross-sectional study investigated the association between C-peptide serum levels and coronary artery calcification (CAC) in patients with rheumatoid arthritis (RA), a high-risk group for cardiovascular events. Fifty-four patients with RA were recruited from an arthritis outpatient department at the University Hospital in Aachen, Germany. CAC was measured by multi-slice CT scan, and blood samples were drawn from all patients for the analysis of C-peptide and other cardiovascular biomarkers. Mean serum levels of C-peptide (1.187 ± 0.771 vs 0.745 ± 0.481 nmol/L, p = 0.02), YKL-40, LDL cholesterol, and triglycerides were significantly higher in patients with CAC (n = 32, 59 %) compared to those without CAC (n = 22, 41 %). Univariate analysis revealed a significant association of C-peptide [OR 4.7, 95 % CI (1.1, 20.2)], YKL-40, triglycerides, hypertension, smoking, age, and male sex with the presence of CAC. After adjustment for body mass index, cholesterol, diabetes, adiponectin, calcium, and phosphate, C-peptide was still significantly associated with CAC in a multivariate logistic regression model. In conclusion, C-peptide serum levels are independently associated with the presence of CAC in patients with RA. These data suggest a potential role of C-peptide in cardiovascular disease in patients with RA.
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Affiliation(s)
- Mathias Burgmaier
- Department of Internal Medicine I - Cardiology, University Hospital of the RWTH Aachen, Pauwelstr 30, 52074, Aachen, Germany
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Pikkemaat M, Melander O, Mölstad S, Garberg G, Boström KB. C-peptide concentration, mortality and vascular complications in people with Type 2 diabetes. The Skaraborg Diabetes Register. Diabet Med 2015; 32:85-9. [PMID: 25354243 DOI: 10.1111/dme.12608] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 08/11/2014] [Accepted: 10/07/2014] [Indexed: 12/17/2022]
Abstract
AIM To study the prognosis of patients with newly diagnosed Type 2 diabetes in primary care in relation to their baseline C-peptide concentration. METHODS C-peptide concentrations were determined in 399 patients aged < 65 years with newly diagnosed Type 2 diabetes using the Skaraborg Diabetes Register, Sweden. Data on cardiovascular complications and death were extracted from national registers and a local study of retinopathy. Statistical analyses were performed using Cox regression. RESULTS An analysis of C-peptide concentrations in quartiles, after adjusting for confounders, showed that patients in the highest quartile had a 2.75-fold higher risk of death from all causes compared with those in the lowest quartile (CI 1.17-6.47). By contrast, C-peptide concentration was not associated with the incidence of cardiovascular events or the development of retinopathy. CONCLUSIONS Measurement of C-peptide concentration at diagnosis could help identify patients who are at high risk and who presumably would benefit from more intensive treatment.
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Affiliation(s)
- M Pikkemaat
- Husensjö Health Care Centre, Helsingborg, Sweden; Centre for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Skövde, Sweden
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Zhao L, Ma J, Wang S, Xie Y. Relationship between β-cell function, metabolic control, and microvascular complications in type 2 diabetes mellitus. Diabetes Technol Ther 2015; 17:29-34. [PMID: 25574593 DOI: 10.1089/dia.2014.0214] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study investigated the relationship among β-cell function, metabolic control, and diabetic microvascular complications in patients with type 2 diabetes mellitus (T2DM). SUBJECTS AND METHODS In total, 885 patients with type 2 diabetes mellitus (DM) were recruited from January 2012 to January 2014 and grouped into three groups according to the area under the curve of C-peptide [AUC(C-pep)] during the 75-g oral glucose tolerance test. Logistic regression analyses were used to evaluate the association between C-peptide and microvascular complications. RESULTS The prevalence of diabetic microvascular complications decreased from the first to the third AUC(C-pep) tertile (P < 0.01 for all), whereas the rates of nonalcoholic fatty liver disease (NAFLD) was positively associated with AUC(C-pep) values. Patients with lower AUC(C-pep) tertile exhibited higher levels of glycosylated hemoglobin and high-density lipoprotein cholesterol and longer duration of DM; however, levels of triglycerides, fasting C-peptide, 2-h C-peptide, body mass index, and homeostasis model assessment of insulin resistance index were lower compared with the third tertile. Comparison among patients with a similar DM duration showed a higher level of AUC(C-pep) was inversely associated with prevalence of microvascular complications. The odds ratios for nephropathy, retinopathy, and neuropathy in the lowest versus the highest AUC(C-pep) tertile were 3.10 (95% confidence interval, 2.01-4.78), 2.83 (1.73-4.64), and 2.04 (1.37-3.04) after adjustment for confounding factors. CONCLUSIONS Higher AUC(C-pep) levels were associated with a decreased prevalence of microvascular complications and a good level of glycemic control, whereas higher endogenous insulin levels were linked to the components of metabolic syndrome and increased rates of NAFLD.
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Affiliation(s)
- Lihua Zhao
- Department of Diabetic Neurology, Hospital of Metabolic Disease, Tianjin Medical University , Tianjin, China
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Li Y, Liu H, Sato Y. The association between the serum C-peptide level and bone mineral density. PLoS One 2013; 8:e83107. [PMID: 24358252 PMCID: PMC3865098 DOI: 10.1371/journal.pone.0083107] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/09/2013] [Indexed: 12/21/2022] Open
Abstract
Objective Although serum C-peptide was previously considered biologically inactive, a growing number of recent studies have shown that it is an active peptide with important physiologic functions. The present study aimed to investigate the association of serum C-peptide level with bone mineral density (BMD) in residents of the United States. Methods The study included 6,625 participants aged 12–85 years. Total and regional BMD were measured using dual-energy X-ray absorptiometry. Stratified multiple linear regression analysis was performed to determine the association of the serum C-peptide level with BMD. Three regression models were produced for each stratum. All models were adjusted for ethnicity, height, weight, education level, physical activity, smoking status, alcohol use, triglycerides and creatinine level, and models 2 and 3 were further adjusted for the fasting plasma glucose (FPG) and alkaline phosphatase (ALP) levels, respectively. Results Sex-specific results showed a significant association between the serum C-peptide level and total BMD in both sexes. Stratified analyses based on age and body mass index showed that serum C-peptide levels were significantly negatively associated with most regional BMD, and most of these associations remained significant after stratification based on the serum insulin level. Conclusion The serum C-peptide level was significantly negatively associated with the total and most regional BMD. These findings suggest that serum C-peptide may have biological activity associated with bone metabolism and therefore serum C-peptide control is advisable in order to reduce the risk of low bone mineral density.
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Affiliation(s)
- Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Zhejiang, China
- * E-mail:
| | - Hua Liu
- School of Basic Medical Sciences, Zhejiang University, Zhejiang, China
| | - Yasuto Sato
- Department of Hygiene and Public Health II, Tokyo Women's Medical University, Tokyo, Japan
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Li Y, Meng L, Li Y, Sato Y. Associations of serum C-peptide level with body fat distribution and ever stroke in nondiabetic subjects. J Stroke Cerebrovasc Dis 2013; 23:e163-9. [PMID: 24139410 DOI: 10.1016/j.jstrokecerebrovasdis.2013.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/10/2013] [Accepted: 09/15/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Although elevated serum C-peptide level as an indicator of insulin resistance increases the obesity-associated risk of cardiovascular disease among diabetic patients, evidence indicating that serum C-peptide level is associated with stroke in nondiabetic subjects is limited. The aim of this study is to evaluate the association between serum C-peptide level and ever stroke in nondiabetic subjects and investigated the associations of serum C-peptide level with body fat distribution and stroke events among nondiabetic subjects. METHODS This study was a population-based cross-sectional study that included 7030 participants aged 12-85 years. Body fat distribution was determined by dual-energy X-ray absorptiometry. Serum C-peptide level was measured using the radioimmunoassay method. The association between serum C-peptide level and body fat distribution was evaluated by multiple linear regression models. Logistic regression analysis was performed to calculate the odds ratio (OR) of serum C-peptide level being associated with ever stroke. RESULTS A total of 103 nondiabetic subjects reported having a stroke. Logistic regression analysis revealed a high-serum C-peptide level significantly associated with ever stroke among nondiabetic subjects (OR: 3.71, 95% confidence interval: 1.78-7.75). Meanwhile, in multiple linear regression analysis, serum C-peptide level was positively associated with total and regional fat distribution among nondiabetic subjects. CONCLUSION The serum C-peptide level is strongly associated with the ever stroke in nondiabetic subjects and significantly associated with total and regional body fat distribution.
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Affiliation(s)
- Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Zhejiang, China.
| | - Lu Meng
- Department of Social Medicine, School of Public Health, Zhejiang University, Zhejiang, China
| | - Yue Li
- Department of Clinical Medicine, School of Medicine, Zhejiang University, Zhejiang, China
| | - Yasuto Sato
- Department of Hygiene and Public Health II, Tokyo Women's Medical University, Tokyo, Japan
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Min JY, Min KB. Serum C-peptide levels and risk of death among adults without diabetes mellitus. CMAJ 2013; 185:E402-8. [PMID: 23589428 PMCID: PMC3680586 DOI: 10.1503/cmaj.121950] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Connecting peptide (C-peptide) plays a role in early atherogenesis in patients with diabetes mellitus and may be a marker for cardiovascular morbidity and mortality in patients without diabetes. We investigated whether serum C-peptide levels are associated with all-cause, cardiovascular-related and coronary artery disease-related mortality in adults without diabetes. METHODS We used data from the Third Nutrition and Health Examination Survey (NHANES III) and the NHANES III Linked Mortality File in the United States. We analyzed mortality data for 5902 participants aged 40 years and older with no history of diabetes and who had available serum C-peptide levels from the baseline examination. We grouped the participants by C-peptide quartile, and we performed Cox proportional hazards regression analysis. The primary outcome was all-cause, cardiovascular-related and coronary artery disease-related mortality. RESULTS The mean serum C-peptide level in the study sample was 0.78 (± standard deviation 0.47) nmol/L. The adjusted hazards ratio comparing the highest quartile with the lowest quartile was 1.80 (95% confidence interval [CI] 1.33-2.43) for all-cause mortality, 3.20 (95% CI 2.07-4.93) for cardiovascular-related mortality, and 2.73 (95% CI 1.55-4.82) for coronary artery disease-related mortality. Higher C-peptide levels were associated with increased mortality among strata of glycated hemoglobin and fasting serum glucose. INTERPRETATION We found an association between serum C-peptide levels and all-cause and cause-specific mortality among adults without diabetes at baseline. Our finding suggests that elevated C-peptide levels may be a predictor of death.
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Affiliation(s)
- Jin-young Min
- From the Department of Epidemiology (J.-Y. Min), Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea; and the Department of Occupational and Environmental Medicine (K.-B. Min), Ajou University School of Medicine, Suwon, Republic of Korea
| | - Kyoung-bok Min
- From the Department of Epidemiology (J.-Y. Min), Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea; and the Department of Occupational and Environmental Medicine (K.-B. Min), Ajou University School of Medicine, Suwon, Republic of Korea
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C-Peptide and Its Career from Innocent Bystander to Active Player in Diabetic Atherogenesis. Curr Atheroscler Rep 2013; 15:339. [DOI: 10.1007/s11883-013-0339-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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