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Association between serum C-peptide levels and chronic microvascular complications in Korean type 2 diabetic patients

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Abstract

This study evaluated the association between serum C-peptide levels and chronic vascular complications in Korean patients with type 2 diabetes. Data for 1,410 patients with type 2 diabetes were evaluated cross-sectionally. Fasting and postprandial 2-hour serum C-peptide levels were analyzed with respect to diabetic micro- and macrovascular complications. In the group of patients with lower fasting serum C-peptide quartile, the prevalences of diabetic retinopathy and neuropathy were significantly higher (P = 0.035, P < 0.001, respectively). In the group of patients with lower delta C-peptide (postprandial − fasting C-peptide) quartile, the prevalences of diabetic retinopathy, nephropathy, and neuropathy were significantly higher (P < 0.001 for all). Low delta C-peptide quartile was also associated with increased severity of retinopathy and nephropathy. The age- and sex-adjusted odds ratios (ORs) for retinopathy, neuropathy, and nephropathy in the lowest versus the highest delta C-peptide quartile were 6.45 (95% confidence interval 3.41–12.22), 3.01 (2.16–4.19), and 2.65 (1.71–4.12), respectively. After further adjustment for the duration of diabetes, type of antidiabetic therapy, mean hemoglobin A1c, body mass index, and blood pressure, the ORs were reduced to 2.83 (1.32–6.08), 1.68 (1.12–2.53), and 1.61 (1.05–2.47), respectively, but remained significant. No significant difference was observed in the prevalence of macrovascular complications with respect to fasting or delta C-peptide quartiles. These results suggest that low C-peptide level is associated with diabetic microvascular, but not macrovascular complications in patients with type 2 diabetes mellitus.

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References

  1. Prando R, Odetti P, Melga P, Giusti R, Ciuchi E, Cheli V (1996) Progressive deterioration of beta-cell function in nonobese type 2 diabetic subjects. Postprandial plasma C-peptide level is an indication of insulin dependency. Diabetes Metab 22:185–191

    PubMed  CAS  Google Scholar 

  2. Haupt E, Haupt A, Herrmann R, Benecke-Timp A, Vogel H, Walter C (1999) The KID study V: the natural history of type 2 diabetes in younger patients still practising a profession. Heterogeneity of basal and reactive C-peptide levels in relation to BMI, duration of disease, age and HbA1. Exp Clin Endocrinol Diabetes 107:236–243

    Article  PubMed  CAS  Google Scholar 

  3. Johansson J, Ekberg K, Shafqat J et al (2002) Molecular effects of proinsulin C-peptide. Biochem Biophys Res Commun 295:1035–1040

    Article  PubMed  CAS  Google Scholar 

  4. Hills CE, Brunskill NJ, Squires PE (2010) C-peptide as a therapeutic tool in diabetic nephropathy. Am J Nephrol 31:389–397

    Article  PubMed  CAS  Google Scholar 

  5. Mughal RS, Scragg JL, Lister P et al (2010) Cellular mechanisms by which proinsulin C-peptide prevents insulin-induced neointima formation in human saphenous vein. Diabetologia 53:1761–1771

    Article  PubMed  CAS  Google Scholar 

  6. Suzuki K, Watanabe K, Motegi T, Kajinuma H (1989) High prevalence of proliferative retinopathy in diabetic patients with low pancreatic B-cell capacity. Diabetes Res Clin Pract 6:45–52

    Article  PubMed  CAS  Google Scholar 

  7. Steffes MW, Sibley S, Jackson M, Thomas W (2003) Beta-cell function and the development of diabetes-related complications in the Diabetes Control and Complications Trial. Diabetes Care 26:832–836

    Article  PubMed  Google Scholar 

  8. Panero F, Novelli G, Zucco C et al (2009) Fasting plasma C-peptide and micro- and macrovascular complications in a large clinic-based cohort of type 1 diabetic patients. Diabetes Care 32:301–305

    Article  PubMed  CAS  Google Scholar 

  9. Bo S, Cavallo-Perin P, Gentile L, Repetti E, Pagano G (2000) Relationship of residual beta-cell function, metabolic control and chronic complications in type 2 diabetes mellitus. Acta Diabetol 37:125–129

    Article  PubMed  CAS  Google Scholar 

  10. Sari R, Balci MK (2005) Relationship between C peptide and chronic complications in type-2 diabetes mellitus. J Natl Med Assoc 97:1113–1118

    PubMed  Google Scholar 

  11. Inukai T, Matsutomo R, Tayama K, Aso Y, Takemura Y (1999) Relation between the serum level of C-peptide and risk factors for coronary heart disease and diabetic microangiopathy in patients with type-2 diabetes mellitus. Exp Clin Endocrinol Diabetes 107:40–45

    Article  PubMed  CAS  Google Scholar 

  12. Ahn HJ, Han KA, Kwon HR et al (2010) Small rice bowl-based meal plan versus food exchange-based meal plan for weight, glucose and lipid control in obese type 2 diabetic patients. Korean Diabetes J 34:86–94

    Article  PubMed  Google Scholar 

  13. Wilkinson CP, Ferris FL 3rd, Klein RE et al (2003) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 110:1677–1682

    Article  PubMed  CAS  Google Scholar 

  14. Casellini CM, Barlow PM, Rice AL et al (2007) A 6-month, randomized, double-masked, placebo-controlled study evaluating the effects of the protein kinase C-beta inhibitor ruboxistaurin on skin microvascular blood flow and other measures of diabetic peripheral neuropathy. Diabetes Care 30:896–902

    Article  PubMed  CAS  Google Scholar 

  15. Pitei DL, Watkins PJ, Stevens MJ, Edmonds ME (1994) The value of the Neurometer in assessing diabetic neuropathy by measurement of the current perception threshold. Diabet Med 11:872–876

    Article  PubMed  CAS  Google Scholar 

  16. De Bacquer D, De Backer G, Kornitzer M, Blackburn H (1998) Prognostic value of ECG findings for total, cardiovascular disease, and coronary heart disease death in men and women. Heart 80:570–577

    PubMed  Google Scholar 

  17. De Bacquer D, De Backer G, Kornitzer M (2000) Prevalences of ECG findings in large population based samples of men and women. Heart 84:625–633

    Article  PubMed  Google Scholar 

  18. Samnegard B, Jacobson SH, Jaremko G, Johansson BL, Sjoquist M (2001) Effects of C-peptide on glomerular and renal size and renal function in diabetic rats. Kidney Int 60:1258–1265

    Article  PubMed  CAS  Google Scholar 

  19. Djemli-Shipkolye A, Gallice P, Coste T et al (2000) The effects ex vivo and in vitro of insulin and C-peptide on Na/K adenosine triphosphatase activity in red blood cell membranes of type 1 diabetic patients. Metabolism 49:868–872

    Article  PubMed  CAS  Google Scholar 

  20. Ekberg K, Brismar T, Johansson BL, Jonsson B, Lindstrom P, Wahren J (2003) Amelioration of sensory nerve dysfunction by C-Peptide in patients with type 1 diabetes. Diabetes 52:536–541

    Article  PubMed  CAS  Google Scholar 

  21. Wahren J, Ekberg K, Johansson J et al (2000) Role of C-peptide in human physiology. Am J Physiol Endocrinol Metab 278:E759–E768

    PubMed  CAS  Google Scholar 

  22. Forst T, De La Tour DD, Kunt T et al (2000) Effects of proinsulin C-peptide on nitric oxide, microvascular blood flow and erythrocyte Na+, K+-ATPase activity in diabetes mellitus type I. Clin Sci (Lond) 98:283–290

    Article  CAS  Google Scholar 

  23. Nordquist L, Shimada K, Ishii T, Furuya DT, Kamikawa A, Kimura K (2010) Proinsulin C-peptide prevents type-1 diabetes-induced decrease of renal Na+, K+-ATPase alpha1-subunit in rats. Diabetes Metab Res Rev 26:193–199

    Article  PubMed  CAS  Google Scholar 

  24. Lee SK, Lee JO, Kim JH et al (2010) C-peptide stimulates nitrites generation via the calcium-JAK2/STAT1 pathway in murine macrophage Raw264.7 cells. Life Sci 86:863–868

    Article  PubMed  CAS  Google Scholar 

  25. Johansson BL, Kernell A, Sjoberg S, Wahren J (1993) Influence of combined C-peptide and insulin administration on renal function and metabolic control in diabetes type 1. J Clin Endocrinol Metab 77:976–981

    Article  PubMed  CAS  Google Scholar 

  26. Johansson BL, Borg K, Fernqvist-Forbes E, Kernell A, Odergren T, Wahren J (2000) Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with type 1 diabetes mellitus. Diabet Med 17:181–189

    Article  PubMed  CAS  Google Scholar 

  27. Johansson BL, Wahren J, Pernow J (2003) C-peptide increases forearm blood flow in patients with type 1 diabetes via a nitric oxide-dependent mechanism. Am J Physiol Endocrinol Metab 285:E864–E870

    PubMed  CAS  Google Scholar 

  28. Walcher D, Babiak C, Poletek P et al (2006) C-Peptide induces vascular smooth muscle cell proliferation: involvement of SRC-kinase, phosphatidylinositol 3-kinase, and extracellular signal-regulated kinase 1/2. Circ Res 99:1181–1187

    Article  PubMed  CAS  Google Scholar 

  29. Ido Y, Vindigni A, Chang K et al (1997) Prevention of vascular and neural dysfunction in diabetic rats by C-peptide. Science 277:563–566

    Article  PubMed  CAS  Google Scholar 

  30. Cotter MA, Ekberg K, Wahren J, Cameron NE (2003) Effects of proinsulin C-peptide in experimental diabetic neuropathy: vascular actions and modulation by nitric oxide synthase inhibition. Diabetes 52:1812–1817

    Article  PubMed  CAS  Google Scholar 

  31. Hovorka R, Chassin L, Luzio SD, Playle R, Owens DR (1998) Pancreatic beta-cell responsiveness during meal tolerance test: model assessment in normal subjects and subjects with newly diagnosed noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 83:744–750

    Article  PubMed  CAS  Google Scholar 

  32. Pasquali R, Buratti P, Biso P et al (1987) Estimation of B-cell function by the urinary excretion rate of C-peptide in diabetic patients: comparison with C-peptide response to glucagon and to a mixed meal. Diabete Metab 13:44–51

    PubMed  CAS  Google Scholar 

  33. Kim RS, Son YJ, Yang IM et al (1985) Postprandial 2-hr serum C-peptide concentration as a guide for insulin treatment in patients with NIDDM. Korean J Intern Med 28:779–786

    Google Scholar 

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None of the authors had any conflicts of interest related to this study.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University College of Medicine, 1174 Jung-Dong, Wonmi-Gu, Bucheon, 420-767, South Korea

    Bo-Yeon Kim, Chan-Hee Jung, Ji-Oh Mok, Sung-Koo Kang & Chul-Hee Kim

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  1. Bo-Yeon Kim
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  2. Chan-Hee Jung
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  3. Ji-Oh Mok
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Correspondence to Chul-Hee Kim.

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Kim, BY., Jung, CH., Mok, JO. et al. Association between serum C-peptide levels and chronic microvascular complications in Korean type 2 diabetic patients. Acta Diabetol 49, 9–15 (2012). https://doi.org/10.1007/s00592-010-0249-6

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  • DOI: https://doi.org/10.1007/s00592-010-0249-6

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