Diabetes Metab J.  2011 Feb;35(1):41-49. 10.4093/dmj.2011.35.1.41.

Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetic Patients

• Kim ST
• Kim BJ
• Lim DM
• Song IG
• Jung JH
• Lee KW
• Park KY
• Cho YZ
• Lee DH
• Koh GP

• KMID: 2281491
• DOI: http://doi.org/10.4093/dmj.2011.35.1.41

Abstract

BACKGROUND
Recent studies have revealed that C-peptide induces smooth muscle cell proliferation and causes human atherosclerotic lesions in diabetic patients. The present study was designed to examine whether the basal C-peptide levels correlate with cardiovascular risk in type 2 diabetes mellitus (T2DM) patients.
METHODS
Data was obtained from 467 patients with T2DM from two institutions who were followed for four years. The medical findings of all patients were reviewed, and patients with creatinine >1.4 mg/dL, any inflammation or infection, hepatitis, or type 1 DM were excluded. The relationships between basal C-peptide and other clinical values were statistically analyzed.
RESULTS
A simple correlation was found between basal C-peptide and components of metabolic syndrome (MS). Statistically basal C-peptide levels were significantly higher than the three different MS criteria used in the present study, the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program's (NCEP's), World Health Organization (WHO), and the International Diabetes Federation (IDF) criteria (NCEP-ATP III, P=0.001; IDF, P<0.001; WHO, P=0.029). The multiple regression analysis between intima-media thickness (IMT) and clinical values showed that basal C-peptide significantly correlated with IMT (P=0.043), while the analysis between the 10-year coronary heart disease risk by the United Kingdom Prospective Diabetes Study risk engine and clinical values showed that basal C-peptide did not correlate with IMT (P=0.226).
CONCLUSION
Basal C-peptide is related to cardiovascular predictors (IMT) of T2DM, suggesting that basal C-peptide does provide a further indication of cardiovascular disease.

Keyword

Atherosclerosis; C-peptide; Carotid artery; Diabetes mellitus; Metabolic syndrome

MeSH Terms

Adult
Atherosclerosis
Biomarkers
C-Peptide
Cardiovascular Diseases
Carotid Arteries
Cholesterol
Coronary Disease
Creatinine
Diabetes Mellitus
Diabetes Mellitus, Type 2
Great Britain
Hepatitis
Humans
Inflammation
Myocytes, Smooth Muscle
World Health Organization
C-Peptide
Cholesterol
Creatinine

Figure

• 

  Fig. 1 Enrollment and exclusions. From October 2005 to June 2009, data was obtained from 1,097 patients with diabetes mellitus (DM), who were hospitalized in one of two university hospitals in Chungcheongnam Province and Jeju Island, Republic of Korea. Among the 1,097 participants, 630 with serum creatinine >1.4 mg/dL, DM foot, an inflammatory or infectious disease, hepatitis, or type 1 DM were excluded. The final sample for the analyses was comprised of 467 participants.

• 

  Fig. 2 The trend of basal C-peptide level according to number of metabolic components. Basal C-peptide level increased according to the number of metabolic components (P value< 0.001). Metabolic components were determined according to NCEP-ATP III criteria. Values are presented as mean±standard deviation.

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