Application of urine C-peptide creatinine ratio in type 2 diabetic patients with different levels of renal function

Abstract

ObjectiveThis study aims to investigate the effect of single urine C peptide/creatinine (UCPCR) in assessing the islet β Cell function of type 2 diabetes mellitus (T2DM) patients with different renal function.MethodsA total of 85 T2DM patients were recruited in this study, all the patients were assigned to one group with estimated glomerular filtration rate (eGFR)≤60 ml·min-1·1.73 m-2 and another group complicated with eGFR>60 ml·min-1·1.73 m-2. Serum creatinine, urine creatinine, serum fasting C-peptide (FCP), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C) and 24-hour urinary C-peptide (24hUCP) were measured. The modified homeostasis model assessment-islet β cell function [HOMA-islet (CP-DM)], the modified homeostasis model assessment-insulin resistance [HOMA-IR(CP)] and UCPCR were calculated.ResultsWhen compared with group eGFR ≤60 ml·min-1·1.73 m-2, the levels of UCPCR, FCP, the modified HOMA-IR(CP) and HOMA-islet (CP-DM) were promoted and the concentrations of HbA1C, FPG, creatinine were decreased in the patients of eGFR>60 ml·min-1·1.73 m-2 (P<0.05); FCP was uncorrelated with 24hUCP while associated with UCPCR in the patients of eGFR ≤ 60 ml·min-1·1.73 m-2; UCPCR was positively correlated with FCP and HOMA-IR(CP) in the T2DM patients with different levels of renal function; the cut-off (UCPCR ≤ 1.13 nmol/g) had 88.37% sensitivity and 95.24% specificity [95% confidence interval (CI):0.919-0.997] for identifying severe insulin deficiency in T2DM patients[area under the curve (AUC) 0.978].ConclusionUCPCR can be used to evaluate islets β Cell function in T2DM patients with different renal function status.

Urinary C-Peptide to Creatinine Ratio (UCPCR) as Indicator for Metabolic Risk in Apparently Healthy Adults—A BioPersMed Cohort Study

“…Importantly, kidney deterioration in DM might not be a problem for the calculation and clinical use of UCPCR values, as demonstrated in a recently published study that refers to 85 T2DM patients with reduced renal function [10]. Nevertheless, all participants in the current study had normal creatinine values.…”

“…Several studies have reported the use of the UCPCR in different applications, including differentiation, clinical monitoring, and therapy adaptation for type 1 diabetes mellitus (T1DM) [5][6][7], hyperinsulinism, and/or type 2 diabetes mellitus (T2DM) [8][9][10][11][12], as well as independently of T2DM [5,13]. Further specific applications might include the detection of clinically relevant conditions like polycystic ovary syndrome (PCOS) or gestational diabetes (GDM) in pregnant women at risk [14,15], and a potential application in postoperative monitoring of pancreas graft function [16], where a close but low threshold, and at best noninvasive, monitoring is mandatory.…”

Effects of mulberry twig alkaloids(Sangzhi alkaloids) and metformin on blood glucose fluctuations in combination with premixed insulin-treated patients with type 2 diabetes

“…An automatic biochemical analyzer assessed hypoglycemia, adverse events, alanine aminotransferase (ALT), aspartate transaminase (AST), creatinine (Cr), and uric acid (UA). The insulin resistance index was assessed for each patients using modified homeostasis model, and expressed as [HOMA-IR(CP)] = 1.5 + FPG (mmol/L) × fasting C-peptide (pmol/L)/2,800 (18).…”