C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study

Wang, Lingshu; Lin, Pei; Ma, Aixia; Zheng, Huizhen; Wang, Kexin; Li, Wenjuan; Zhao, Ruxing; Liang, Kai; Liu, Fuqiang; Hou, Xinguo; Song, Jun; Lu, Yiran; Zhu, Ping; Sun, Yu; Chen, Li

doi:10.1371/journal.pone.0127112

Cited by 25 publications

(23 citation statements)

References 35 publications

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“…It could be used to represent endogenous insulin secretion by islet β cells and insulin resistance . Studies have found that C‐peptide is significantly associated with NAFLD, being one of the three most important predictors in the general US population, as well as potential risk factors and outcomes of NAFLD, such as cardiovascular diseases and MetS . However, rather limited studies have measured the association between C‐peptide and advanced NAFLD stages.…”

Section: Introductionmentioning

confidence: 99%

C‐peptide is associated with NAFLD inflammatory and fibrotic progression in type 2 diabetes

Wang

Zhang

et al. 2019

Diabetes Metabolism Res

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Background: A higher prevalence of nonalcoholic steatohepatitis (NASH) and advanced stages of fibrosis was observed in type 2 diabetes. We aim to investigate whether C-peptide is associated with nonalcoholic fatty liver disease (NAFLD) progression in type 2 diabetic adults. Methods:A total of 4937 diabetic participants were enrolled from China in 2018.Liver steatosis was detected by ultrasound. Subjects with NAFLD were categorized into simple NAFLD and probable NASH by the concurrent presence of metabolic syndrome. NAFLD fibrosis score was used to identify patients with probable advanced fibrosis.Results: Individuals with a longer history of type 2 diabetes had a lower C-peptide level and a lower prevalence of probable NASH but a higher prevalence of advanced fibrosis. C-peptide was positively associated with simple NAFLD and probable NASH, with odds ratios (ORs) of 4.55 [95% confidence interval (CI) 3.16, 6.55] and 5.28 (95% CI 3.94, 7.09), respectively, comparing quartile 4 with quartile 1 (both p for trend <0.001). However, C-peptide quartiles were negatively associated with the probable presence of advanced fibrosis (Q4 vs. Q1, OR 0.59, 95% CI 0.36, 0.97, p for trend <0.05). A 1-SD increment of ln(C-peptide) was also significantly associated with inflammatory and fibrotic progression (OR 1.34, 95% CI 1.27, 1.41; OR 0.88, 95% CI 0.79, 0.98, respectively).Conclusions: Significant but opposite associations between C-peptide and inflammatory and fibrotic progression of NAFLD were observed. Understanding islet hormone changes during type 2 diabetes and differentiating the stage of NAFLD may help to personalize treatment strategies for NAFLD patients with type 2 diabetes. KEYWORDS

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Section: Introductionmentioning

confidence: 99%

C‐peptide is associated with NAFLD inflammatory and fibrotic progression in type 2 diabetes

Wang

Zhang

et al. 2019

Diabetes Metabolism Res

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“…According to Wang et al (2015) [28], a fasting C-peptide level greater than 1 ng/dl in a patient who has had diabetes for more than 1-2 years is suggestive of T2DM (i.e. residual b-cell function).…”

Section: Discussionmentioning

confidence: 99%

Etiology, risk factors, clinical features, and pitfalls in the management of newly diagnosed diabetic children and adolescents

Hassan

Hafez

Koura³

et al. 2015

Medical Research Journal

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Objective The aim of this study was to identify the etiology, risk factors, and the most common clinical features of newly diagnosed diabetes in children and adolescents, in addition to the factors related to delayed diagnosis or mismanagement in these children.Materials and methods Ninety-nine children and adolescents aged from one month to 13 years with newly diagnosed type 1 diabetes (T1DM) were recruited from the inpatient department of the Diabetic, Endocrine, and Metabolic Pediatric Unit (DEMPU), New Children Hospital, Cairo University.Results Classic symptoms (polyuria and polydipsia, and weight loss) were the most common symptoms (the first two symptoms in 95.9 and the last one in 90.7%) preceding the diagnosis, and diabetic ketoacidosis was present in 51.5% of cases. Delayed and missed diagnosis was recorded in 49.5% of patients, with no significant relation with age, district of accommodation, or family history of diabetes. Cow's milk feeding was more frequent, being recorded in 75.2% vs. 19.6% with exclusive breast feeding, and positive family history of diabetes was recorded in 77.3%. Severity at presentation showed no significant relation with age, type of feeding, family history of diabetes, or C-peptide level.Conclusion Increased public awareness of early symptoms of diabetes is needed to reduce the frequency and severity of ketoacidosis. In addition, greater medical alertness to the possibility of T1DM in a young child should be stressed. Breastfeeding and avoidance of early cow milk introduction should be encouraged to decrease the risk for T1DM during infancy with its early complications and morbidity.

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“…93 However, patients with early T2DM and insulin resistance have elevated serum levels of C-peptide, and an increased cardiovascular risk has been reported in these patients. 94 In addition, several studies in individuals without diabetes showed positive correlation between Cpeptide levels and the incidence of several cardiovascular diseases, such as coronary artery disease and myocardial infarction. [95][96][97] Altogether, these data suggest that elevated C-peptide levels, due to insulin resistance, contribute to atherosclerosis vascular disease in these patients.…”

Section: Figurementioning

confidence: 99%

The dual effect of C‐peptide on cellular activation and atherosclerosis: Protective or not?

Alves

Ortiz

Reis

et al. 2018

Diabetes Metabolism Res

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C-peptide is a cleavage product of proinsulin that acts on different type of cells, such as blood and endothelial cells. C-peptide biological effects may be different in type 1 and type 2 diabetes. Besides, there are further evidence for a functional interaction between C-peptide and insulin. In this way, C-peptide has ambiguous effects, acting as an antithrombotic or thrombotic molecule, depending on the physiological environment and disease conditions. Moreover, C-peptide regulates interaction of leucocytes, erythrocytes, and platelets with the endothelium. The beneficial effects include stimulation of nitric oxide production with its subsequent release by platelets and endothelium, the interaction with erythrocytes leading to the generation of adenosine triphosphate, and inhibition of atherogenic cytokine release. The undesirable action of C-peptide includes the chemotaxis of monocytes, lymphocytes, and smooth muscle cells. Also, C-peptide was related with increased lipid deposits and elevated smooth muscle cells proliferation in the vessel wall, contributing to atherosclerosis. Purpose of this review is to explore these dual roles of C-peptide on the blood, contributing at one side to haemostasis and the other to atherosclerotic process.

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C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study

Cited by 25 publications

References 35 publications

C‐peptide is associated with NAFLD inflammatory and fibrotic progression in type 2 diabetes

C‐peptide is associated with NAFLD inflammatory and fibrotic progression in type 2 diabetes

Etiology, risk factors, clinical features, and pitfalls in the management of newly diagnosed diabetic children and adolescents

The dual effect of C‐peptide on cellular activation and atherosclerosis: Protective or not?

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