Effects of Serum C‐Peptide Level on Blood Lipid and Cardiovascular and Cerebrovascular Injury in Patients with Type 2 Diabetes Mellitus: A Meta‐Analysis

Qin, Juan; Sun, Rongli; Ding, Ding

doi:10.1155/2022/6314435

Cited by 6 publications

(1 citation statement)

References 20 publications

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“…В контексте темы нашего исследования любопытны данные T. Wang et al о том, что у пациентов без ожирения при высокой ИР риск развития ССЗ повышается на 77 % (отношение шансов 1,77, 95%-й доверительный интервал 1,26-2,46), тогда как у участников с сахарным диабетом 2 типа без ожирения -на 70 % (отношение шансов 1,70, 95%-й доверительный интервал 1,43-2,02) [23]. При этом J. Qin et al представили метаанализ (n = 2588), согласно которому низкий уровень С-пептида способствует усугублению гипоХС-ЛПВП и значительно увеличивает частоту ишемической болезни сердца и цереброваскулярной болезни у пациентов с сахарным диабетом 2 типа [24]. Судя по всему, характер влияния С-пептида на метаболические процессы определяется не только его концентрацией, но и уровнем некоторых других веществ (инсулина, глюкозы, липидов и т.д.).…”

Section: показатель / Parametersunclassified

Associations of C-peptide with cardiometabolic parameters in women aged 25–44 years with different metabolic phenotypes

Мустафина

Alferova

Щербакова

et al. 2023

jour

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The development of atherosclerotic diseases is pathogenetically associated with an increase in insulin resistance, an indirect marker of which is the C-peptide. In addition, literature data indicate the intrinsic proatherogenic effects of C-peptide. In recent years, the concept of separating metabolically healthy (MHP) and unhealthy phenotype (MUHP) at different body weights has become increasingly widespread. It believed that the key difference between MHP and MUHP is the more pronounced insulin resistance in the latter, but there are no clear data on the association of C-peptide with MHP or MUHP. Aim of the study was to investigate the association of C-peptide level with different metabolic phenotypes in women aged 25–44 years. Material and methods. The study was conducted on the basis of a representative sample of women aged 25–44 years (n = 1513, of which 840 women). The analysis included indicators of 655 women. The definition of MHP and MUHP carried out using the IDF criteria, 2005 for the diagnosis of metabolic syndrome. Anthropometric measurements, biochemical and hormonal blood tests have been carried out in groups divided by the body mass index (BMI). The level of C-peptide was determined by the method of multiplex analysis. Results. C-peptide content in the examined sample was 0.9 [0.5; 1.3] ng/ml (Me [Q1; Q3]), with MHP – 0.8 [0.5; 1.1] ng/ml, with MUHP – 1.3 [0.7; 1.8] ng/ml, p < 0.0001. With an increase in BMI, the median of C-peptide increased both in MHP (from 0.8 [0.4; 1.1] to 1.2 [0.8; 1.7] ng/mL, ptrend < 0.0001) and with MUHP (from 0.8 [0.2; 1.2] to 1.5 [0.9; 2.1] ng/mL, ptrend = 0.006). The frequency of MUHP in the 4th quartile of the C-peptide is 2.7 times higher than in the 1st quartile (p < 0.0001), and the frequency of MHP – 1.6 times lower (p = 0.001). C-peptide content correlated with anthropometric parameters, glucose, lipid concentration, transaminase activity, kidney filtration capacity. A C-peptide level of more than 1.33 in young women indicates a high probability of having MUHP with maximum sensitivity and specificity (Se = 49.3 %, Sp = 85.9 %). Conclusions. In women with MUHP, C-peptide content is 38.5 % higher than in women with MHP. The frequency of MUHP in the 4th quartile of the C-peptide is 3.2 times higher than in the 1st quartile. The level of C-peptide above 1.33 ng/ml is associated with the presence of MUHP.

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Section: показатель / Parametersunclassified

Associations of C-peptide with cardiometabolic parameters in women aged 25–44 years with different metabolic phenotypes

Мустафина

Alferova

Щербакова

et al. 2023

jour

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The Impact of C-Peptide and Diabetes Mellitus on Coronary Ectasia and Effect of Coronary Ectasia and C-Peptide on Long-Term Outcomes: A Retrospective Cohort Study

Toprak

Kaplangöray

Palice

2022

International Journal of Clinical Practice

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Background. Coronary artery ectasia (CAE) is an entity frequently associated with atherosclerotic coronary artery disease (CAD) in clinical practice. Although it has common risk factors with atherosclerotic CAD in its development, the pathophysiology of CAE is not fully known and it is not seen in every CAD suggesting that different determinants may play a pivotal role in the development of CAD. This study aimed to reveal the impact of C-peptide and diabetes mellitus (DM) on CAE and the effect of C-peptide and coronary ectasia on long-term outcomes in patients who underwent coronary angiography. Methods. A total of 6611 patients who underwent coronary angiography were followed up retrospectively, and their major adverse cardiovascular event (MACE) status of an average of sixty months was recorded. According to their angiographic features, the patients were divided into two groups those with and without CAE. MACE development was accepted as the primary endpoint. Results. A total of 552 patients had CAE and MACE developed in 573 patients. Patients with CAE and higher C-peptide levels (Q4 + Q3) showed higher rates of MACE as compared to those without CAE and lower C-peptide levels (Q1 + Q2) (20.8% vs 7.6%; 70.1% vs 29.1%; p < 0.001 , for both of them). In multivariate regression analysis, high C-peptide levels were determined as an independent risk factor for CAE (OR 2.417; 95% CI 2.212–2.641; p < 0.001 ). The Kaplan–Meier cumulative survival curves showed that the risks for MACE increased as the C-peptide levels increased. The Cox regression analysis for 5-years MACE related to the plasma C-peptide levels and presence of CAE, C-peptide, and CAE were found to be independent predictors of MACE (HR = 1.255, 95% CI: 1.164–1.336, p < 0.001 and HR = 1.012, 95% CI: 1.002–1.023, p = 0.026 , respectively). Conclusion. Our study revealed that a high C-peptide level is an independent risk factor for CAE and that CAE and C-peptide are independent predictors for the development of MACE.

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The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study

Yan

Sun

et al. 2022

Cardiovasc Diabetol

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Background Recent literature reported the biological role of C-peptide, but this role is still controversial and unclear. The primary aim of this study was to investigate associations between C-peptide and cardiovascular biomarkers as well as events. Methods A total of 55636 participants who had a health examination from 2017 to 2021 were included. Of them, 6727 participants visited the hospital at least twice. Cardiovascular biomarkers like high-sensitivity C-reactive protein (hs-CRP) and high-sensitivity cardiac troponin T (hs-cTnT) were measured and their relationships with fasting C-peptide were evaluated for all participants. Cardiovascular events were obtained during the last visit and their associations with C-peptide were evaluated for those participants who visited the hospital at least twice. Results Among the included participants, 11.1% had a previous type 2 diabetes mellitus (T2DM). In the participants without previous T2DM, the relationships between fasting C-peptide and hs-CRP and hs-cTnT were negative if the value of fasting C-peptide was < 1.4 ng/mL and positive if the value was ≥ 1.4 ng/mL. These relationships remained significant after adjusting for hemoglobin A1c, insulin resistance index, and its interaction with C-peptide, even if the participants were stratified by glucose metabolism status or levels of insulin resistance index. Hazard ratios of cardiovascular events were first decreased and then increased with the increasing of baseline C-peptide levels, though these associations became unsignificant using the multivariate Cox regression model. Unlike the participants without previous T2DM, the associations of C-peptide with cardiovascular biomarkers and events were not significant in the patients with previous T2DM. Conclusions The associations of C-peptide with cardiovascular biomarkers and events were different between the participants without previous T2DM and those with previous T2DM. The effect of C-peptide on cardiovascular risk may be bidirectional, play a benefit role at a low level, and play a harmful role at a high level in the nondiabetic adults and the patients with newly diagnosed T2DM.

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Effects of Serum C‐Peptide Level on Blood Lipid and Cardiovascular and Cerebrovascular Injury in Patients with Type 2 Diabetes Mellitus: A Meta‐Analysis

Cited by 6 publications

References 20 publications

Associations of C-peptide with cardiometabolic parameters in women aged 25–44 years with different metabolic phenotypes

Associations of C-peptide with cardiometabolic parameters in women aged 25–44 years with different metabolic phenotypes

The Impact of C-Peptide and Diabetes Mellitus on Coronary Ectasia and Effect of Coronary Ectasia and C-Peptide on Long-Term Outcomes: A Retrospective Cohort Study

The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study

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