Fasting Serum C‐Peptide Levels Predict Cardiovascular and Overall Death in Nondiabetic Adults

Patel, Nileshkumar; Taveira, Tracey H.; Choudhary, Gaurav; Whitlatch, Hilary; Wu, Wen‐Chih

doi:10.1161/jaha.112.003152

Cited by 77 publications

(73 citation statements)

References 47 publications

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“…The pro-atherogenic effects are doserelated and produce increased chemotactic activity, proliferation of aortic smooth muscle cells, and activation of key inflammatory mediators involved in atherogenic processes, including the NFκ B factor (Lebbherz and Marx, 2013). Positive correlations of high C-peptide levels with cardiovascular deaths are stronger than fasting glucose levels, homeostatic model assessment index or insulin in adult non-diabetics (Patel et al, 2012;Min and Min, 2013). High fasting C-peptide concentrations are also related to risk of liver and biliary tract cancer and low cognition scores in middle age subjects with insulin resistance (Pedersen et al, 2012;Aleksandrovaet et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease

Calderón‐Garcidueñas

Franco-Lira

D’Angiulli

et al. 2015

Environmental Research

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Section: Discussionmentioning

confidence: 99%

Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease

Calderón‐Garcidueñas

Franco-Lira

D’Angiulli

et al. 2015

Environmental Research

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“…Our findings are consistent with the results of previous studies and suggest a role for C-peptide in predicting increased risk of cardiovascular events and death regardless of the presence of diabetes. [6][7][8][9][10][11][12] Among patients with type 2 diabetes, C-peptide level has been reported to be significantly correlated with intima-media thickness, 10 triglyceride level, high-density lipoproten cholesterol levels, leptin levels and BMI. 8 The Wisconsin Epidemiologic Study of Diabetic Retinopathy followed 1007 individuals with older-onset diabetes over 16 years.…”

Section: Discussionmentioning

confidence: 99%

“…12 A community-based survey of adults aged 30 years and older with normal glucose tolerance found that serum C-peptide levels were quantitatively associated with the signs and symptoms of metabolic syndrome X, including BMI, triglyceride level, high-density lipoprotein cholesterol level and blood pressure. 7,9 The recent study by Patel and colleagues 11 found that C-peptide levels were superior to other known indices (e.g., serum insulin, the homeostatic model assessment of insulin resistance, and the quantitative insulin sensitivity check index) in predicting all-cause and cardiovascular-related mortality among adults without diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…6 Recent studies have suggested that Cpeptide may be a valuable predictor of cardiovascular events and mortality (all-cause and cardiovascular-related mortality). [6][7][8][9][10][11][12] In this study, we investigated the association between serum C-peptide level and all-cause, cardiovascular-related and coronary artery disease-related mortality among patients without diabetes. We also estimated mortality as C-peptide increased across glycated hemoglobin and fasting blood glucose quartiles.…”

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confidence: 99%

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Serum C-peptide levels and risk of death among adults without diabetes mellitus

Min

2013

CMAJ

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Background:Connecting peptide (C-peptide) plays a role in early atherogenesis in patients with diabetes mellitus and may be a marker for cardiovascular morbidity and mortality in patients without diabetes. We investigated whether serum C-peptide levels are associated with all-cause, cardiovascular-related and coronary artery disease-related mortality in adults without diabetes. Methods:We used data from the Third Nutrition and Health Examination Survey (NHANES III) and the NHANES III Linked Mortality File in the United States. We analyzed mortality data for 5902 participants aged 40 years and older with no history of diabetes and who had available serum C-peptide levels from the baseline examination. We grouped the participants by C-peptide quartile, and we performed Cox proportional hazards regression analysis. The primary outcome was all-cause, cardiovascular-related and coronary artery diseaserelated mortality. Results:The mean serum C-peptide level in the study sample was 0.78 (± standard deviation 0.47) nmol/L. The adjusted hazards ratio comparing the highest quartile with the lowest quartile was 1.80 (95% confidence interval [CI] 1.33-2.43) for all-cause mortality, 3.20 (95% CI 2.07-4.93) for cardiovascular-related mortality, and 2.73 (95% CI 1.55-4.82) for coronary artery disease-related mortality. Higher C-peptide levels were associated with increased mortality among strata of glycated hemoglobin and fasting serum glucose. Interpretation:We found an association between serum C-peptide levels and all-cause and cause-specific mortality among adults without diabetes at baseline. Our finding suggests that elevated C-peptide levels may be a predictor of death. AbstractResearch CMAJ, June 11, 2013, 185(9) E403

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“…For instance, when C-peptide levels were analyzed in 5153 non-diabetic adults between 40 and 74 years of age, individuals with the highest C-peptide measurements (≥0.984 nmol/L = 2.95 ng/ml, (27)) had a 60% increase in the adjusted hazards of cardiovascular death compared to those with the lowest (≤0.418 nmol/L = 1.25 ng/ml). This trend persisted in risk for cerebrovascular disease, ischemic heart disease, myocardial infarction, and overall mortality (29). C-peptide induces proliferation of smooth muscle cells potentially leading to the development of atherosclerotic lesions (30).…”

Section: Discussionmentioning

confidence: 95%

Association of Insulin-Related Serum Factors with Colorectal Polyp Number and Type in Adult Males

Comstock

Hortos

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Dysregulated insulin signaling is thought to contribute to cancer risk. Methods To determine if insulin-related serum factors are associated with colon polyps, 126 asymptomatic men (48–65yr) were recruited at colonoscopy. Blood was collected. Odds ratios were determined using polytomous logistic regression for polyp number and type. Results Males with serum C-peptide concentration >3.3 ng/ml were 3.8 times more likely to have an adenoma relative to no polyp than those with C-peptide ≤1.8 ng/ml. As C-peptide tertile increased, an individual was 2 times more likely to have an adenoma (p=0.01) than no polyp. There were no associations between insulin-like growth factor or its binding proteins with polyp number or type. Males with soluble receptor for advanced glycation end products (sRAGE) concentration >120.4 pg/ml were 0.25 times less likely to have ≥3 polyps relative to no polyps compared to males with sRAGE ≤94.5 pg/ml. For each increase in sRAGE tertile, a man was 0.5 times less likely to have ≥3 polyps than no polyps (p=0.03). Compared to males with a serum vascular endothelial growth factor (VEGF) concentration ≤104.7 pg/ml, males with a serum VEGF concentration >184.2 pg/ml were 3.4 times more likely to have ≥3 polyps relative to no polyps. As the VEGF tertile increased, a man was 1.9 times more likely to have ≥3 polyps than no polyps (p=0.049). Conclusions Serum concentrations of C-peptide, sRAGE, and VEGF may indicate which men could benefit most from colonoscopy. Impact Identification of biomarkers could reduce medical costs through the elimination of colonoscopies on low-risk individuals.

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Fasting Serum C‐Peptide Levels Predict Cardiovascular and Overall Death in Nondiabetic Adults

Cited by 77 publications

References 47 publications

Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease

Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease

Serum C-peptide levels and risk of death among adults without diabetes mellitus

Association of Insulin-Related Serum Factors with Colorectal Polyp Number and Type in Adult Males

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