History and Diagnostic Significance of C‐Peptide

Brandenburg, Dietrich

doi:10.1155/2008/576862

Cited by 37 publications

(20 citation statements)

References 48 publications

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“…The first radioimmunoassay for C‐peptide was developed in 1970 with clinical studies following shortly after . We have deliberately emphasized studies reporting diagnostic performance and more recent evidence (where available) in view of improvements in the C‐peptide assay (see ‘The C‐peptide assay’ below) and changes in classification and treatment of diabetes over time .…”

Section: Methodsmentioning

confidence: 99%

The clinical utility of C‐peptide measurement in the care of patients with diabetes

2013

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C-peptide is produced in equal amounts to insulin and is the best measure of endogenous insulin secretion in patients with diabetes. Measurement of insulin secretion using C-peptide can be helpful in clinical practice: differences in insulin secretion are fundamental to the different treatment requirements of Type 1 and Type 2 diabetes. This article reviews the use of C-peptide measurement in the clinical management of patients with diabetes, including the interpretation and choice of C-peptide test and its use to assist diabetes classification and choice of treatment. We provide recommendations for where C-peptide should be used, choice of test and interpretation of results. With the rising incidence of Type 2 diabetes in younger patients, the discovery of monogenic diabetes and development of new therapies aimed at preserving insulin secretion, the direct measurement of insulin secretion may be increasingly important. Advances in assays have made C-peptide measurement both more reliable and inexpensive. In addition, recent work has demonstrated that C-peptide is more stable in blood than previously suggested or can be reliably measured on a spot urine sample (urine C-peptide:creatinine ratio), facilitating measurement in routine clinical practice. The key current clinical role of C-peptide is to assist classification and management of insulin-treated patients. Utility is greatest after 3–5 years from diagnosis when persistence of substantial insulin secretion suggests Type 2 or monogenic diabetes. Absent C-peptide at any time confirms absolute insulin requirement and the appropriateness of Type 1 diabetes management strategies regardless of apparent aetiology.

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Section: Methodsmentioning

confidence: 99%

The clinical utility of C‐peptide measurement in the care of patients with diabetes

2013

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“…Although BNP, C‐Pep and SP have physiological roles in humans 18–23, DJNKI is a synthetic inhibitor of Jun kinases that shows therapeutic effect on various diseases in human or animal models 24–26 (http://www.xigen.ch).…”

Section: Introductionmentioning

confidence: 99%

Comparison between a linear ion trap and a triple quadruple MS in the sensitive detection of large peptides at femtomole amounts on column

Vatansever

Lahrichi

Thiocone

et al. 2010

J of Separation Science

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In addition to the importance of sample preparation and extract separation, MS detection is a key factor in the sensitive quantification of large undigested peptides. In this article, a linear ion trap MS (LIT-MS) and a triple quadrupole MS (TQ-MS) have been compared in the detection of large peptides at subnanomolar concentrations. Natural brain natriuretic peptide, C-peptide, substance P and D-Junk-inhibitor peptide, a full D-amino acid therapeutic peptide, were chosen. They were detected by ESI and simultaneous MS(1) and MS(2) acquisitions. With direct peptide infusion, MS(2) spectra revealed that fragmentation was peptide dependent, milder on the LIT-MS and required high collision energies on the TQ-MS to obtain high-intensity product ions. Peptide adsorption on surfaces was overcome and peptide dilutions ranging from 0.1 to 25 nM were injected onto an ultra high-pressure LC system with a 1 mm id analytical column and coupled with the MS instruments. No difference was observed between the two instruments when recording in LC-MS(1) acquisitions. However, in LC-MS(2) acquisitions, a better sensitivity in the detection of large peptides was observed with the LIT-MS. Indeed, with the three longer peptides, the typical fragmentation in the TQ-MS resulted in a dramatic loss of sensitivity (> or = 10x).

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“…Stimulated insulin secretion capacity is currently used as an indirect measure of BCM. However, insulin secretion measurements are limited not only by their inability to predict the development of diabetes, for which metabolic or inflammatory stress may reversibly compromise β-cell function without BCM losses, but also by their large intraassay variability (4). Direct invasive β-cell sampling is technically difficult and not practical.…”

Section: Search For Biomarkers Of β-Cellsmentioning

confidence: 99%

“…(Left) Cytoplasmic dopamine is synthesized (1) and then transported (2) by VMAT2 into presynaptic vesicles and later delivered to synaptic junction by exocytosis (3). Dopamine diffuses across junction and binds to receptors on postsynaptic cell (4). Activated receptors change activity of postsynaptic neuron.…”

Section: Figurementioning

confidence: 99%

Imaging of β-Cell Mass and Function

Ichise

Harris

2010

J Nucl Med

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In both type 1 and type 2 diabetes mellitus, β-cell mass (BCM), which exclusively produces insulin, is lost. Various therapeutic strategies are being developed that target BCM to restore its function by promoting β-cell neogenesis and regeneration or by preventing its apoptosis. To this end, it is essential to identify biomarkers of BCM. Of the various imaging platforms, radionuclide-based imaging methods using radioligands that directly target BCM appear promising. In particular, the vesicular monoamine transporter type 2 (VMAT2), which is expressed almost exclusively by β-cells and found in close association with insulin, can be noninvasively imaged with PET and 11C-dihydrotetrabenazine or its derivatives. Despite the major limitation that β-cells are low in abundance (1%–2%) and dispersed throughout the pancreas, VMAT2 PET is sensitive enough to detect VMAT2 signal and to allow kinetic model–based quantification of VMAT2 binding within the pancreas. However, these techniques are still in early stages, and careful further evaluations and technical developments are needed before they can be clinically used as a valid biomarker of BCM.

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History and Diagnostic Significance of C‐Peptide

Cited by 37 publications

References 48 publications

The clinical utility of C‐peptide measurement in the care of patients with diabetes

The clinical utility of C‐peptide measurement in the care of patients with diabetes

Comparison between a linear ion trap and a triple quadruple MS in the sensitive detection of large peptides at femtomole amounts on column

Imaging of β-Cell Mass and Function

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