Urinary C-peptide and urinary C-peptide creatinine ratio as markers for insulin resistance in obese children and adolescents

Hassan, Ahmed A.; Elshall, Sara; Erfan, Adel Ali; Hafez, Mona; Salah, Wesam; Elrifaey, Shaymaa; Amrousy, Doaa El

doi:10.1038/s41390-021-01847-2

Cited by 6 publications

(7 citation statements)

References 35 publications

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“…19 Our study showed a significant positive correlation between UCPCR and HOMA-IR that remains significant after regression analysis, which may indicate that UCPCR can also be a potentially useful method for the assessment of the degree of insulin resistance in NAFLD in children with obesity. 19 This is in accordance with Hassan et al 18 , who reported that in obese children, UCPCR was a better predictor of IR than UCP in a multivariate logistic regression research. This showed that UCPCR is more reliable marker for predicting IR in obese children than UCP; nonetheless, both markers have good sensitivity for predicting IR.…”

Section: Discussionsupporting

confidence: 89%

“…The sensitivity of UCP and UCPCR to diagnose IR in children with obesity was 71.4% and 87.6%, respectively and the specificity was 70% and 84%, respectively. 18 Our results were expected as the measurement of UCPCR reflects the endogenous insulin secretion which has already been established to be higher in children with obesity and NAFLD and this can discriminate it from those without NAFLD. 11,12 UCPCR is a simple, practical, non-invasive, easy test that is stable at room temperature for 3 days in a preservative which allows outpatient and home samples to be collected and sent for analysis later on.…”

Section: Discussionsupporting

confidence: 52%

“…This showed that UCPCR is more reliable marker for predicting IR in obese children than UCP; nonetheless, both markers have good sensitivity for predicting IR. 18 Insulin resistance is a common feature of obesity and the link between the two has long been known, with substantial scientific and therapeutic implications. 5…”

Section: Discussionmentioning

confidence: 99%

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Urinary C-peptide creatinine ratio is a significant indicator of non-alcoholic fatty liver disease in children with obesity

Farghaly¹,

Metwalley²,

Gamal³

et al. 2022

Turk J Pediatr

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Background. Nonalcoholic fatty liver disease (NAFLD) is the commonest etiology of chronic hepatic problems in children with obesity. This study aimed to assess whether urinary C-peptide creatinine ratio (UCPCR) might be a potential indicator of NAFLD in obese children. Methods. The study included 240 children with simple obesity. Hepatic ultrasonic examination, anthropometric and laboratory measurements including fasting plasma glucose, fasting insulin, fasting C peptide, liver, renal profile, lipid profile, and UCPCR were obtained in all cases. According to the results of the hepatic ultrasonography, cases were classified into two categories, those with NAFLD (n=98) and without NAFLD (n= 142). Results. In cases with NAFLD, UCPCR was significantly higher than those without NAFLD (P &amp;lt; 0.001). A significant positive correlation between UCPCR and waist circumference (WC SDS), triglyceride, fasting C-peptide, HOMA-IR and alanine aminotransferase (ALT) was found (P &amp;lt; 0.001 for each). Adjusting for other variables, UCPCR was the most significant predictor of NAFLD in children with obesity with higher odds ratio (OR = 3.26) than fasting C peptide (OR = 2.87), triglyceride (OR = 1.89), ALT (OR = 2.20), WC SDS (OR = 1.32) and age (OR=1.27) . UCPCR cut-off value of 0.755 nmol/mmol was able to discriminate cases with NAFLD from those without NAFLD with a sensitivity of 95%, a specificity of 87%. Conclusions. We concluded that UCPCR is a useful, practical and non-invasive predictor of NAFLD in children with obesity with high sensitivity and specificity.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 52%

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Urinary C-peptide creatinine ratio is a significant indicator of non-alcoholic fatty liver disease in children with obesity

Farghaly¹,

Metwalley²,

Gamal³

et al. 2022

Turk J Pediatr

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“…For clinical use, a number of potential indications and approaches for diagnostic applications have already been suggested. These applications cover topics from pediatric measurements [5,12] to pregnant women at risk for GDM to elderly people with hyperinsulinemic obesity [12], and have been validated as a reproducible alternative to serum C-peptide, e.g., in patients with T2DM [23]. Additionally, Oram et.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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Background: C-peptide is produced in equimolar amounts with insulin from pancreatic beta cells, and thus is a fundamental biomarker for beta cell function. A non-invasive urinary C-peptide-to-creatinine ratio (UCPCR) has attracted attention as a biomarker for metabolic conditions. However, the UCPCR as an indicative risk predictor for prediabetes is still being investigated. Methods: We aimed to characterize UCPCRs in healthy people using American Diabetes Association (ADA) criteria and to evaluate their metabolic outcomes over time. A total of 1022 participants of the Biomarkers in Personalized Medicine cohort (BioPersMed) were screened for this study. Totals of 317 healthy with normal glucose metabolism, 87 prediabetic, and 43 diabetic subjects were included. Results: Prediabetic participants had a significantly higher UCPCR median value than healthy participants (p < 0.05). Dysglycaemia of healthy baseline participants was measured twice over 4.5 ± 0.9 years; 25% and 30% were detected with prediabetes during follow-ups, predicted by UCPCR both for the first (p < 0.05) and the second visit (p < 0.05), respectively. This is in good agreement with the negative predictive UCPCR value of 60.2% based on logistic regression. UCPCR levels were equal in both sexes. Conclusion: UCPCR measurements provide an indicative approach for metabolic risk, representing a potential use for prevention and monitoring of impaired glucose metabolism.

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Urinary c‐peptide creatinine ratio (UCPCR) as a predictor of coronary artery disease in type 1 diabetes mellitus

Irilouzadian

Afaghi

Tarki

et al. 2023

Endocrino Diabet & Metabol

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Background Elevated C‐peptide has been suggested as a risk factor for coronary artery disease (CAD). Elevated urinary C‐peptide to creatinine ratio (UCPCR) as an alternative measurement is shown to be related to insulin secretion dysfunction; however, data regarding UCPCR predictive value for CAD in diabetes mellitus (DM) are scarce. Therefore, we aimed to assess the UCPCR association with CAD in type 1 DM (T1DM) patients. Methods 279 patients previously diagnosed with T1DM included and categorized into two groups of CAD (n = 84) and without‐CAD (n = 195). Furthermore, each group was divided into obese (body mass index (BMI) ≥ 30) and non‐obese (BMI < 30) groups. Four models utilizing the binary logistic regression were designed to evaluate the role of UCPCR in CAD adjusted for well‐known risk factors and mediators. Results Median level of UCPCR was higher in CAD group compared to non‐CAD group (0.07 vs. 0.04, respectively). Also, the well‐acknowledged risk factors including being active smoker, hypertension, duration of diabetes, and body mass index (BMI) as well as higher levels of haemoglobin A1C (HbA1C), total cholesterol (TC), low‐density lipoprotein (LDL) and estimated glomeruli filtration rate (e‐GFR) had more significant pervasiveness in CAD patients. Based on multiple adjustments by logistic regression, UCPCR was a strong risk factor of CAD among T1DM patients independent of hypertension, demographic variables (gender, age, smoking, alcohol consumption), diabetes‐related factors (diabetes duration, FBS, HbA1C), lipid profile (TC, LDL, HDL, TG) and renal‐related indicators (creatinine, e‐GFR, albuminuria, uric acid) in both patients with BMI≥30 and BMI < 30. Conclusion UCPCR is associated with clinical CAD, independent of CAD classic risk factors, glycaemic control, insulin resistance and BMI in type 1 DM patients.

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Urinary C-peptide and urinary C-peptide creatinine ratio as markers for insulin resistance in obese children and adolescents

Cited by 6 publications

References 35 publications

Urinary C-peptide creatinine ratio is a significant indicator of non-alcoholic fatty liver disease in children with obesity

Urinary C-peptide creatinine ratio is a significant indicator of non-alcoholic fatty liver disease in children with obesity

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

Urinary c‐peptide creatinine ratio (UCPCR) as a predictor of coronary artery disease in type 1 diabetes mellitus

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