Diabetes & Metabolism Journal

Original Article

Correlations between Glucagon Stimulated C-peptide Levels and Microvascular Complications in Type 2 Diabetes Patients: Hye-Jin Yoon, Youn-Zoo Cho, Ji-young Kim, Byung-Joon Kim, Keun-Young Park, Gwan-Pyo Koh, Dae-Ho Lee, Dong-Mee Lim; Diabetes Metab J. 2012;36(5):379-387. Published online October 18, 2012; DOI: https://doi.org/10.4093/dmj.2012.36.5.379

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Background

This study aimed to investigate whether stimulated C-peptide is associated with microvascular complications in type 2 diabetes mellitus (DM).

Methods

A cross-sectional study was conducted in 192 type 2 diabetic patients. Plasma basal C-peptide and stimulated C-peptide were measured before and 6 minutes after intravenous injection of 1 mg glucagon. The relationship between C-peptide and microvascular complications was statistically analyzed.

Results

In patients with retinopathy, basal C-peptide was 1.9±1.2 ng/mL, and stimulated C-peptide was 2.7±1.6 ng/mL; values were significantly lower compared with patients without retinopathy (P=0.031 and P=0.002, respectively). In patients with nephropathy, basal C-peptide was 1.6±0.9 ng/mL, and stimulated C-peptide was 2.8±1.6 ng/mL; values were significantly lower than those recorded in patients without nephropathy (P=0.020 and P=0.026, respectively). Stimulated C-peptide level was associated with increased prevalence of microvascular complications. Age-, DM duration-, and hemoglobin A1c-adjusted odds ratios for retinopathy in stimulated C-peptide value were 4.18 (95% confidence interval [CI], 1.40 to 12.51) and 3.35 (95% CI, 1.09 to 10.25), respectively. The multiple regression analysis between nephropathy and C-peptide showed that stimulated C-peptide was statistically correlated with nephropathy (P=0.03).

Conclusion

In patients with type 2 diabetes, the glucagon stimulation test was a relatively simple method of short duration for stimulating C-peptide response. Stimulated C-peptide values were associated with microvascular complications to a greater extent than basal C-peptides.

Citations

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Response

Response: Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetic Patients (Diabetes Metab J 2011;35:41-9): Sung-Tae Kim, Byung-Joon Kim, Dong-Mee Lim, In-Geol Song, Jang-Han Jung, Kang-Woo Lee, Keun-Young Park, Youn-Zoo Cho, Dae-Ho Lee, Gwan-Pyo Koh; Diabetes Metab J. 2011;35(2):190-191. Published online April 30, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.2.190

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Original Articles

Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetic Patients: Sung-Tae Kim, Byung-Joon Kim, Dong-Mee Lim, In-Geol Song, Jang-Han Jung, Kang-Woo Lee, Keun-Young Park, Youn-Zoo Cho, Dae-Ho Lee, Gwan-Pyo Koh; Diabetes Metab J. 2011;35(1):41-49. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.41

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22 Crossref

Abstract PDF PubReader

Background

Recent studies have revealed that C-peptide induces smooth muscle cell proliferation and causes human atherosclerotic lesions in diabetic patients. The present study was designed to examine whether the basal C-peptide levels correlate with cardiovascular risk in type 2 diabetes mellitus (T2DM) patients.

Methods

Data was obtained from 467 patients with T2DM from two institutions who were followed for four years. The medical findings of all patients were reviewed, and patients with creatinine >1.4 mg/dL, any inflammation or infection, hepatitis, or type 1 DM were excluded. The relationships between basal C-peptide and other clinical values were statistically analyzed.

Results

A simple correlation was found between basal C-peptide and components of metabolic syndrome (MS). Statistically basal C-peptide levels were significantly higher than the three different MS criteria used in the present study, the Adult Treatment Panel III (ATP III) of the National Cholesterol Education Program's (NCEP's), World Health Organization (WHO), and the International Diabetes Federation (IDF) criteria (NCEP-ATP III, P=0.001; IDF, P<0.001; WHO, P=0.029). The multiple regression analysis between intima-media thickness (IMT) and clinical values showed that basal C-peptide significantly correlated with IMT (P=0.043), while the analysis between the 10-year coronary heart disease risk by the United Kingdom Prospective Diabetes Study risk engine and clinical values showed that basal C-peptide did not correlate with IMT (P=0.226).

Conclusion

Basal C-peptide is related to cardiovascular predictors (IMT) of T2DM, suggesting that basal C-peptide does provide a further indication of cardiovascular disease.

Citations

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The Correlation Between C-Peptide and Severity of Peripheral Atherosclerosis in Type 2 Diabetes Mellitus
Maisa A Wahab, Alshaymaa Alhabibi, Ahmed Khairy Sakr, Mohamed Yahia Zakaria, Ola I Saleh, Inass Hassan Ahmad, Eman Abdelrahman, Randa Taha, Fayka Karem Abdel Azeem Ahmed, Bothayna Ismail, Lamiaa Hosney Azel, Asmaa S Hassan, Hanaa Mohammed Eid El Sayed, Sa
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Blood C‐peptide concentration as a proxy marker of cardiovascular disease: An observational cross‐sectional study
Laurinda Adusu‐Donkor, Emmanuel Kwaku Ofori, Fleischer C. N. Kotey, Francis Kwaku Dogodzi, Wormenor Dziedzorm, Alfred Buabeng, Segla Kwame Bernard, Seth K. Amponsah, Henry Asare‐Anane
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The impact of insulin induced lipohypertrophy on carotid intima-media thickness in patients with type 2 diabetes mellitus
Cem Onur Kirac, Vehbi Sirikci, Huseyin Avni Findikli
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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
Juan Qin, Rongli Sun, Ding Ding, Yuvaraja Teekaraman
Contrast Media & Molecular Imaging.2022;[Epub] CrossRef
Correlation between serum C-peptide-releasing effects and the risk of elevated uric acid in type 2 diabetes mellitus
Yanyan Liu, Xue Zhao, Zequn Yang, Shurui Wang, Cong Han, Huijuan Zhang
Endocrine Journal.2022; 69(7): 773. CrossRef
Human C-peptide is a ligand of the elastin-receptor-complex and therewith central to human vascular remodelling and disease in metabolic syndrome
Gert Wensvoort
Medical Hypotheses.2022; 168: 110964. CrossRef
Influence of blood glucose fluctuation, C-peptide level and conventional risk factors on carotid artery intima–media thickness in Chinese Han patients with type 2 diabetes mellitus
Min Liu, Li Ao, Xinyu Hu, Jianning Ma, Kena Bao, Ye Gu, Jing Zhao, Weiping Huang
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Serum C peptide and carotid intima-medial thickness are independent markers of glucose intolerance among patients with ischemic cerebrovascular stroke
Nearmeen M. Rashad, Ghada M. Samir, Hanan M. Sabry, Nesreen M. Mohy, Shereen M. El Shabrawy
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Biomarker potential of C-peptide for screening of insulin resistance in diabetic and non-diabetic individuals
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SERUM C-PEPTIDE LEVEL IN OBESE AND NON-OBESE PATIENTS WITH TYPE 2 DIABETES MELLITUS
Shamha Beegum Mariyam, Saboora Beegum Muthubeevi, Sandhya Chandrasekharan Vasantha
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Zhi‐Qi Wu, Ju Lu, Hua‐Guo Xu
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Itahisa Marcelino Rodríguez, José Oliva García, José Juan Alemán Sánchez, Delia Almeida González, Santiago Domínguez Coello, Buenaventura Brito Díaz, Fadoua Gannar, María del Cristo Rodríguez Pérez, Roberto Elosua, Antonio Cabrera de León
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C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study
Lingshu Wang, Peng Lin, Aixia Ma, Huizhen Zheng, Kexin Wang, Wenjuan Li, Chuan Wang, Ruxing Zhao, Kai Liang, Fuqiang Liu, Xinguo Hou, Jun Song, Yiran Lu, Ping Zhu, Yu Sun, Li Chen, Marta Letizia Hribal
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Antonio Cabrera de León, José Gregorio Oliva García, Itahisa Marcelino Rodríguez, Delia Almeida González, José Juan Alemán Sánchez, Buenaventura Brito Díaz, Santiago Domínguez Coello, Vicente Bertomeu Martínez, Armando Aguirre Jaime, María del Cristo Rodr
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Susan Costantini, Francesca Capone, Eliana Guerriero, Raffaele Marfella, Angela Sorice, Patrizia Maio, Michele Di Stasio, Giuseppe Paolisso, Giuseppe Castello, Giovanni Colonna, Patricia Fitzgerald-Bocarsly
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Dusica Vasic, Daniel Walcher
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Letter: Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetes Patients (Diabetes Metab J 2011;35:41-9)
Min Suk Lee, Hae Jin Kim
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Response: Basal C-peptide Level as a Surrogate Marker of Subclinical Atherosclerosis in Type 2 Diabetic Patients (Diabetes Metab J 2011;35:41-9)
Sung-Tae Kim, Byung-Joon Kim, Dong-Mee Lim, In-Geol Song, Jang-Han Jung, Kang-Woo Lee, Keun-Young Park, Youn-Zoo Cho, Dae-Ho Lee, Gwan-Pyo Koh
Diabetes & Metabolism Journal.2011; 35(2): 190. CrossRef

Clinical Characteristics of Type 2 Diabetes Patients according to Family History of Diabetes: Seung Uk Jeong, Dong Gu Kang, Dae Ho Lee, Kang Woo Lee, Dong-Mee Lim, Byung Joon Kim, Keun-Yong Park, Hyoun-Jung Chin, Gwanpyo Koh; Korean Diabetes J. 2010;34(4):222-228. Published online August 31, 2010; DOI: https://doi.org/10.4093/kdj.2010.34.4.222

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Abstract PDF PubReader

Background

Type 2 diabetes mellitus (T2DM) has a strong genetic component, and its prevalence is notably increased in the family members of T2DM patients. However, there are few studies about the family history of T2DM. We carried out this study to assess the influences of family history on clinical characteristics in T2DM patients.

Methods

This is a cross-sectional study involving 651 T2DM patients. Patient history and physical examination were performed and fasting blood was taken. If any first degree relative was diabetic, a family history of diabetes was considered to exist.

Results

Among the total 621 patients, 38.4% had a family history of diabetes. Patients with a family history had a younger age, higher weight, younger age at diagnosis and higher triglyceride level than did those without a family history. Dyslipidemia medication and metabolic syndrome were more prevalent in familial diabetes. Sex, blood pressure, previous treatment for diabetes, HbA1c, C-peptide, total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol were not different between familial and non-familial diabetes. Upon multiple linear regression analysis, the family history of diabetes remained significantly associated with serum triglyceride level.

Conclusion

In T2DM patients with a family history of diabetes, the disease tended to develop earlier. Metabolic syndrome and cardiovascular risk factors are more prevalent in familial T2DM than they were in non-familial T2DM. These results support the necessity of earlier screening for diabetes in family members of T2DM patients and more active prevention against cardiovascular disease in T2DM patients with a family history.

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