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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
  • 7,014 View
  • 51 Download
  • 23 Crossref
AbstractAbstract PDFPubReader   
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

Citations to this article as recorded by  
  • A Nomogram for Predicting Vision-Threatening Diabetic Retinopathy Among Mild Diabetic Retinopathy Patients: A Case–Control and Prospective Study of Type 2 Diabetes
    Jing Ke, Kun Li, Bin Cao
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 275.     CrossRef
  • The average 30-minute post-prandial C-peptide predicted diabetic retinopathy progress: a retro-prospective study
    Ting Pan, Jie Gao, Xinghua Cai, Huihui Zhang, Jun Lu, Tao Lei
    BMC Endocrine Disorders.2023;[Epub]     CrossRef
  • Dysregulation of miR-374a is involved in the progression of diabetic retinopathy and regulates the proliferation and migration of retinal microvascular endothelial cells
    Zhanhong Wang, Xiao Zhang, Yanjun Wang, Dailing Xiao
    Clinical and Experimental Optometry.2022; 105(3): 287.     CrossRef
  • The Relationship between the Lipid Accumulation Product and Beta-cell Function in Korean Adults with or without Type 2 Diabetes Mellitus: The 2015 Korea National Health and Nutrition Examination Survey
    Hye Eun Cho, Seung Bum Yang, Mi Young Gi, Ju Ae Cha, so Young Park, Hyun Yoon
    Endocrine Research.2022; 47(2): 80.     CrossRef
  • 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
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    Mehmet AYTEMUR, Bahar İNKAYA
    Turkish Journal of Diabetes and Obesity.2022; 6(2): 121.     CrossRef
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    Eli Ipp
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
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    Y. Wang, H. Wan, Y. Chen, F. Xia, W. Zhang, C. Wang, S. Fang, K. Zhang, Q. Li, N. Wang, Y. Lu
    Diabetes & Metabolism.2020; 46(1): 33.     CrossRef
  • Variations in glucose/C-peptide ratio in patients with type 2 diabetes associated with renal function
    John A. D'Elia, Christopher Mulla, Jiankang Liu, Larry A. Weinrauch
    Diabetes Research and Clinical Practice.2019; 150: 1.     CrossRef
  • The pharmacokinetics of porcine C‐peptide after intraperitoneal injection
    Naho Iizuka, Masuhiro Nishimura, Yasutaka Fujita, Osamu Sawamoto, Shinichi Matsumoto
    Xenotransplantation.2019;[Epub]     CrossRef
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    Lenin M, Ramesh Ramasamy, Sweta Kulkarani, Seetesh Ghose, Srinivasan A.R.S., Sathish Babu M
    Meta Gene.2018; 16: 134.     CrossRef
  • Glucagon secretion is increased in patients with Type 2 diabetic nephropathy
    Xiaoyu Wang, Juhong Yang, Baocheng Chang, Chunyan Shan, Yanguang Xu, Miaoyan Zheng, Ying Wang, Huizhu Ren, Liming Chen
    Journal of Diabetes and its Complications.2016; 30(3): 488.     CrossRef
  • Relationship between serum C-peptide level and diabetic retinopathy according to estimated glomerular filtration rate in patients with type 2 diabetes
    Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung
    Journal of Diabetes and its Complications.2015; 29(3): 350.     CrossRef
  • Independent association between serum C‐peptide levels and fat mass‐to‐lean mass ratio in the aging process
    Ying Li, Lian Shun Zheng, Yue Li, Duo Duo Zhao, Lu Meng
    Geriatrics & Gerontology International.2015; 15(7): 918.     CrossRef
  • Relationship Between β-Cell Function, Metabolic Control, and Microvascular Complications in Type 2 Diabetes Mellitus
    Lihua Zhao, Jing Ma, Shaoxin Wang, Yun Xie
    Diabetes Technology & Therapeutics.2015; 17(1): 29.     CrossRef
  • Association of fasting insulin and C peptide with diabetic retinopathy in Latinos with type 2 diabetes
    Jane Z Kuo, Xiuqing Guo, Ronald Klein, Barbara E Klein, Robert N Weinreb, Pauline Genter, Fone-Ching Hsiao, Mark O Goodarzi, Jerome I Rotter, Yii-Der Ida Chen, Eli Ipp
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    Ying Li, Lu Meng, QianQian Miao, Yasuto Sato
    Geriatrics & Gerontology International.2014; 14(3): 647.     CrossRef
  • Age at Diagnosis and C-Peptide Level Are Associated with Diabetic Retinopathy in Chinese
    Xiaoling Cai, Xueyao Han, Simin Zhang, Yingying Luo, Yingli Chen, Linong Ji, Alfred S. Lewin
    PLoS ONE.2014; 9(3): e91174.     CrossRef
  • Prevalence and risk factors for diabetic retinopathy in Asian Indians with young onset Type 1 and Type 2 Diabetes
    Ramachandran Rajalakshmi, Anandakumar Amutha, Harish Ranjani, Mohammed K. Ali, Ranjit Unnikrishnan, Ranjit Mohan Anjana, K.M. Venkat Narayan, Viswanathan Mohan
    Journal of Diabetes and its Complications.2014; 28(3): 291.     CrossRef
  • Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
    Kenjiro Imai, Tetsuro Tsujimoto, Atsushi Goto, Maki Goto, Miyako Kishimoto, Ritsuko Yamamoto-Honda, Hiroshi Noto, Hiroshi Kajio, Mitsuhiko Noda
    Diabetology & Metabolic Syndrome.2014;[Epub]     CrossRef
  • The Association between the Serum C-Peptide Level and Bone Mineral Density
    Ying Li, Hua Liu, Yasuto Sato, Bin He
    PLoS ONE.2013; 8(12): e83107.     CrossRef
  • C-Peptide and Its Career from Innocent Bystander to Active Player in Diabetic Atherogenesis
    Corinna Lebherz, Nikolaus Marx
    Current Atherosclerosis Reports.2013;[Epub]     CrossRef
  • C-Peptide and Vascular Complications in Type 2 Diabetic Subjects
    Seok Man Son
    Diabetes & Metabolism Journal.2012; 36(5): 345.     CrossRef
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
  • 65,535 View
  • 27 Download
PDFPubReader   
Original Article
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
  • 4,789 View
  • 40 Download
  • 22 Crossref
AbstractAbstract PDFPubReader   
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

Citations to this article as recorded by  
  • Impact of Fat Distribution and Metabolic Diseases on Cerebral Microcirculation: A Multimodal Study on Type 2 Diabetic and Obese Patients
    Regina Esze, László Balkay, Sándor Barna, Lilla Szatmáriné Egeresi, Miklós Emri, Dénes Páll, György Paragh, Liliána Rajnai, Sándor Somodi, Zita Képes, Ildikó Garai, Miklós Káplár
    Journal of Clinical Medicine.2024; 13(10): 2900.     CrossRef
  • 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
    Diabetes, Metabolic Syndrome and Obesity.2023; Volume 16: 2617.     CrossRef
  • 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
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    Medicine.2023; 102(39): e34696.     CrossRef
  • 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
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    Endocrine Journal.2022; 69(7): 773.     CrossRef
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    Gert Wensvoort
    Medical Hypotheses.2022; 168: 110964.     CrossRef
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    European Journal of Medical Research.2019;[Epub]     CrossRef
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    The Egyptian Journal of Internal Medicine.2019; 31(3): 368.     CrossRef
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    Haseeb A. Khan, Samia H. Sobki, Aishah Ekhzaimy, Isra Khan, Mona A. Almusawi
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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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    A. O. Shpakov
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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
    Diabetes & Metabolism Journal.2011; 35(2): 188.     CrossRef
  • 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

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