High c-peptide level: marker of mortality in type 2 diabetes mellitus patients

Year 2018, Volume: 10 Issue: 2, 27 - 31, 07.12.2018

Çiğdem Budak Ece Zafer Pekkolay , Alpaslan Kemal Tuzcu

Abstract

Objective: We aimed to retrospectively investigate the effect of c-peptide level on mortality in patients with Type 2 Diabetes Mellitus.
Methods: Patients who applied to the Dicle University Medical Faculty in 2012 were screened in the database and included a 1000 DM patient with c-peptide, after 5 years the patients were re-evaluated. The patients were then categorized. The patients were divided into two groups, dead patients and living patients. Two groups of c-peptide levels were compared.
Results: Totally 1000 patients included in the study. 392 (39.2%) of the patients were male and 608 (60.8%) were female, the mean age was 57. Patients were divided into two groups: the patient group who died and the patient group who was living. The number of patients died was 146 (14.6%) and the number of living patients was 844 (75.4%). C-peptide levels were found to be higher in patients who died (3,5 ± 2,7 ng / ml) than those who survived (2,9 ± 1,7 ng / ml) and statistically significant (p<0.05).
Conclusion: The high c-peptide levels in patients with Diabetes Mellitus, it may be an important parameter to predict mortality.

Keywords

Diabetes mellitus, c-peptide

References

• 1- American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013 Jan;36 Suppl 1:S67-74. doi: 10.2337/dc13-S067.
• 2- Steiner DF, Cunningham D, Spigelman L, Aten B. Insulin biosynthesis: evidence for a precursor. Science 1967;157:697–700.
• 3- Wahren J, Ekberg K, Jörnvall H. C-peptide is a bioactive peptide. Diabetologia 2007; 50:503–509.
• 4- Zhang W, Kamiya H, Ekberg K, Wahren J, Sima AA. C-peptide improves neuropathy in type 1 diabetic BB/Wor-rats. Diabetes Metab Res Rev. 2007 Jan;23(1):63-70.
• 5- Vasic D, Marx N, Sukhova G, et al. C-peptide promotes lesion development in a mouse model of arteriosclerosis. J Cell Mol Med 2012; 16: 927–935.
• 6- Marx N, Walcher D, Raichle C, et al. C-peptide colocalizes with macrophages in early arteriosclerotic lesions of diabetic subjects and induces monocyte chemotaxis in vitro. Arterioscler Thromb Vasc Biol 2004; 24: 540–545.
• 7- Walcher D, Babiak C, Poletek P, et al. C-Peptide induces vascular smooth muscle cell proliferation: involvement of SRC-kinase, phosphatidylinositol 3-kinase, and extracellular signal-regulated kinase 1/2. Circ Res 2006; 99: 1181–1187.
• 8- Pikkemaat M, Melander O, Mölstad S, Garberg G, Boström KB. C-peptide concentration, mortality and vascular complications in people with Type 2 diabetes. The Skaraborg Diabetes Register. Diabet Med. 2015 Jan;32(1):85-9. doi:10.1111/dme.12608.
• 9- Nawal C L, Goyal LK, Kumar V, Gautam A, Agrawal A, Mital P. Serum C-peptide level as a predictor of atherosclerosis and cardiovascular disease in type 2 diabetes mellitus. J Mahatma Gandhi Inst Med Sci 2016;21:25-9
• 10- Irwin ML, Duggan C, Wang CY, et al. Fasting C-peptide levels and death resulting from all causes and breast cancer: the health, eating, activity, and life style study. J Clin Oncol 2011; 29:47 – 53.
• 11- Vasic D, Marx N, Sukhova G, et al. C-peptide promotes lesion development in a mouse model of arteriosclerosis. J Cell Mol Med 2012; 16: 927–935.
• 12- Rask-Madsen C and King GL. Vascular complications of diabetes: mechanisms of injury and protective factors. Cell Metab 2013; 17: 20–33.
• 13- Nikolaus Marx, Guenther Silbernagel, Vincent Brandenburg, et al. Diabetes Care. 2013 Mar; 36(3):708-14
• 14- Flavio E. Hirai, MPH, Scot E. Moss, MA, Barbara E.K. Klein, Ronald Klein, Diabetes Care. 2008 Mar; 31(3):493-7.