Association between serum C-peptide levels and chronic microvascular complications in Korean type 2 diabetic patients

Acta Diabetol. 2012 Feb;49(1):9-15. doi: 10.1007/s00592-010-0249-6. Epub 2011 Jan 7.

Abstract

This study evaluated the association between serum C-peptide levels and chronic vascular complications in Korean patients with type 2 diabetes. Data for 1,410 patients with type 2 diabetes were evaluated cross-sectionally. Fasting and postprandial 2-hour serum C-peptide levels were analyzed with respect to diabetic micro- and macrovascular complications. In the group of patients with lower fasting serum C-peptide quartile, the prevalences of diabetic retinopathy and neuropathy were significantly higher (P = 0.035, P < 0.001, respectively). In the group of patients with lower delta C-peptide (postprandial - fasting C-peptide) quartile, the prevalences of diabetic retinopathy, nephropathy, and neuropathy were significantly higher (P < 0.001 for all). Low delta C-peptide quartile was also associated with increased severity of retinopathy and nephropathy. The age- and sex-adjusted odds ratios (ORs) for retinopathy, neuropathy, and nephropathy in the lowest versus the highest delta C-peptide quartile were 6.45 (95% confidence interval 3.41-12.22), 3.01 (2.16-4.19), and 2.65 (1.71-4.12), respectively. After further adjustment for the duration of diabetes, type of antidiabetic therapy, mean hemoglobin A1c, body mass index, and blood pressure, the ORs were reduced to 2.83 (1.32-6.08), 1.68 (1.12-2.53), and 1.61 (1.05-2.47), respectively, but remained significant. No significant difference was observed in the prevalence of macrovascular complications with respect to fasting or delta C-peptide quartiles. These results suggest that low C-peptide level is associated with diabetic microvascular, but not macrovascular complications in patients with type 2 diabetes mellitus.

MeSH terms

  • Adult
  • Aged
  • Asians / statistics & numerical data
  • C-Peptide / blood*
  • Chronic Disease
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetic Angiopathies / blood*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / ethnology
  • Diabetic Angiopathies / pathology
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / epidemiology
  • Diabetic Retinopathy / blood
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / epidemiology
  • Female
  • Humans
  • Male
  • Microvessels / pathology
  • Middle Aged
  • Prevalence
  • Republic of Korea / epidemiology
  • Young Adult

Substances

  • C-Peptide