Objective. C-peptide is a reliable marker of beta cell reserve and is associated with diabetic complications. Furthermore, HbA1c level is associated with micro- and macro-vascular complications in diabetic patients. HbA1c measurement of diabetic patients with anemia may be misleading because HbA1c is calculated in percent by taking reference to hemoglobin measurements. We hypothesized that there may be a relationship between C-peptide index (CPI) and proteinuria in anemic patients with type 2 diabetes mellitus (T2DM). Therefore, the aim of the present study was to investigate the association between C-peptide levels and CPI in anemic patients with T2DM and proteinuria.Methods. The patients over 18 years of age with T2DM whose C-peptide levels were analyzed in Endocrinology and Internal medicine clinics between 2014 and 2018 with normal kidney functions (GFR>60 ml/min) and who do not use any insulin secretagogue oral antidiabetic agent (i.e. sulfonylurea) were enrolled into the study.Results. Hemoglobin levels were present in 342 patients with T2DM. Among these 342 cases, 258 (75.4%) were non-anemic whereas 84 (24.6%) were anemic. The median DM duration of the anemic group was statistically significantly higher in T2DM (p=0.003). There was no statistically significant difference found in proteinuria prevalence between non-anemic and anemic patient groups (p=0.690 and p=0.748, respectively). Anemic T2DM cases were corrected according to the age, gender, and duration of DM. C-peptide and CPI levels were not statistically significant to predict proteinuria (p=0.449 and p=0.465, respectively).Conclusion. The present study sheds light to the association between C-peptide, CPI, and anemic diabetic nephropathy in T2DM patients and indicates that further prospective studies are needed to clarify this issue.
Objective: Though the C-peptide index (CPI) has been a reliable marker for estimation of the beta-cell reserve, its association with microvascular complications in Type 2 diabetes mellitus (DM) patients has not been elucidated as yet. This study, therefore, aimed to investigate the relationship between C-peptide levels and CPI with microvascular complications in Type 2 DM patients. Material and Methods: Type 2 DM patients, over 18 years of age, whose C-peptide levels were analyzed in the endocrinology and internal medicine clinics between 2014 and 2018, having normal kidney functions (glomerular filtration rate >60 mL/min) and who are not dependent on any insulin secretagogue oral antidiabetic agent (i.e., sulfonylurea) were enrolled the study. Blood samples were collected after at least 12 h of fasting, without any drug or insulin administration. Hemogram, hemoglobin A1c (HbA1c), lipid, glucose, C-peptide parameters were analyzed from the same serum sample. The patients were classified into three groups according to the spot urine albumin/creatinine ratio. Patients with no proteinuria, patients with microalbuminuria, and patients with macroalbuminuria were defined as group 1, group 2, and group 3, respectively. Results: A statistically significant difference between CPI levels in the groups was observed (p<0.001). CPI levels of Groups 2 and 3 were lower than that of group 1 (p=0.007 and p<0.001). In addition, the CPI level of group 3 was significantly lower than that of group 2 (p=0.015). An inverse association between CPI level and proteinuria was thus recognized. HbA1c and proteinuria were found to be positively correlated (p<0.001). Conclusion: This study highlights the association between C-peptide, CPI, and diabetic nephropathy in Type 2 DM patients.
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