Association of C-peptide with diabetic vascular complications in type 2 diabetes

Wang, Ying; Wan, Heng; Chen, Y.; Xia, Fangzhen; Zhang, W.; Wang, C.; Fang, Sijie; Zhang, K.; Li, Quan; Wang, N.; Lu, Yingli

doi:10.1016/j.diabet.2019.04.004

Cited by 28 publications

(30 citation statements)

References 34 publications

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“…The questionnaire about demographics, medical history, family history, and lifestyle factors was filled out by the same trained personnel in the SPECT-China study [18,19] during the interview. Clinical examinations, including height, weight, and blood pressure, were measured according to a standard protocol as before [20,21]. Body mass index (BMI) was calculated as the weight in kilograms divided by the height in meters squared.…”

Section: Measurementsmentioning

confidence: 99%

Associations between the Neutrophil-to-Lymphocyte Ratio and Diabetic Complications in Adults with Diabetes: A Cross-Sectional Study

Wan

Wang

Fang

et al. 2020

Journal of Diabetes Research

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Objective. The neutrophil-to-lymphocyte ratio (NLR) is an inexpensive and easily measurable laboratory index indicating systemic inflammation, while the application of many other inflammatory markers has been limited in daily clinical practice. However, large population studies about investigating the associations of the NLR level with diabetic complications including cardiovascular and cerebrovascular diseases (CVD), diabetic kidney disease (DKD), and diabetic retinopathy (DR) in the same population were limited. The aim of our study is to evaluate the associations between the NLR level and the prevalence of CVD, DKD, and DR in adults with diabetes simultaneously. Methods. A cross-sectional survey of 4,813 diabetic adults was conducted in seven communities in China. Persons underwent several medical examinations, including the measurement of anthropometric factors, blood pressure, routinely analyzed leukocyte characteristics, glucose, lipid profiles, urine albumin/creatinine ratio, and fundus photographs. Results. Compared with the first quartile of the NLR level, the odds of having CVD was significantly increased by 21% for participants in the highest quartile (OR 1.21; 95% CI 1.00, 1.47) (P for trend<0.05). Similarly, the prevalence of DKD among participants in the highest quartile of the NLR level was significantly increased by 150% (OR 2.50; 95% CI 1.95, 3.19) (P for trend<0.05). However, no association was found between the NLR level and the prevalence of DR (P for trend>0.05). These associations were all fully adjusted. Conclusions. A higher NLR level was associated with an increased prevalence of CVD and DKD, other than DR, in diabetic adults.

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Section: Measurementsmentioning

confidence: 99%

Associations between the Neutrophil-to-Lymphocyte Ratio and Diabetic Complications in Adults with Diabetes: A Cross-Sectional Study

Wan

Wang

Fang

et al. 2020

Journal of Diabetes Research

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“…In T2DM, elevated fasting C‐peptide (FCP) levels >2.00 nmol/L indicate the presence of insulin insensitivity (resistance) that is often associated with a higher body mass index (BMI), requiring a higher dose to achieve target levels of HbA1c . Recent findings also confirm a positive association of high C‐peptide levels with the prevalence of cardiovascular disease and an inverse association with progression of diabetic retinopathy . By contrast, low FCP levels (<0.40 nmol/L) indicate a condition of advanced insulin deficiency in T2DM, and are predictive of a poor glycaemic response to insulin secretagogues including glucagon‐like peptide‐1 (GLP‐1) receptor agonists …”

Section: Introductionmentioning

confidence: 88%

“…6,7 Recent findings also confirm a positive association of high C-peptide levels with the prevalence of cardiovascular disease and an inverse association with progression of diabetic retinopathy. 8,9 By contrast, low FCP levels (<0.40 nmol/L) indicate a condition of advanced insulin deficiency in T2DM, and are predictive of a poor glycaemic response to insulin secretagogues including glucagon-like peptide-1 (GLP-1) receptor agonists. 10 Current clinical practice guidelines for T2DM recommend a selective and stepwise approach to therapies, which primarily follows HbA1c values and the presence of concomitant cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Fasting C‐peptide, a biomarker for hypoglycaemia risk in insulin‐naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL

Landgraf

Owens

Frier

et al. 2019

Diabetes Obesity Metabolism

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Aim To examine the relationship between baseline fasting C‐peptide (FCP) and outcomes in insulin‐naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL (Gla‐100). Materials and methods Post hoc pooled analysis of nine randomized, treat‐to‐target trials in patients with type 2 diabetes inadequately controlled on oral antihyperglycaemic drugs initiating once‐daily Gla‐100. Participants (n = 2165) were stratified at baseline according to FCP (≤0.40, >0.40–1.20, >1.20–2.00, >2.00 nmol/L). Glycaemic control, body weight, insulin dose and hypoglycaemia were determined at 24 weeks. Results At baseline low FCP levels were associated with longer known diabetes duration, lower body mass index and higher fasting plasma glucose (FPG). Following Gla‐100 introduction, the mean HbA1c reduction at week 24 was similar in all four FCP groups, albeit fewer people in the lowest FCP group achieved HbA1c <7.0% versus FCP groups >0.40 nmol/L. By contrast, FPG reduction and proportion reaching FPG ≤5.6 mmol/L were greatest in the lowest FCP group, diminishing at higher FCP levels. Gla‐100 dose at week 24 was lowest in the ≤0.40 nmol/L FCP group and highest in the >1.20 nmol/L FCP group. Incidence and event rate of overall, nocturnal and severe hypoglycaemia were higher at week 24 in groups with lower FCP levels. In multivariable regression analysis baseline FCP, concomitant sulphonylurea use and endpoint HbA1c were strong predictors of hypoglycaemia. Conclusions FCP levels identified patients with type 2 diabetes experiencing different responses to basal insulin Gla‐100. A low FCP identifies a markedly insulin‐deficient, insulin‐sensitive subgroup/phenotype with an enhanced risk of hypoglycaemia, which requires a low initial basal insulin dose, cautious titration and earlier addition of prandial glucose‐lowering therapy.

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“…A population-based study named the METAL study (Environmental Pollutant Exposure and Metabolic Diseases in Shanghai, ChiCTR1800017573, www.chictr.org.cn) was conducted in 2018 (15). Participants were randomly enrolled from seven communities in Huangpu and Pudong District, Shanghai, China and were randomly selected from half of the type 2 diabetic patients in the registration platform of each community healthcare center.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Bone Turnover Markers and Probable Advanced Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Men and Postmenopausal Women With Type 2 Diabetes

Wang

Chen

et al. 2020

Front. Endocrinol.

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Objective: Type 2 diabetic patients have a higher incidence of nonalcoholic steatohepatitis (NASH) and advanced stages of fibrosis, and nonalcoholic fatty liver disease (NAFLD) is associated with impaired bone health. We aimed to investigate whether bone turnover is associated with the probable presence of NASH and fibrosis.Methods: In total, 4,937 diabetic participants from Shanghai, China were enrolled in 2018. Subjects with NAFLD were categorized into simple NAFLD and probable NASH groups based on the presence of a metabolic syndrome. The NAFLD fibrosis score was used to identify patients with a higher likelihood of advanced fibrosis.Results: In postmenopausal women, large N-mid fragment of osteocalcin (N-MID osteocalcin) was negatively associated with probable NASH (P for trend < 0.001). β-C-terminal cross-linked telopeptides of type I collagen (β-CTX) and procollagen type I N-terminal propeptide (P1NP) were positively associated with the probable presence of significant fibrosis in postmenopausal women (P for trend 0.015 and <0.001). However, in men, N-MID osteocalcin and β-CTX were negatively associated with the probable presence of significant fibrosis (P for trend 0.029 and 0.027).Conclusions: Significant associations among N-MID osteocalcin, β-CTX and P1NP, and probable advanced NAFLD were observed. Further prospective and animal studies are warranted to understand the causal relationship and underlying mechanism.

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Association of C-peptide with diabetic vascular complications in type 2 diabetes

Cited by 28 publications

References 34 publications

Associations between the Neutrophil-to-Lymphocyte Ratio and Diabetic Complications in Adults with Diabetes: A Cross-Sectional Study

Associations between the Neutrophil-to-Lymphocyte Ratio and Diabetic Complications in Adults with Diabetes: A Cross-Sectional Study

Fasting C‐peptide, a biomarker for hypoglycaemia risk in insulin‐naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL

Bone Turnover Markers and Probable Advanced Nonalcoholic Fatty Liver Disease in Middle-Aged and Elderly Men and Postmenopausal Women With Type 2 Diabetes

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