C-peptide as a risk factor of coronary artery disease in the general population

Abstract

Objective: To analyse the association between serum C-peptide and coronary artery disease in the general population. Methods: Follow-up study of 6630 adults from the general population. They were stratified into group 1 (no insulin resistance: C-peptide < third tercile and glycaemia < 100 mg/dL), group 2 (initial insulin resistance: C-peptide ⩾ third tercile and glycaemia < 100 mg/dL) and group 3 (advanced insulin resistance: glycaemia ⩾ 100 mg/dL). Results: After 3.5 years of follow-up, group 2 had a higher incidence of myocardial infarction (relative risk (RR) = 4.2, 95% confidence interval (CI) = 1.7-10.6) and coronary artery disease (RR = 3.5, 95% CI = 1.9-6.6) than group 1. Group 3 also had increased incidences of both diseases. In multivariable analysis of the entire population, groups 2 and 3 showed significant risks of myocardial infarction and coronary artery disease (RR > 3 and RR > 2, respectively). However, when people with diabetes were excluded, the increased risks were corroborated only in group 2 for myocardial infarction (RR = 2.8, 95% CI = 1.1-6.9; p = 0.025) and coronary artery disease (RR = 2.4, 95% CI = 1.3-4.6; p = 0.007). Conclusion: Elevated C-peptide is associated with the incidence of myocardial infarction and coronary artery disease in the general population. It can be an earlier predictor of coronary events than impaired fasting glucose.

Dietary patterns and cardiometabolic and endocrine plasma biomarkers in US women

“…Elevated C-peptide and insulin are markers of insulin resistance, which is implicated in the development of T2D and CVD (38). Fasting insulin has been associated with the incidence of cardiovascular disease (39,40), and elevated C-peptide has been associated with the incidence of coronary artery disease and with cardiovascular and total mortality in individuals without diabetes (41,42). In addition, lower SHBG was consistently associated with the incidence of T2D in epidemiologic studies (43).…”

The dual effect of C‐peptide on cellular activation and atherosclerosis: Protective or not?

“…However, patients with early T2DM and insulin resistance have elevated serum levels of C‐peptide, and an increased cardiovascular risk has been reported in these patients . In addition, several studies in individuals without diabetes showed positive correlation between C‐peptide levels and the incidence of several cardiovascular diseases, such as coronary artery disease and myocardial infarction . Altogether, these data suggest that elevated C‐peptide levels, due to insulin resistance, contribute to atherosclerosis vascular disease in these patients.…”

“…94 In addition, several studies in individuals without diabetes showed positive correlation between Cpeptide levels and the incidence of several cardiovascular diseases, such as coronary artery disease and myocardial infarction. [95][96][97] Altogether, these data suggest that elevated C-peptide levels, due to insulin resistance, contribute to atherosclerosis vascular disease in these patients. On the other hand, C-peptide replacement in T1DM patients exerts a beneficial influence on development of microvascular complications, since this disease is marked by serum peptide deficiency.…”

Conditions of gestation, childbirth and childhood associated with C-peptide in young adults in the 1982 Birth Cohort in Pelotas-RS; Brazil

“…Donatelli et al reported higher C-peptide levels among obese hypertensive diabetics compared to obese and obese-hypertensive individuals [13]. Cabrera de Leon et al reported that among persons with insulin resistance, C-peptide would be positively associated with the risk of myocardial infarction (RR 2.8; CI95% 1.1–6.9) and coronary artery disease (RR 2.4; CI95% 1.3–4.6) [14]. These studies have not been able to evaluate whether C-Peptide is a marker of insulin resistance or an independent cardiovascular risk factor.…”