Serum C-peptide levels and risk of death among adults without diabetes mellitus

Abstract

Background:Connecting peptide (C-peptide) plays a role in early atherogenesis in patients with diabetes mellitus and may be a marker for cardiovascular morbidity and mortality in patients without diabetes. We investigated whether serum C-peptide levels are associated with all-cause, cardiovascular-related and coronary artery disease-related mortality in adults without diabetes. Methods:We used data from the Third Nutrition and Health Examination Survey (NHANES III) and the NHANES III Linked Mortality File in the United States. We analyzed mortality data for 5902 participants aged 40 years and older with no history of diabetes and who had available serum C-peptide levels from the baseline examination. We grouped the participants by C-peptide quartile, and we performed Cox proportional hazards regression analysis. The primary outcome was all-cause, cardiovascular-related and coronary artery diseaserelated mortality. Results:The mean serum C-peptide level in the study sample was 0.78 (± standard deviation 0.47) nmol/L. The adjusted hazards ratio comparing the highest quartile with the lowest quartile was 1.80 (95% confidence interval [CI] 1.33-2.43) for all-cause mortality, 3.20 (95% CI 2.07-4.93) for cardiovascular-related mortality, and 2.73 (95% CI 1.55-4.82) for coronary artery disease-related mortality. Higher C-peptide levels were associated with increased mortality among strata of glycated hemoglobin and fasting serum glucose. Interpretation:We found an association between serum C-peptide levels and all-cause and cause-specific mortality among adults without diabetes at baseline. Our finding suggests that elevated C-peptide levels may be a predictor of death. AbstractResearch CMAJ, June 11, 2013, 185(9) E403

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).…”

Mexico City normal weight children exposed to high concentrations of ambient PM2.5 show high blood leptin and endothelin-1, vitamin D deficiency, and food reward hormone dysregulation versus low pollution controls. Relevance for obesity and Alzheimer disease

“…The pro-atherogenic effects are doserelated and produce increased chemotactic activity, proliferation of aortic smooth muscle cells, and activation of key inflammatory mediators involved in atherogenic processes, including the NFκ B factor (Lebbherz and Marx, 2013). Positive correlations of high C-peptide levels with cardiovascular deaths are stronger than fasting glucose levels, homeostatic model assessment index or insulin in adult non-diabetics (Patel et al, 2012;Min and Min, 2013). High fasting C-peptide concentrations are also related to risk of liver and biliary tract cancer and low cognition scores in middle age subjects with insulin resistance (Pedersen et al, 2012;Aleksandrovaet et al, 2014).…”

Post‐partum plasma C‐peptide and ghrelin concentrations are predictive of type 2 diabetes in women with previous gestational diabetes mellitus 曾患妊娠期糖尿病的妇女的产后血浆C‐肽与饥饿素浓度是2型糖尿病的预测因子

“…These relationships were maintained after adjustment for age and BMI. Interestingly, other studies have shown that C‐peptide is a risk factor for other diseases, including cancer, and all‐cause cardiovascular‐related disease and coronary artery–related mortality among adults without diabetes . C‐peptide is a small peptide that is cleaved from proinsulin in the synthesis of active insulin.…”

“…Interestingly, other studies have shown that C-peptide is a risk factor for other diseases, including cancer, 11 and all-cause cardiovascular-related disease and coronary artery-related mortality among adults without diabetes. 12 C-peptide is a small peptide that is cleaved from proinsulin in the synthesis of active insulin. Although there was a significant correlation between insulin and C-peptide (r = 0.7, P < 0.001), the fasting insulin level 12 weeks after the index GDM pregnancy was not associated with the development of type 2 diabetes.…”