The role of C-peptide in the attenuation of outcomes of diabetic kidney disease: a systematic review and meta-analysis

Abstract

The results of the studies included in the systematic review diverged. However, the meta-analysis showed that the animals given C-peptide had lower glomerular volumes and lower urine potassium levels.

Non-linear association of fasting C-peptide and uric acid levels with renal dysfunction based on restricted cubic spline in patients with type 2 diabetes: A real-world study

“…Chronic kidney disease is a very common complication of T2DM in clinical practice, its early diagnosis, intervention and treatment may have a critical impact on the delay of its progression to end-stage renal disease and the improvement of the patients prognosis ( 22 ). In recent years, the physiological function of C-peptide has been gradually discovered ( 11 ), C-peptide may block the activity of renal Na + -K + -ATPase, thus decreasing the Na + reabsorption by the proximal convoluted tubule and the glomerular filtration pressure ( 9 ); the decrease of C-peptide may also promote the occurrence of microvascular complications in patients with diabetes mellitus ( 23 ). Therefore, some researchers had focused on exploring the effects of exogenous human C-peptide supplementation on the improvement of DKD ( 24 – 26 ).…”

“…C-peptide consists of 31amino acids, and is formed by the cleavage of pro-insulin ( 9 ). Compared with insulin, C-peptide is secreted in equimolar amounts and has a longer half-life, hence, it is recognized as a reliable indicator of the function of pancreatic β-cell ( 10 ).…”

“…Recently, C-peptide is no longer considered an inert molecule, it may have multiple functions, including signaling pathways activation, physiological effects, and protection against complications of diabetes ( 11 ). Animal studies have demonstrated that C-peptide can improve functional abnormalities in the glomeruli, reduce the risk of albuminuria and hyper-filtration, and prevent the chronic complications of diabetes ( 9 , 12 ). However, several small-scale clinical trials and/or animal studies showed the divergent findings in the role of C-peptide administration in the outcomes of patients with DKD ( 9 ).…”

“…Animal studies have demonstrated that C-peptide can improve functional abnormalities in the glomeruli, reduce the risk of albuminuria and hyper-filtration, and prevent the chronic complications of diabetes ( 9 , 12 ). However, several small-scale clinical trials and/or animal studies showed the divergent findings in the role of C-peptide administration in the outcomes of patients with DKD ( 9 ). Therefore, the association of serum C-peptide with the risk of DKD is complicated, and it needs to be further clarified in patients with diabetes mellitus.…”