Postprandial C-peptide is more relevant to hemoglobin A1c levels and diabetic microvascular complications than fasting C-peptide in type 2 diabetes.

IF 4.6 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-09-15 DOI:10.4239/wjd.v16.i9.109414

Zheng Wang, Ming-Qun Deng, Li-Xin Guo, Qi Pan

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Abstract

Background: Type 2 diabetes mellitus (T2DM), driven by insulin resistance and β cell dysfunction, necessitates reliable assessment of β cell function. C-peptide (CP) measurement, a stable marker of endogenous insulin secretion, is useful for this clinically as it avoids interference from exogenous insulin. While fasting CP (FCP) and postprandial CP (PCP), along with glucose-adjusted indices and ratios, such as FCP/fasting plasma glucose (FPG), 2 hours postprandial CP (2hCP)/postprandial blood glucose (PBG) and CP ratio, are used, their comparative efficacy in reflecting β cell function remains unclear. Hemoglobin A1c (HbA1c), a key glycemic control indicator, theoretically links β cell function to complications, but limited studies have explored the associations between diverse CP indices, HbA1c, and diabetic microvascular complications.

Aim: To investigate the relationships between different CP indices and HbA1c as well as diabetic microvascular complications in T2DM.

Methods: T2DM patients admitted to Department of Endocrinology at Beijing Hospital between July 1, 2021 and December 31, 2021 were included in the study. Clinical and laboratory data were collected, including CP levels, glucose levels, HbA1c levels and diabetic microvascular complications. Statistical analysis was performed using Statistical Package for the Social Sciences 24.0.

Results: A total of 453 patients were included in the final analysis. Adjusted by confounding factors, CP ratio and CP/blood glucose (BG) ratio were not relevant to HbA1c, but FCP, 2hCP, delta CP, FCP/FPG, 2hCP/PBG and delta CP/BG were still negatively correlated to HbA1c_, of which 2hCP/PBG showed the strongest negative correlation (r = -0.485, P < 0.001). Independent of HbA1c and other confounding factors, 2hCP, 2hCP/PBG, delta CP and delta CP/BG were protective factors of diabetic retinopathy while 2hCP, delta CP and FCP/FPG were protective factors of diabetic peripheral neuropathy.

Conclusion: This study indicates that higher levels of CP indices suggest better glucose control and a lower prevalence of diabetic microvascular complications, and PCP indices, particularly 2hCP/PBG, were more relevant to HbA1c and diabetic microvascular complications than FCP indices. These results suggest CP-related indices could be useful biomarkers for diabetes management, warranting further research.

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2型糖尿病餐后c肽与血红蛋白A1c水平及糖尿病微血管并发症的相关性高于空腹c肽。

背景：2型糖尿病（T2DM）由胰岛素抵抗和β细胞功能障碍驱动，需要可靠的β细胞功能评估。c肽（CP）测量是一种内源性胰岛素分泌的稳定标记物，在临床上很有用，因为它避免了外源性胰岛素的干扰。虽然使用了空腹CP （FCP）和餐后CP （PCP）以及血糖调节指标和比值，如FCP/空腹血糖（FPG）、餐后2小时CP (2hCP)/餐后血糖（PBG）和CP比值，但它们在反映β细胞功能方面的比较功效尚不清楚。糖化血红蛋白（HbA1c）是一个关键的血糖控制指标，理论上将β细胞功能与并发症联系起来，但有限的研究探讨了不同CP指标、糖化血红蛋白与糖尿病微血管并发症之间的关系。目的：探讨不同CP指标与T2DM患者HbA1c及糖尿病微血管并发症的关系。方法：选取北京医院内分泌科2021年7月1日至2021年12月31日收治的2型糖尿病患者。收集临床和实验室数据，包括CP水平、葡萄糖水平、HbA1c水平和糖尿病微血管并发症。使用Statistical Package for the Social Sciences 24.0进行统计分析。结果：共纳入453例患者。经混杂因素调整后，CP比、CP/血糖（BG）比与HbA1c无关，但FCP、2hCP、δ CP、FCP/FPG、2hCP/PBG、δ CP/BG与HbA1c仍呈负相关，其中2hCP/PBG负相关最强（r = -0.485, P < 0.001）。与HbA1c等混杂因素无关，2hCP、2hCP/PBG、δ CP和δ CP/BG是糖尿病视网膜病变的保护因素，2hCP、δ CP和FCP/FPG是糖尿病周围神经病变的保护因素。结论：本研究提示，高水平的CP指数表明血糖控制较好，糖尿病微血管并发症发生率较低，PCP指数特别是2hCP/PBG与HbA1c和糖尿病微血管并发症的相关性高于FCP指数。这些结果表明，cp相关指标可能是糖尿病管理的有用生物标志物，值得进一步研究。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.