ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

The Relationship Between C-Peptide Index and Proteinuria in Patients with Type 2 Diabetes Mellitus
Tip 2 Diabetes Mellitus Hastalarında C-Peptid İndeks ile Diyabetik Nefropati Arasındaki İlişki
Received Date : 11 Sep 2019
Accepted Date : 29 Jan 2020
Available Online : 11 Feb 2020
Doi: 10.25179/tjem.2019-71377 - Makale Dili: EN
Turk J Endocrinol Metab 2020;24:23-28
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Though the C-peptide index (CPI) has been a reliable marker for estimation of the beta-cell reserve, its association with microvascular complications in Type 2 diabetes mellitus (DM) patients has not been elucidated as yet. This study, therefore, aimed to investigate the relationship between C-peptide levels and CPI with microvascular complications in Type 2 DM patients. Material and Methods: Type 2 DM patients, over 18 years of age, whose C-peptide levels were analyzed in the endocrinology and internal medicine clinics between 2014 and 2018, having normal kidney functions (glomerular filtration rate >60 mL/min) and who are not dependent on any insulin secretagogue oral antidiabetic agent (i.e., sulfonylurea) were enrolled the study. Blood samples were collected after at least 12 h of fasting, without any drug or insulin administration. Hemogram, hemoglobin A1c (HbA1c), lipid, glucose, C-peptide parameters were analyzed from the same serum sample. The patients were classified into three groups according to the spot urine albumin/ creatinine ratio. Patients with no proteinuria, patients with microalbuminuria, and patients with macroalbuminuria were defined as group 1, group 2, and group 3, respectively. Results: A statistically significant difference between CPI levels in the groups was observed (p<0.001). CPI levels of Groups 2 and 3 were lower than that of group 1 (p=0.007 and p<0.001). In addition, the CPI level of group 3 was significantly lower than that of group 2 (p=0.015). An inverse association between CPI level and proteinuria was thus recognized. HbA1c and proteinuria were found to be positively correlated (p<0.001). Conclusion: This study highlights the association between C-peptide, CPI, and diabetic nephropathy in Type 2 DM patients.
ÖZET
Amaç: C-peptid indeksi (CPI), beta hücre rezervinin daha güvenilir bir markırı olarak kabul edilir, ancak Tip 2 diabetes mellitus (DM) hastalarında CPI’nın mikrovasküler komplikasyonlarla ilişkisi net olarak aydınlatılamamıştır. Bu nedenle, bu çalışmada, Tip 2 DM hastalarında C-peptid düzeyleri ile mikrovasküler komplikasyonların arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: 2014- 2018 yılları arasında endokrinoloji ve dahiliye kliniklerinde Tip 2 DM tanısı ile takipli, C-peptid seviyeleri analiz edilen, normal böbrek fonksiyonları (glomerüler filtrasyon hızı >60 mL/dak olan) ve insülin sekretagog türevi oral antidiyabetik kullanmayan (sülfonilüre vb.) 18 yaş üstü hastalar çalışmaya dâhil edildi. Oral ilaçlarını almamış veya insulin yapmamış olan hastaların 12 saat açlık sonrası serum örnekleri alınarak hemogram, hemoglobin A1c (HbA1c), lipid, glukoz, C-peptid parametreleri çalışıldı. Çalışmaya katılan hastalar, spot idrar albumin/kreatinin oranına göre 3 gruba ayrıldı. Proteinürisi olmayanlar grup 1, mikroalbuminürisi olanlar grup 2, makroalbuminürisi olanlar grup 3 olarak adlandırıldı. Bulgular: CPI düzeyinde gruplar arasında istatistiksel olarak anlamlı fark bulundu (p<0,001). Grup 2, 3’ün CPI düzeyleri grup 1’den daha düşüktü (p=0,007 ve p<0,001). Ayrıca, grup 3’ün CPI düzeyi de grup 2’den düşüktü (p=0,015). CPI ile proteinüri varlığı arasında ters bir ilişki bulduk. HbA1c’nin proteinüri ile pozitif ilişkili olduğunu saptadık (p<0,001). Sonuç: Bu çalışma, Tip 2 DM hastalarında C-peptid, CPI ve diyabetik nefropati arasındaki ilişkiye ışık tutmaktadır.
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