Wahren J, Ekberg K, Samnegård B, Johansson B L
Department of Surgical Sciences, Karolinska Hospital, Stockholm SE 171 76, Sweden.
Curr Diab Rep. 2001 Dec;1(3):261-6. doi: 10.1007/s11892-001-0044-4.
C-peptide is formed in the biosynthesis of insulin and the two peptides are subsequently released in equimolar amounts to the circulation. C-peptide has long been considered to be without physiologic effects. Recent data now demonstrate that C-peptide in the nanomolar concentration range binds specifically to cell surfaces, probably to G protein-coupled receptors, with subsequent activation of Ca(2+)-dependent intracellular signaling pathways and stimulation of Na+, K(+)-ATPase activities. C-peptide replacement in animal models of type 1 diabetes results in diminished hyperfiltration, improved functional reserve, reduction of urinary albumin excretion, and prevention of glomerular and renal hypertrophy. Administration of C-peptide to physiologic concentrations in patients with type 1 diabetes and incipient nephropathy for periods of 3 hours to 3 months is accompanied by reduced glomerular hyperfiltration and filtration fraction, and diminished urinary albumin excretion. C-peptide replacement together with insulin therapy may be beneficial in type 1 diabetes patients with nephropathy.
C肽在胰岛素生物合成过程中形成，随后这两种肽以等摩尔量释放进入循环系统。长期以来，C肽一直被认为没有生理作用。现在有最新数据表明，纳摩尔浓度范围内的C肽能特异性结合细胞表面，可能是与G蛋白偶联受体结合，随后激活依赖钙离子的细胞内信号通路并刺激钠钾ATP酶活性。在1型糖尿病动物模型中补充C肽可减少超滤过、改善功能储备、降低尿白蛋白排泄，并预防肾小球和肾脏肥大。对1型糖尿病和早期肾病患者给予生理浓度的C肽，持续3小时至3个月，可使肾小球超滤过和滤过分数降低，尿白蛋白排泄减少。在1型糖尿病肾病患者中，C肽替代疗法与胰岛素治疗联合使用可能有益。
