Chung Jin Ook, Cho Dong Hyeok, Chung Dong Jin, Chung Min Young
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, 8 Hak-Dong, Dong-Gu, Gwangju, 501-757, Republic of Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, 8 Hak-Dong, Dong-Gu, Gwangju, 501-757, Republic of Korea.
J Diabetes Complications. 2015 Apr;29(3):350-5. doi: 10.1016/j.jdiacomp.2014.12.013. Epub 2014 Dec 30.
To test the hypothesis that serum C-peptide level would relate to the risk of diabetic retinopathy (DR) in type 2 diabetic patients independently of estimated glomerular filtration rate (eGFR).
A total of 2,062 patients with type 2 diabetes were investigated in this cross-sectional study. Fasting C-peptide, 2-hour postprandial C-peptide, and ΔC-peptide (postprandial C-peptide minus fasting C-peptide) levels were measured. The patients were divided into two groups according to eGFR (ml∙min(-1)1.73m(-2)): patients without renal impairment (eGFR ≥60) and those with renal impairment (eGFR <60).
In subjects both with and without renal impairment, patients with DR showed lower levels of fasting C-peptide, postprandial C-peptide and ΔC-peptide. In multivariate analysis, serum C-peptide levels were significantly associated with DR (odds ratio [OR] of each standard deviation increase in the logarithmic value, 0.85; 95% confidence interval [CI], 0.78-0.92 for fasting C-peptide, P<0.001; OR, 0.87; 95% CI, 0.82-0.92 for postprandial C-peptide, P<0.001; OR, 0.88; 95% CI, 0.82-0.94 for ΔC-peptide, P<0.001) after adjustment for age, gender, and other confounding factors including eGFR.
Serum C-peptide levels are inversely associated with the prevalence of DR in type 2 diabetic patients independently of eGFR.
检验2型糖尿病患者血清C肽水平与糖尿病视网膜病变（DR）风险相关这一假设，且该相关性独立于估算肾小球滤过率（eGFR）。
本横断面研究共纳入2062例2型糖尿病患者。测量空腹C肽、餐后2小时C肽以及ΔC肽（餐后C肽减去空腹C肽）水平。根据eGFR（ml∙min⁻¹/1.73m⁻²）将患者分为两组：无肾功能损害患者（eGFR≥60）和有肾功能损害患者（eGFR<60）。
在有和无肾功能损害的受试者中，DR患者的空腹C肽、餐后C肽和ΔC肽水平均较低。多因素分析显示，在校正年龄、性别以及包括eGFR在内的其他混杂因素后，血清C肽水平与DR显著相关（空腹C肽每增加一个标准差对数值的比值比[OR]为0.85；95%置信区间[CI]为0.78 - 0.92，P<0.001；餐后C肽的OR为0.87；95%CI为0.82 - 0.92，P<0.001；ΔC肽的OR为0.88；95%CI为0.82 - 0.94，P<0.001）。
2型糖尿病患者血清C肽水平与DR患病率呈负相关，且独立于eGFR。
