Bulum Tomislav, Tomić Martina, Vučković-Rebrina Sandra, Roso Vinko, Vučić Lovrenčić Marijana, Duvnjak Lea
Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, 10000 Zagreb, Croatia.
Medical School, University of Zagreb, Zagreb, Croatia.
J Diabetes Metab Disord. 2020 Aug 29;19(2):1185-1189. doi: 10.1007/s40200-020-00620-2. eCollection 2020 Dec.
Previous studies suggested that long-term perseverance of beta-cell function in patients with type 1 diabetes (T1DM) is associated with lower incidence of microvascular complications. The objective of this study was to evaluate preserved C-peptide secretion in patients with T1DM without overt chronic complications and to explore associations with resistin and uric acid as biomarkers of microvascular complication pathogenesis.
We assessed residual beta-cell function in 164 T1DM patients (male/female = 91/73; age/diabetes duration range = 18-70/1-30 years) using an ultrasensitive C-peptide ELISA assay with detection limit of 2.5 pmol/L and total coefficient of variation (CV) 5,8% (Mercodia, Sweden). Serum level of uric acid was measured by enzymatic method (AU680, Beckman Coulter, USA) while resistin concentration was determined by the ELISA assay (Biovendor, Czech Republic).
C-peptide secretors had shorter diabetes duration (5.1 vs. 16 years; < 0,001), lower resistin (4.53 vs. 4.93 mg/mL = 0.045), and higher uric acid (259 vs 238 μmol/L, = 0.048) level than T1DM patients with no detectable C-peptide levels, while no differences in routine anthropometric and laboratory variables, including HbA1c, were observed. Although the proportion of C-peptide secretors significantly decreased across categories of diabetes duration (70%, 38%, 17% and 15% for <5, 5-10, 10-20 and 20-30 years of duration, respectively; < 0,001), detectable C-peptide was found in 5/23 T1DM patients who were diagnosed with T1DM more than 20 years ago.
The results of our study revealed that patients with detectable C-peptide had lower resistin and higher uric acid level compared to patients with undetectable C-peptide.
既往研究表明，1型糖尿病（T1DM）患者β细胞功能的长期维持与微血管并发症的较低发生率相关。本研究的目的是评估无明显慢性并发症的T1DM患者中保留的C肽分泌情况，并探讨其与作为微血管并发症发病机制生物标志物的抵抗素和尿酸之间的关联。
我们使用检测限为2.5 pmol/L、总变异系数（CV）为5.8%的超敏C肽ELISA检测法（瑞典Mercodia公司），评估了164例T1DM患者（男/女 = 91/73；年龄/糖尿病病程范围 = 18 - 70/1 - 30年）的残余β细胞功能。采用酶法（美国贝克曼库尔特公司AU680）测定血清尿酸水平，而抵抗素浓度则通过ELISA检测法（捷克共和国Biovendor公司）测定。
与C肽水平不可检测的T1DM患者相比，C肽分泌者的糖尿病病程较短（5.1年对16年；< 0.001），抵抗素水平较低（4.53对4.93 mg/mL，P = 0.045），尿酸水平较高（259对238 μmol/L，P = 0.048），而在常规人体测量和实验室指标（包括糖化血红蛋白）方面未观察到差异。尽管C肽分泌者的比例在不同糖尿病病程类别中显著下降（病程<5年、5 - 10年、10 - 20年和20 - 30年的患者分别为70%、38%、17%和15%；< 0.001），但在20多年前被诊断为T1DM的23例患者中有5例检测到了可检测的C肽。
我们的研究结果显示，与C肽不可检测的患者相比，C肽可检测的患者抵抗素水平较低，尿酸水平较高。
