平均 30 分钟餐后 C 肽预测糖尿病视网膜病变进展：一项回顾性前瞻性研究。
The average 30-minute post-prandial C-peptide predicted diabetic retinopathy progress: a retro-prospective study.
机构信息
School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, 164 LanXi Road, 200062, Shanghai, China.
出版信息
BMC Endocr Disord. 2023 Mar 16;23(1):63. doi: 10.1186/s12902-023-01300-x.
BACKGROUND
The conclusion between Connecting peptide (C-peptide) and diabetic chronic complication was controversial. The purpose of this study is to explore the possible association between average C-peptide with diabetic retinopathy (DR) progression in Chinese patients with type 2 diabetes.
METHODS
This is a retro-prospective study. 622 patients with type 2 diabetes were included. DR was evaluated using non-mydriatic fundus photography and DR progression was defined as any deterioration of either eye. Fasting and postprandial c-peptide levels were assayed at baseline and follow-up period. Differences between continuous variables were compared using the Mann-Whitney U test; and categorical variables were analyzed by the chi-square test. Correlation between parameters and 30-minute postprandial C-peptide were determined by Spearman correlation test. The relationship between C-peptide and DR progression was evaluated by multivariable binary logistic regression. Two-tailed P-values < 0.05 were regarded as statistically significant.
RESULTS
DR was present in 162 (26.0%) patients at baseline, and 26.4% of patients were found progression of DR at follow-up. Patients with progression of DR had lower average levels of 30-minute postprandial C-peptide (2.01 ng/ml vs. 2.6 ng/ml, p = 0.015) and 120-minute postprandial C-peptide (3.17 ng/ml vs. 3.92 ng/ml, p < 0.029), as well as average increment of 30-minute (0.41 ng/ml vs. 0.64 ng/ml, p = 0.015) and 120-minute postprandial C-peptide (1.48 ng/ml vs. 1.93 ng/ml, p < 0.017), than those without DR aggravation. Multivariate logistic regression analysis determined that 30-minute postprandial C-peptide and its increment were related to reduced odds ratios for DR progression (odds ratios [OR] = 0.83 and 0.74, respectively).
CONCLUSION
Our results suggest that the Average 30-minute post-prandial C-peptide and increment were negatively correlated with DR progression, which further demonstrates the importance to preserve β-cell residual function in the prevention for DR progression.
TRIAL REGISTRATION
Not applicable.
背景
连接肽（C 肽）与糖尿病慢性并发症之间的关系存在争议。本研究旨在探讨中国 2 型糖尿病患者平均 C 肽与糖尿病视网膜病变（DR）进展之间的可能关联。
方法
这是一项回顾性前瞻性研究。纳入 622 例 2 型糖尿病患者。使用非散瞳眼底摄影评估 DR，将任何一只眼的病情恶化定义为 DR 进展。在基线和随访期间检测空腹和餐后 C 肽水平。采用 Mann-Whitney U 检验比较连续变量之间的差异；采用卡方检验分析分类变量。采用 Spearman 相关检验确定参数与餐后 30 分钟 C 肽之间的相关性。采用多变量二项逻辑回归评估 C 肽与 DR 进展的关系。双侧 P 值<0.05 被认为具有统计学意义。
结果
基线时，162 例（26.0%）患者存在 DR，随访时，26.4%的患者出现 DR 进展。DR 进展患者的餐后 30 分钟 C 肽（2.01ng/ml 比 2.6ng/ml，p=0.015）和 120 分钟 C 肽（3.17ng/ml 比 3.92ng/ml，p<0.029）平均水平较低，以及餐后 30 分钟（0.41ng/ml 比 0.64ng/ml，p=0.015）和 120 分钟 C 肽（1.48ng/ml 比 1.93ng/ml，p<0.017）的平均增量也较低。多变量逻辑回归分析确定，餐后 30 分钟 C 肽及其增量与 DR 进展的降低比值有关（比值比[OR]分别为 0.83 和 0.74）。
结论
我们的结果表明，平均餐后 30 分钟 C 肽及其增量与 DR 进展呈负相关，进一步证明了在预防 DR 进展中保留β细胞残余功能的重要性。
试验注册
不适用。
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