1型糖尿病患者中可检测到的C肽水平与血糖控制及慢性并发症的关联：一项系统评价和荟萃分析。

Association of detectable C-peptide levels with glycemic control and chronic complications in individuals with type 1 diabetes mellitus: A systematic review and meta-analysis.

作者信息

Alan Mahin Seifi, Tayebi Amirhossein, Afshar Elmira Jafari, Alan Sanaz Seifi, Alan Mahnaz Seifi, Fazeli Ramina, Sohbatzade Tooba, Samimisedeh Parham, Rastad Hadith

机构信息

Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran.

Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran; Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.

出版信息

J Diabetes Complications. 2025 Mar;39(3):108867. doi: 10.1016/j.jdiacomp.2024.108867. Epub 2024 Sep 26.

DOI:10.1016/j.jdiacomp.2024.108867

PMID:39879848

Abstract

AIMS

Multiple studies have addressed the association between detectable levels of C-peptide and glycemic control, as well as the development of chronic complications of type 1 diabetes mellitus (T1DM), including both macrovascular and microvascular diseases. We aimed to summarize the available evidence on the clinical significance of detectable levels of C-peptide in T1DM.

METHOD

A systematic search was performed on online databases using the following key terms: T1DM, C-peptide, diabetes mellitus complications, and glycemic parameters. We pooled standardized mean difference (SMD) and odds ratios (OR).

RESULTS

Of the 1519 articles retrieved from the initial search, 38 (12 cohort and 26 cross-sectional studies) met our eligibility criteria. Individuals with T1DM in the detectable C-peptide group, compared with the undetectable C-peptide group, had lower mean HbA1c [pooled SMD (95 % confidence interval (95 % CI)): -0.08 (-0.13 to -0.02), I = 0 %, p.

VALUE

0.005] and daily insulin dose [-0.41 (-0.65 to -0.18), I = 83 %, p.value < 0.001]. They also showed lower odds for retinopathy [pooled crude OR (95 % CI): 0.53 (0.41 to 0.69), I = 65 %, p.value < 0.001] and nephropathy complications [0.62 (0.55 to 0.70), I = 19 %, p.value < 0.001]; however, the two groups were similar regarding neuropathy [0.92 (0.65 to 1.31), I = 0 %, p.

VALUE

0.31].

CONCLUSIONS

The available evidence suggests that individuals with T1DM in the detectable C-peptide group may experience better clinical outcomes.

摘要

目的

多项研究探讨了可检测到的C肽水平与血糖控制之间的关联，以及1型糖尿病（T1DM）慢性并发症的发生情况，包括大血管和微血管疾病。我们旨在总结关于T1DM中可检测到的C肽水平的临床意义的现有证据。

方法

使用以下关键词在在线数据库中进行系统检索：T1DM、C肽、糖尿病并发症和血糖参数。我们汇总了标准化均数差（SMD）和比值比（OR）。

结果

在初步检索中检索到的1519篇文章中，38篇（12项队列研究和26项横断面研究）符合我们的纳入标准。与不可检测到C肽的组相比，可检测到C肽的T1DM个体的平均糖化血红蛋白水平更低[汇总SMD（95%置信区间（95%CI））：-0.08（-0.13至-0.02），I=0%，p值：0.005]，每日胰岛素剂量也更低[-0.41（-0.65至-0.18），I=83%，p值<0.001]。他们患视网膜病变的几率也更低[汇总粗OR（95%CI）：0.53（0.41至0.69），I=65%，p值<0.001]以及肾病并发症的几率更低[汇总粗OR（95%CI）：0.53（0.41至0.69），I=65%，p值<0.001]；然而，两组在神经病变方面相似[0.92（0.65至1.31），I=0%，p值：0.31]。