The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study
Abstract Background Recent literature reported the biological role of C-peptide, but this role is still controversial and unclear. The primary aim of this study was to investigate associations between C-peptide and cardiovascular biomarkers as well as events. Methods A total of 55636 participants wh...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01636-z |
| _version_ | 1797996060793110528 |
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| author | Shuang-Tong Yan Jing Sun Zhao-Yan Gu Xin-Yu Miao Li-Chao Ma Ban-Ruo Sun Xiao-Min Fu Hong-Zhou Liu Guang Yang Fu-Sheng Fang Hong Li |
| author_facet | Shuang-Tong Yan Jing Sun Zhao-Yan Gu Xin-Yu Miao Li-Chao Ma Ban-Ruo Sun Xiao-Min Fu Hong-Zhou Liu Guang Yang Fu-Sheng Fang Hong Li |
| author_sort | Shuang-Tong Yan |
| collection | DOAJ |
| description | Abstract Background Recent literature reported the biological role of C-peptide, but this role is still controversial and unclear. The primary aim of this study was to investigate associations between C-peptide and cardiovascular biomarkers as well as events. Methods A total of 55636 participants who had a health examination from 2017 to 2021 were included. Of them, 6727 participants visited the hospital at least twice. Cardiovascular biomarkers like high-sensitivity C-reactive protein (hs-CRP) and high-sensitivity cardiac troponin T (hs-cTnT) were measured and their relationships with fasting C-peptide were evaluated for all participants. Cardiovascular events were obtained during the last visit and their associations with C-peptide were evaluated for those participants who visited the hospital at least twice. Results Among the included participants, 11.1% had a previous type 2 diabetes mellitus (T2DM). In the participants without previous T2DM, the relationships between fasting C-peptide and hs-CRP and hs-cTnT were negative if the value of fasting C-peptide was < 1.4 ng/mL and positive if the value was ≥ 1.4 ng/mL. These relationships remained significant after adjusting for hemoglobin A1c, insulin resistance index, and its interaction with C-peptide, even if the participants were stratified by glucose metabolism status or levels of insulin resistance index. Hazard ratios of cardiovascular events were first decreased and then increased with the increasing of baseline C-peptide levels, though these associations became unsignificant using the multivariate Cox regression model. Unlike the participants without previous T2DM, the associations of C-peptide with cardiovascular biomarkers and events were not significant in the patients with previous T2DM. Conclusions The associations of C-peptide with cardiovascular biomarkers and events were different between the participants without previous T2DM and those with previous T2DM. The effect of C-peptide on cardiovascular risk may be bidirectional, play a benefit role at a low level, and play a harmful role at a high level in the nondiabetic adults and the patients with newly diagnosed T2DM. |
| first_indexed | 2024-04-11T10:11:31Z |
| format | Article |
| id | doaj.art-2d5efdff63f542f5a9a06216079c1853 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-11T10:11:31Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-2d5efdff63f542f5a9a06216079c18532022-12-22T04:30:06ZengBMCCardiovascular Diabetology1475-28402022-10-0121111110.1186/s12933-022-01636-zThe bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort studyShuang-Tong Yan0Jing Sun1Zhao-Yan Gu2Xin-Yu Miao3Li-Chao Ma4Ban-Ruo Sun5Xiao-Min Fu6Hong-Zhou Liu7Guang Yang8Fu-Sheng Fang9Hong Li10Department of Geriatric Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalHealth Management Institute, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Geriatric Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Geriatric Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Geriatric Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Geriatric Endocrinology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Endocrinology, The First Medical Center, Chinese PLA General HospitalDepartment of Geriatric Nephrology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Health Care, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalHealth Management Institute, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalAbstract Background Recent literature reported the biological role of C-peptide, but this role is still controversial and unclear. The primary aim of this study was to investigate associations between C-peptide and cardiovascular biomarkers as well as events. Methods A total of 55636 participants who had a health examination from 2017 to 2021 were included. Of them, 6727 participants visited the hospital at least twice. Cardiovascular biomarkers like high-sensitivity C-reactive protein (hs-CRP) and high-sensitivity cardiac troponin T (hs-cTnT) were measured and their relationships with fasting C-peptide were evaluated for all participants. Cardiovascular events were obtained during the last visit and their associations with C-peptide were evaluated for those participants who visited the hospital at least twice. Results Among the included participants, 11.1% had a previous type 2 diabetes mellitus (T2DM). In the participants without previous T2DM, the relationships between fasting C-peptide and hs-CRP and hs-cTnT were negative if the value of fasting C-peptide was < 1.4 ng/mL and positive if the value was ≥ 1.4 ng/mL. These relationships remained significant after adjusting for hemoglobin A1c, insulin resistance index, and its interaction with C-peptide, even if the participants were stratified by glucose metabolism status or levels of insulin resistance index. Hazard ratios of cardiovascular events were first decreased and then increased with the increasing of baseline C-peptide levels, though these associations became unsignificant using the multivariate Cox regression model. Unlike the participants without previous T2DM, the associations of C-peptide with cardiovascular biomarkers and events were not significant in the patients with previous T2DM. Conclusions The associations of C-peptide with cardiovascular biomarkers and events were different between the participants without previous T2DM and those with previous T2DM. The effect of C-peptide on cardiovascular risk may be bidirectional, play a benefit role at a low level, and play a harmful role at a high level in the nondiabetic adults and the patients with newly diagnosed T2DM.https://doi.org/10.1186/s12933-022-01636-zC-peptideCardiac troponin TC-reactive proteinBiomarkersCardiovascular eventsDiabetes |
| spellingShingle | Shuang-Tong Yan Jing Sun Zhao-Yan Gu Xin-Yu Miao Li-Chao Ma Ban-Ruo Sun Xiao-Min Fu Hong-Zhou Liu Guang Yang Fu-Sheng Fang Hong Li The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study Cardiovascular Diabetology C-peptide Cardiac troponin T C-reactive protein Biomarkers Cardiovascular events Diabetes |
| title | The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study |
| title_full | The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study |
| title_fullStr | The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study |
| title_full_unstemmed | The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study |
| title_short | The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study |
| title_sort | bidirectional association of c peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus a retrospective cohort study |
| topic | C-peptide Cardiac troponin T C-reactive protein Biomarkers Cardiovascular events Diabetes |
| url | https://doi.org/10.1186/s12933-022-01636-z |
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