Association Between Serum C-Peptide Level and Cardiovascular Autonomic Neuropathy According to Estimated Glomerular Filtration Rate in Individuals with Type 2 Diabetes

Abstract

Objective To investigate the association between serum C-peptide level and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (DM) according to estimated glomerular filtration rate (eGFR)

Methods In a cross-sectional study, we examined 939 individuals with type 2 DM. We measured fasting C-peptide, 2-hour postprandial C-peptide, and ΔC-peptide (postprandial C-peptide minus fasting C-peptide) levels. The individuals were classified into 2 groups based on eGFR: individuals without impaired renal function (eGFR ≥60 ml∙min⁻¹ 1.73m⁻²) and those with impaired renal function (eGFR <60 ml∙min⁻¹ 1.73m⁻²).

Results Individuals with CAN had lower fasting C-peptide, postprandial C-peptide, and ΔC-peptide levels in patients both with and without impaired renal function. Multivariate logistic regression analyses adjusted for gender, age, and other confounders, including eGFR, showed that serum C-peptide level was significantly associated with CAN (odds ratio [OR] per standard deviation increase in the log-transformed value, 0.67; 95% confidence interval [CI], 0.52–0.87 for fasting C-peptide, P < 0.01; OR, 0.62; 95% CI, 0.47–0.83 for postprandial C-peptide, P < 0.01; OR, 0.71; 95% CI, 0.54–0.93 for ΔC-peptide, P < 0.05).

Conclusions Serum C-peptide level was negatively associated with CAN in individuals with type 2 DM independent of eGFR.

Key words

C-peptide - diabetes mellitus, type 2 - diabetic neuropathies - glomerular filtration rate

Publication History

Received: 26 April 2019
Received: 02 September 2019

Accepted: 23 September 2019

Article published online:
14 October 2019

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