Serum C-peptide level and the risk of cardiovascular diseases mortality and all-cause mortality: a meta-analysis and systematic review

Elevated Fasting C-Peptide Levels Correlate with Increased 10-Year Risk of Atherosclerotic Cardiovascular Disease in Newly Diagnosed Type 2 Diabetes Patients

Purpose

This study aims to analyze the impact of serum C-peptide levels in patients with newly diagnosed type 2 diabetes (T2DM) on the 10-year risk of atherosclerotic cardiovascular disease (ASCVD).

Patients and Methods

A total of 1923 patients with newly diagnosed T2DM were selected and categorized into four groups based on the interquartile range of fasting C-peptide (FCP) levels: Q1 group (FCP≤0.568 ng/mL), Q2 group (0.568 < FCP≤0.751 ng/mL), Q3 group (0.751 < FCP≤0.980 ng/mL), and Q4 group (FCP > 0.980 ng/mL). Clinical data were collected, and the China-PAR model was employed to evaluate the risk score of ASCVD within 10 years. Additionally, the correlation between FCP levels and the risk of ASCVD was analyzed.

Results

As the quartiles of FCP increased, the 10-year ASCVD risk exhibited a gradual increase. The risk score in the FCP > 0.980 ng/mL group was significantly higher than that in the other groups, with noted differences related to gender and weight. Multiple linear regression analysis indicated that, even after adjusting for confounding factors such as gender, age, body mass index (BMI), and glycosylated hemoglobin, FCP levels remained a positive predictor of the 10-year ASCVD risk.

Conclusion

High FCP levels are identified as a risk factor for ASCVD within 10 years in patients with newly diagnosed T2DM.

Exercise improves body composition, physical fitness, and blood levels of C-peptide and IGF-1 in 11- to 12-year-old boys with obesity

Introduction

Exercise is vital in preventing and treating obesity. Despite its importance, the understanding of how exercise influences childhood obesity at the biochemical level is limited. In this study, we explore the effects of a 16-week exercise program (EP) on body composition, physical fitness, and the blood levels of hormones related to obesity.

Methods

Sixteen boys with obesity (n = 16) and seventeen boys without obesity (n = 17) took part in an EP comprising sports games and aerobic and resistance exercises. We examined alterations in body composition and physical fitness. In addition, we measured circulating hormone levels, including C-peptide, resistin, insulin-like growth factor 1 (IGF-1), and growth hormone (GH), in the blood.

Results

Body fat percentage (BFP) decreased from 37.61% at pre-EP to 29.16% at post-EP in the obese group, but not in the non-obese group. The EP decreased C-peptide (4.58 ng/mL vs. 2.96 ng/mL, p < 0.001) and resistin levels (14.05 ng/mL vs. 11.06 ng/mL, p < 0.001) in the obese group. After the EP, significant improvement in IGF-1 (non-obese: 265.56 ng/mL vs. 311.81 ng/mL, p < 0.001; obese: 224.74 ng/mL vs. 272.89 ng/mL, p < 0.001) and GH levels (non-obese: 3.91 ng/mL vs. 4.80 ng/mL, p < 0.05; obese: 1.76 ng/mL vs. 2.51 ng/mL, p < 0.05) were observed in both groups. Lower C-peptide levels were associated with BFP (r = 0.447, p = 0.009) and muscle mass (r = -0.385, p = 0.02), whereas enhanced IGF-1 levels correlated with increased muscle strength (r = 0.343, p = 0.05) and cardiovascular fitness (r = 0.347, p = 0.04). Multiple linear regression analysis revealed that cardiovascular fitness variability and BFP in the obese group were determined by C-peptide (β = -0.054, p < 0.001) and IGF-1 levels (β = -2.936, p < 0.05), respectively.

Discussion

Exercise may induce positive effects on improvements in body composition and physical fitness, as well as on blood levels of metabolic biochemicals such as C-peptide and IGF-1, in adolescent boys with obesity.

Cigarette smoking and cardiovascular disease incidence and all-cause mortality: the modifying role of diet quality

BACKGROUND

This study examines the potential long-term joint association between smoking and diet quality as modifiable risk factors concerning cardiovascular diseases (CVDs) incidence and all-cause mortality among current and former smokers.

METHODS

The study followed 955 smokers from the third and fourth examinations of the Tehran Lipid and Glucose Study to March 2018. Dietary data was collected using a food frequency questionnaire. Three diet quality indices (DQIs) were computed at baseline: DQI-international (DQI-I), DQI-revised (DQI-R), and Mediterranean-DQI (Med-DQI). Cox proportional hazards regression models were used to determine the HR (95% CI) of the joint association between smoking and diet quality among heavy and light smokers, based on the number of cigarettes per day and pack-years, as well as between current and former smokers based on smoking habits.

RESULTS

Over a follow-up period of almost eight years, 94 cases of CVDs (9.80%) and 40 cases of mortality (4.20%) were documented. The lower diet quality based on the Med-DQI was associated with a higher risk of mortality among current smokers (HR:3.45; 95%CI:1.12, 10.57). Light smokers with good diet quality, compared to heavy smokers with poor diet quality, had a lower risk of CVDs incident (HR:0.35; 95%CI: 0.15, 0.83) and all-cause mortality (HR:0.20; 95%CI:0.05, 0.77). Current smokers with good DQI had a lower risk of mortality compared to current smokers with poor DQI (HR:0.26; 95%CI:0.08, 0.80). However, this lower risk was more significant in former smokers with good DQI (HR:0.10; 95%CI:0.02, 0.45).

CONCLUSIONS

Light and former smokers had a lower risk of developing CVDs and experiencing mortality. However, when coupled with a high-quality diet, this protective effect is even more pronounced.

Mechanisms of Diabetic Nephropathy Not Mediated by Hyperglycemia

Diabetes mellitus (DM) is characterized by the appearance of progressive kidney damage, which may progress to end-stage kidney disease. The control of hyperglycemia is usually not sufficient to halt this progression. The kidney damage is quantitatively and qualitatively different in the two forms of diabetes; the typical nodular fibrosis (Kimmelstiel Wilson nodules) appears mostly in type 1 DM, whereas glomerulomegaly is primarily present in type 2 obese DM. An analysis of the different metabolites and hormones in type 1 and type 2 DM and their differential pharmacological treatments might be helpful to advance the hypotheses on the different histopathological patterns of the kidneys and their responses to sodium/glucose transporter type 2 inhibitors (SGLT2i).