Relationship of residual beta-cell function, metabolic control and chronic complications in type 2 diabetes mellitus.
As the relationships between C-peptide levels and metabolic control and chronic complications are poorly known in type 2 diabetes, due to the slow decline of beta-cell function, we evaluated these associations in a cohort of type 2 diabetic patients. After excluding insulin-treated subjects, 1,533 patients were divided according to their C-peptide fasting levels in quartiles. Patients within the lowest C-peptide quartile showed significantly higher duration of diabetes, prevalence of retinopathy and values of HDL-cholesterol, albumin excretion rate and HbA1c, while BMI, diastolic blood pressure, percentages of hypertension and metabolic syndrome, and values of triglycerides and uric acid were significantly higher in the highest C-peptide quartile. The associations between C-peptide and duration of diabetes, AER, HbA1c, retinopathy and the components of the metabolic syndrome remained significant, after multiple adjustments. In conclusion, these data support the hypothesis that a reduced insulin secretion is associated with a longer duration of diabetes and a greater prevalence of microvascular complications, while higher insulin levels are associated with the components of the metabolic syndrome.
Department of Internal Medicine, University of Turin, Italy.
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D000368:Aged; D000419:Albuminuria / Q000652:urine; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007515:Islets of Langerhans / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood
D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D014280:Triglycerides; D014527:Uric Acid