title: C-peptide levels predict type 2 diabetes remission after bariatric surgery.
abstract: BACKGROUND
  C-peptide (Cp) serves as a surrogate of pancreatic beta-cell reserve. This study evaluates the clinical significance of basal Cp as a predictor of type 2 diabetes (T2D) remission after bariatric surgery (BS).
  
  
  METHODS
  Retrospective study of 22 patients with BMI > 35 kg/m² and T2D who underwent BS. Evaluation of anthropometric and glucose metabolism parameters before BS and at one-year follow-up. Analysis of patients with T2D remission (HbA1c < 6%, fasting glucose (FG) < 100 mg/dl, absence of pharmacologic treatment) and preoperative characteristics associated (logistic binary regression model). ROC curve to estimate an optimal Cp value to predict T2D remission.
  
  
  RESULTS
  Preoperativeley (mean ± SD): age 53.3 ± 9.4 years, BMI 42.9 ± 6.8 kg/m², T2D duration 6.9 ± 5.2 years, FG 159.6 ± 56.6 mg/dL, HbA1c 7.5 ± 1.1%, Cp 4.0 ± 2.0 (median 3.8, range 0.1-8.9) ng/mL. At one year follow-up, remission of T2D in 12 cases (54.5%). Preoperative Cp correlated with 12-month HbA1c (r = -0.519, p = 0.013). Preoperative Cp was higher in those who achieved remission: 5.0 ± 1.7 vs 3.0 ± 1.7 ng/ml, p = 0,013. A Cp concentration > 3.75 ng/mL provided a clinically useful cut-off for prediction of T2D remission. T2D remission rates were different according to median preoperative Cp: 27.3% if Cp < 3.8 ng/mL and 81.7% if Cp > 3.8 ng/mL (p = 0.010).
  
  
  CONCLUSIONS
  Patients with elevated preoperative Cp levels achieve higher rates of T2D remission one year after BS. A Cp concentration > 3.75 ng/mL seems clinically useful.
authors.affiliation: Servicio de Endocrinología y Nutrición. Hospital Clínico San Carlos. IdISSC. Madrid.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Ramos-Leví
authors.forename: Pilar
authors.initials: P
authors.lastname: Matía
authors.forename: Lucio
authors.initials: L
authors.lastname: Cabrerizo
authors.forename: Ana
authors.initials: A
authors.lastname: Barabash
authors.forename: María José
authors.initials: MJ
authors.lastname: Torrejón
authors.forename: Andrés
authors.initials: A
authors.lastname: Sánchez-Pernaute
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Torres
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Rubio
mesh_terms: D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D002096:C-Peptide / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012074:Remission Induction; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D002096:C-Peptide