title: C-peptide as a risk factor of coronary artery disease in the general population.
abstract: OBJECTIVE
  To analyse the association between serum C-peptide and coronary artery disease in the general population.
  
  
  METHODS
  Follow-up study of 6630 adults from the general population. They were stratified into group 1 (no insulin resistance: C-peptide < third tercile and glycaemia < 100 mg/dL), group 2 (initial insulin resistance: C-peptide ⩾ third tercile and glycaemia < 100 mg/dL) and group 3 (advanced insulin resistance: glycaemia ⩾ 100 mg/dL).
  
  
  RESULTS
  After 3.5 years of follow-up, group 2 had a higher incidence of myocardial infarction (relative risk (RR) = 4.2, 95% confidence interval (CI) = 1.7-10.6) and coronary artery disease (RR = 3.5, 95% CI = 1.9-6.6) than group 1. Group 3 also had increased incidences of both diseases. In multivariable analysis of the entire population, groups 2 and 3 showed significant risks of myocardial infarction and coronary artery disease (RR > 3 and RR > 2, respectively). However, when people with diabetes were excluded, the increased risks were corroborated only in group 2 for myocardial infarction (RR = 2.8, 95% CI = 1.1-6.9; p = 0.025) and coronary artery disease (RR = 2.4, 95% CI = 1.3-4.6; p = 0.007).
  
  
  CONCLUSIONS
  Elevated C-peptide is associated with the incidence of myocardial infarction and coronary artery disease in the general population. It can be an earlier predictor of coronary events than impaired fasting glucose.
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain University of La Laguna, La Laguna, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain acableo@gobiernodecanarias.org.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cabrera de León
authors.affiliation: Endocrine Diseases Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
authors.forename: José Gregorio
authors.initials: JG
authors.lastname: Oliva García
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain.
authors.forename: Itahisa
authors.initials: I
authors.lastname: Marcelino Rodríguez
authors.affiliation: Cardiovascular Research Network of the Carlos III Institute of Health, Spain Immunology Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
authors.forename: Delia
authors.initials: D
authors.lastname: Almeida González
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain.
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Alemán Sánchez
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain.
authors.forename: Buenaventura
authors.initials: B
authors.lastname: Brito Díaz
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Domínguez Coello
authors.affiliation: Cardiovascular Research Network of the Carlos III Institute of Health, Spain Servicio de Cardiología, Hospital San Juan, Universidad Miguel Hernández, Alicante, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu Martínez
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
authors.forename: Armando
authors.initials: A
authors.lastname: Aguirre Jaime
authors.affiliation: Research Unit, Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain Cardiovascular Research Network of the Carlos III Institute of Health, Spain.
authors.forename: María del Cristo
authors.initials: Mdel C
authors.lastname: Rodríguez Pérez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000097:blood*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002096:C-Peptide
keywords: C-peptide; coronary artery disease; insulin resistance; risk factor