title: C-Peptide Is Independently Associated with an Increased Risk of Coronary Artery Disease in T2DM Subjects: A Cross-Sectional Study.
abstract: OBJECTIVE
  C-peptide has been reported to be a marker of subclinical atherosclerosis in type 2 diabetes mellitus (T2DM) patients, whereas its role in coronary artery disease (CAD) has not been clarified, especially in diabetics with differing body mass indices (BMIs).
  
  
  METHODS
  This cross-sectional study included 501 patients with T2DM. First, all subjects were divided into the following two groups: CAD and non-CAD. Then, binary logistic regression was used to determine the risk factors for CAD for all patients. To clarify the role of obesity, we re-divided all subjects into two additional groups (obese and non-obese) based on BMI. Finally, binary logistic regression was used to determine the risk factors for CAD for each weight group.
  
  
  RESULTS
  The patients with CAD showed a higher BMI and fasting C-peptide level in addition to an increased prevalence of traditional risk factors for CAD, such as hypertension, insulin resistance, higher cholesterol, cysteine-C (Cys-C) and lower estimated glomerular filtration rate (eGFR). Logistic regression analysis showed that fasting C-peptide (OR=1.513, p=0.005), insulin treatment (OR=1.832, p=0.027) hypertension (OR=1.987, p=0.016) and hyperlipidemia (OR=4.159, p<0.001) significantly increased the risk of clinical CAD in the T2DM patients independent of age, gender, diabetes duration, smoking and alcohol statuses, fasting insulin and glucose, hypoglycemic episodes, UA and eGFR. Additionally, in both of the obese (OR=1.488, p=0.049) and non-obese (OR=1.686, p=0.037) DM groups, C-peptide was associated with an increased risk of CAD after multiple adjustments.
  
  
  CONCLUSIONS
  C-peptide is associated with an increased CAD risk in T2DM patients, no matter whether they are obese or not.
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Lingshu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Lin
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Aixia
authors.initials: A
authors.lastname: Ma
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Huizhen
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Kexin
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Chuan
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Ruxing
authors.initials: R
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liang
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Fuqiang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Xinguo
authors.initials: X
authors.lastname: Hou
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Song
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Yiran
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Ophthalmology, College of medicine, University of Florida, Gainesville, FL 32610-0284, United States of America.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhu
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China; Institute of Endocrinology and Metabolism, Shandong University, Jinan, Shandong 250012, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
mesh_terms: D015992:Body Mass Index; D002096:C-Peptide / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology; D006973:Hypertension / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D016015:Logistic Models; D009765:Obesity / Q000473:pathology; D012307:Risk Factors
chemical_list: D002096:C-Peptide