title: Association between low C-peptide and fragility fractures in postmenopausal women without diabetes.
abstract: OBJECTIVE
  C-peptide has been shown to exert several, previously unknown, biological effects. A recent cross-sectional study demonstrated an association between low C-peptide serum levels and low lumbar bone density of postmenopausal women not affected by diabetes. To date, very little research attention has been directed toward the association between C-peptide and osteoporotic fractures. To contribute toward filling this gap, we investigated the association between C-peptide and fractures in postmenopausal women.
  
  
  METHODS
  A cohort of 133 non-diabetic postmenopausal women with and without a history of fractures was evaluated in this cross-sectional investigation. Standardized interviews were performed to gather information on the patients' fracture history. All of the participants underwent a bone mineral density assessment by DXA, radiographs, and a serum C-peptide measurement.
  
  
  RESULTS
  Thirty-four women presented fractures. Bivariate analysis revealed an inverse correlation between C-peptide and fractures (r = -0.27, p = 0.002). A significant difference in mean C-peptide levels was also found between women with vs. without fractures (p = 0.01, adjusted for age, BMI and glucose). Logistic regression analysis showed that C-peptide levels, femoral and vertebral BMD were all negatively associated with fracture status (B = -1.097, ES = 0.401, p = 0.006, 95% CI 0.15-0.73; B = -15.6, SE = 4.17, p < 0.001, CI 0.001-0.002; B = -24.8, SE = 5.23, p < 0.001, CI 0001-0.002; respectively).
  
  
  CONCLUSIONS
  This study confirms an inverse association between serum C-peptide levels and a history of fractures in postmenopausal women without diabetes. These results suggest that C-peptidemay exert an effect on bone mineral density. However, further large-scale studies are needed to corroborate this finding and investigate the potential underlying mechanisms involved.
authors.affiliation: Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy.
authors.forename: Y
authors.initials: Y
authors.lastname: Ferro
authors.affiliation: Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Russo
authors.affiliation: Department of Health Science, University Magna Graecia, Catanzaro, 88100, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Russo
authors.affiliation: Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Gazzaruso
authors.affiliation: Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Coppola
authors.affiliation: Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Gallotti
authors.affiliation: Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Zambianchi
authors.affiliation: Internal and Emergency Medicine and Centre for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fodaro
authors.affiliation: Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy.|Department of Molecular and Clinical Medicine, Sahlgrenska Center for Cardiovascolar and Metabolic Research, University of Gothenburg, Göteborg, 42246, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Romeo
authors.affiliation: Department of Biomedical, Surgical and Dental Science, University of Milan and Orthopaedic Institute IRCCS Galeazzi, 20161, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Galliera
authors.affiliation: Department of Health Biomedical Science, University of Milan and Unit of SMEL-1 Clinical Pathology Unit, San Donato Hospital IRCCS, San Donato Milanese, 20097, Milan, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Marazzi
authors.affiliation: Department of Health Biomedical Science, University of Milan and Unit of SMEL-1 Clinical Pathology Unit, San Donato Hospital IRCCS, San Donato Milanese, 20097, Milan, Italy.
authors.forename: M M C
authors.initials: MMC
authors.lastname: Romanelli
authors.affiliation: Department of Medical and Surgical Sciences, University of Padova, 35128, Padua, Italy.|National Research Council, Center for Aging Studies of Padova, 35128, Padua, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Giannini
authors.affiliation: Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Pujia
authors.affiliation: Menopause Clinic, Department of Clinical and Experimental Medicine, University Magna Graecia, Campus Universitario Germaneto, Viale S. Venuta, floor III, Catanzaro, 88100, Italy. tmontalcini@unicz.it.
authors.forename: T
authors.initials: T
authors.lastname: Montalcini
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D015519:Bone Density; D002096:C-Peptide / Q000097:blood / Q000172:deficiency*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D017698:Postmenopause; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002096:C-Peptide
keywords: C-Peptide; Diabetes; Fractures; Osteoporosis; Postmenopausal women