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C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study

OBJECTIVE: C-peptide is a proinsulin cleavage product released from the pancreas in amounts equimolar to insulin, and elevated levels of C-peptide have been found in patients with insulin resistance and early type 2 diabetes mellitus. Recent data suggest that C-peptide could play a causal role in th...

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Autores principales: Marx, Nikolaus, Silbernagel, Guenther, Brandenburg, Vincent, Burgmaier, Mathias, Kleber, Marcus E., Grammer, Tanja B., Winkelmann, Bernhard R., Boehm, Bernhard O., März, Winfried
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579368/
https://www.ncbi.nlm.nih.gov/pubmed/23204248
http://dx.doi.org/10.2337/dc12-1211
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author Marx, Nikolaus
Silbernagel, Guenther
Brandenburg, Vincent
Burgmaier, Mathias
Kleber, Marcus E.
Grammer, Tanja B.
Winkelmann, Bernhard R.
Boehm, Bernhard O.
März, Winfried
author_facet Marx, Nikolaus
Silbernagel, Guenther
Brandenburg, Vincent
Burgmaier, Mathias
Kleber, Marcus E.
Grammer, Tanja B.
Winkelmann, Bernhard R.
Boehm, Bernhard O.
März, Winfried
author_sort Marx, Nikolaus
collection PubMed
description OBJECTIVE: C-peptide is a proinsulin cleavage product released from the pancreas in amounts equimolar to insulin, and elevated levels of C-peptide have been found in patients with insulin resistance and early type 2 diabetes mellitus. Recent data suggest that C-peptide could play a causal role in the pathophysiology of vascular disease, but nothing is known about the prognostic value of C-peptide concentrations in the circulation. RESEARCH DESIGN AND METHODS: We examined whether C-peptide is associated with cardiovascular and total mortality in 2,306 patients from the Ludwigshafen Risk and Cardiovascular Health Study who underwent coronary angiography at baseline (1997–2000). RESULTS: During a mean follow-up of 7.6 years, 440 deaths (19.1%) occurred, 252 (10.9%) of which were due to cardiovascular causes. Age- and sex-adjusted hazard ratios (HRs) in the third compared with the first tertile of C-peptide were 1.46 (95% CI 1.15–1.85; P = 0.002) for all cause and 1.58 (1.15–2.18; P = 0.005) for cardiovascular mortality. After further adjustment for common risk factors as well as markers of glucose metabolism, these HRs remained significant at 1.46 (1.10–1.93; P = 0.008) and 1.55 (1.07–2.24; P = 0.022), respectively. Moreover, patients in higher tertiles of C-peptide exhibited higher levels of markers of endothelial dysfunction and atherosclerosis as well as a more severe extent of coronary lesions. CONCLUSIONS: In patients undergoing coronary angiography, C-peptide levels are independently associated with all cause and cardiovascular mortality as well as presence and severity of coronary artery disease. Further studies are needed to examine a potential causal role of C-peptide in atherogenesis in humans.
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spelling pubmed-35793682014-03-01 C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study Marx, Nikolaus Silbernagel, Guenther Brandenburg, Vincent Burgmaier, Mathias Kleber, Marcus E. Grammer, Tanja B. Winkelmann, Bernhard R. Boehm, Bernhard O. März, Winfried Diabetes Care Original Research OBJECTIVE: C-peptide is a proinsulin cleavage product released from the pancreas in amounts equimolar to insulin, and elevated levels of C-peptide have been found in patients with insulin resistance and early type 2 diabetes mellitus. Recent data suggest that C-peptide could play a causal role in the pathophysiology of vascular disease, but nothing is known about the prognostic value of C-peptide concentrations in the circulation. RESEARCH DESIGN AND METHODS: We examined whether C-peptide is associated with cardiovascular and total mortality in 2,306 patients from the Ludwigshafen Risk and Cardiovascular Health Study who underwent coronary angiography at baseline (1997–2000). RESULTS: During a mean follow-up of 7.6 years, 440 deaths (19.1%) occurred, 252 (10.9%) of which were due to cardiovascular causes. Age- and sex-adjusted hazard ratios (HRs) in the third compared with the first tertile of C-peptide were 1.46 (95% CI 1.15–1.85; P = 0.002) for all cause and 1.58 (1.15–2.18; P = 0.005) for cardiovascular mortality. After further adjustment for common risk factors as well as markers of glucose metabolism, these HRs remained significant at 1.46 (1.10–1.93; P = 0.008) and 1.55 (1.07–2.24; P = 0.022), respectively. Moreover, patients in higher tertiles of C-peptide exhibited higher levels of markers of endothelial dysfunction and atherosclerosis as well as a more severe extent of coronary lesions. CONCLUSIONS: In patients undergoing coronary angiography, C-peptide levels are independently associated with all cause and cardiovascular mortality as well as presence and severity of coronary artery disease. Further studies are needed to examine a potential causal role of C-peptide in atherogenesis in humans. American Diabetes Association 2013-03 2013-02-13 /pmc/articles/PMC3579368/ /pubmed/23204248 http://dx.doi.org/10.2337/dc12-1211 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Marx, Nikolaus
Silbernagel, Guenther
Brandenburg, Vincent
Burgmaier, Mathias
Kleber, Marcus E.
Grammer, Tanja B.
Winkelmann, Bernhard R.
Boehm, Bernhard O.
März, Winfried
C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study
title C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study
title_full C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study
title_fullStr C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study
title_full_unstemmed C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study
title_short C-Peptide Levels Are Associated With Mortality and Cardiovascular Mortality in Patients Undergoing Angiography: The LURIC study
title_sort c-peptide levels are associated with mortality and cardiovascular mortality in patients undergoing angiography: the luric study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579368/
https://www.ncbi.nlm.nih.gov/pubmed/23204248
http://dx.doi.org/10.2337/dc12-1211
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